What I need to know about Peptic Ulcers, Exercises of Medicine

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What I need to know about Peptic Ulcers U.S. Department of Health and Human Services NATIONAL INSTITUTES OF HEALTH National Digestive Diseases Information Clearinghouse Contents What is a peptic ulcer?............................................ 1 What causes peptic ulcers? ..................................... 2 What are the symptoms of peptic ulcers? ............. 4 How are peptic ulcers diagnosed? ......................... 6 How are peptic ulcers treated? .............................. 7 Can antacids or milk help peptic ulcers heal? ...... 9 What if peptic ulcers don’t heal? ......................... 10 Can peptic ulcers come back?.............................. 11 What can I do to prevent peptic ulcers? ............. 11 Points to Remember ............................................. 12 Hope through Research ....................................... 14 Pronunciation Guide............................................. 15 For More Information .......................................... 15 Acknowledgments ................................................. 16 What is a peptic ulcer? A peptic ulcer is a sore in the lining of your stomach or duodenum.* The duodenum is the first part of your small intestine. A peptic ulcer in the stomach is called a gastric ulcer. One that is in the duodenum is called a duodenal ulcer. A peptic ulcer also may develop just above your stomach in the esophagus, the tube that connects the mouth to the stomach. But most peptic ulcers develop in the stomach or duodenum. Ulcer Peptic ulcers occur in the lining of your stomach, duodenum, or esophagus. *See page 15 for tips on how to say the words in bold type. 1 What are the symptoms of peptic ulcers? A dull or burning pain in your stomach is the most common symptom of peptic ulcers. You may feel the pain anywhere between your belly button and breastbone. The pain often ● starts between meals or during the night ● briefly stops if you eat or take antacids ● lasts for minutes to hours ● comes and goes for several days or weeks Other symptoms of peptic ulcers may include ● weight loss ● poor appetite ● bloating ● burping ● vomiting ● feeling sick to your stomach A dull or burning pain in your stomach is the most common symptom of peptic ulcers. 4 Even if your symptoms are mild, you may have peptic ulcers. You should see your doctor to talk about your symptoms. Peptic ulcers can get worse if they aren’t treated. Call your doctor right away if you have ● sudden sharp stomach pain that doesn’t go away ● black or bloody stools ● bloody vomit or vomit that looks like coffee grounds These symptoms could be signs an ulcer has ● broken a blood vessel ● gone through, or perforated, your stomach or duodenal wall ● stopped food from moving from your stomach into the duodenum These symptoms must be treated quickly. You may need surgery. Call your doctor if the pain gets worse. 5 How are peptic ulcers diagnosed? Tell your doctor about your symptoms and which medicines you take. Be sure to mention those you get without a prescription, such as Bayer, Motrin, Advil, or Aleve. These medicines are all NSAIDs. To see if you have an H. pylori infection, your doctor will test your blood, breath, or stool. About half of all people who develop an ulcer from NSAIDs also have an H. pylori infection. Your doctor also may want to look inside your stomach and duodenum by doing an endoscopy or an upper gastrointestinal (GI) series—a type of x ray. Both procedures are painless. Peptic ulcers can show up on x rays. 6 9 Can antacids or milk help peptic ulcers heal? Neither antacids—such as Tums—nor milk can heal peptic ulcers, although each may make you feel better briefly. Check with your doctor before taking antacids or drinking milk while your ulcers are healing. Some of the antibiotics used for H. pylori infection may not work as well if you take antacids. And while antacids may make ulcer pain go away for a while, they won’t kill the H. pylori germ. Only antibiotics can do that. Many people used to think that drinking milk helped peptic ulcers heal. But doctors know now that while milk may make ulcers feel better briefly, it also increases stomach acid. Too much stomach acid makes ulcers worse. Check with your doctor before taking antacids while your ulcers are healing. What if peptic ulcers don’t heal? In many cases, medicines heal ulcers. If an H. pylori infection caused your ulcers, you must finish all antibiotics and take any other medicines your doctor prescribes. The infection and ulcers will only heal if you take all medicines as prescribed. When you have finished your medicines, your doctor will do a breath or stool test to be sure the H. pylori infection is gone. Sometimes, the H. pylori germ is still there, even after a person has taken all the medicines correctly. If that happens, your doctor will prescribe different antibiotics to get rid of the infection and cure your ulcers. Rarely, surgery is needed to help ulcers heal. You may need surgery if your ulcers ● don’t heal ● keep coming back ● bleed ● perforate the stomach or duodenal wall ● block food from moving out of the stomach Surgery can ● remove the ulcers ● reduce the amount of acid in your stomach 10 Can peptic ulcers come back? Yes. If you smoke or take NSAIDs, your ulcers may come back. If you need to take an NSAID, your doctor may switch you to a different medicine or add medicines to help prevent ulcers. What can I do to prevent peptic ulcers? To help prevent ulcers caused by H. pylori, ● wash your hands with soap and water after using the bathroom and before eating ● eat food that has been washed well and cooked properly ● drink water from a clean, safe source 11 Hope through Research The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) conducts and supports research into many kinds of digestive disorders, including peptic ulcers. Scientists are working to identify ● antibiotics that will treat the H. pylori infection in less time ● antibiotic combinations that get rid of hard-to­ treat H. pylori infections ● ways the H. pylori germ spreads and infects people ● new NSAIDs and medicines that offer the same benefits of NSAIDs but that won’t cause ulcers ● new medicines to protect the lining of the stomach and duodenum Participants in clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research. For information about current studies, visit www.ClinicalTrials.gov. 14 Pronunciation Guide barium (BA-ree-uhm) biopsy (BY-op-see) duodenum (doo-OD-uh-nuhm) endoscopy (en-DOSS-kuh-pee) esophagus (uh-SOF-uh-guhss) Helicobacter pylori (HEL-uh-koh-BAK-tur) (py-LOR-eye) For More Information American College of Gastroenterology P.O. Box 342260 Bethesda, MD 20827–2260 Phone: 301–263–9000 Internet: www.acg.gi.org American Gastroenterological Association 4930 Del Ray Avenue Bethesda, MD 20814 Phone: 301–654–2055 Fax: 301–654–5920 Email: member@gastro.org Internet: www.gastro.org 15 Acknowledgments Publications produced by the Clearinghouse are carefully reviewed by both NIDDK scientists and outside experts. The National Digestive Diseases Information Clearinghouse would like to thank the following individuals for assisting with the scientific and editorial review of the original version of this publication: David A. Peura, M.D. University of Virginia Steven J. Czinn, M.D. Case Western University Thank you also to Anne Barker, R.N., at the Health Alliance, Columbia, MD, for facilitating field-testing of the original version of this publication. The U.S. Government does not endorse or favor any specifi c commercial product or company. Trade, proprietary, or company names appearing in this document are used only because they are considered necessary in the context of the information provided. If a product is not mentioned, the omission does not mean or imply that the product is unsatisfactory. 16