A patient with peptic ulcer does feel handicapped in his social life, because of the fear of eating or drinking, which may aggravate the symptom of the ulcer pain. Treatment to cure peptic ulcer disease (PUD) and its pain is simple and if taken religiously, can rid you of this irritating problem.

The peptic ulcer treatment, which includes treating the stomach ulcer or duodenal ulcer aims at managing the cause of the ulcer.

As part of ulcer management, a prescribed diet for PUD plays a significant role. Treating ulcers is important to prevent the serious ulcer complications that can arise if the ulcer is left untreated.

Some natural home remedies too are effective and can be used along with the treatment prescribed by your doctor. However, you should take his consent before starting on them.

Treatment of peptic ulcer disease

Treatment of peptic ulcers consists of two parts:

  • The first part involves some natural dos and don’ts in your lifestyle along with some dietary recommendations and restrictions.
  • The second part of the treatment consists of medications and surgery to treat complications if they develop.

Lifestyle changes for peptic ulcer patients

You will have to make certain changes in your lifestyle habits to promote the healing of the ulcer and to enhance the effect of the medicines, which may have been prescribed for your ulcer.

  • Have frequent small meals because this will prevent the stomach from staying empty for a long time. The idea is to prevent the gastric acid from coming into direct contact with the raw surface of the ulcer and aggravating it. Secondly, small meals are easier to digest and do not burden the ulcerated stomach.
  • Avoid spicy and fried foods as they delay the healing of the ulcer. Fried foods are more difficult to digest and require more gastric acid for digestion.
  • Avoid tea and coffee because they contain caffeine, which stimulates the secretion of gastric acid.
  • Avoid Alcohol as it stimulates the secretion of gastric acid in the stomach. Alcohol also relaxes the sphincter between the esophagus and the stomach causing the stomach contents to reflux into the esophagus. That is why such patients have a burning sensation in the chest after drinking alcohol.
  • Avoid Smoking because it has been found to delay the healing of the ulcer. The incidence of recurrence of an ulcer is found to be higher in smokers.
  • Avoid Stress situations because stress aggravates the pain of the ulcer. Learn stress handling techniques like meditation, which can increase your stress threshold.

Diet for peptic ulcer patients

Diet for ulcers forms an important part of ulcer therapy. Your diet should be rich in fiber content. It should consist of vegetables, fruits, legumes, and whole grains such as whole wheat, brown rice, and brown bread.

Drinking milk forms an important factor, though some schools of thought differ. Most of all, the diet should be non-spicy and non-oily. For more details on the diet, you could read this post on the diet for peptic ulcer patients.

Medicines for peptic ulcers (stomach and duodenal)

You can divide the treatment regimen into two parts, function-wise. One regimen consists of medicines for symptomatic relief of the ulcer pain. Some of these medicines act by reducing the acid secretion in the stomach and some act by neutralizing the acidic secretion.

The other regimen consists of drugs to kill the Helicobacter pylori bacteria, which is the main cause of ulceration in your stomach and duodenum.

Drugs used for the treatment of symptomatic relief of peptic ulcer pain

  • Avoid Non-steroid anti-inflammatory drugs (NSAIDs) for any pain relief such as aspirin, ibuprofen, and naproxen. Once informed of your ulcer, your physician will prescribe you alternative drugs for the ulcer pain or any pain for that matter.
  • Initially, non-prescription over-the-counter medicines like antacids are given for ulcer pain relief. Antacids act by neutralizing the acid in the stomach and forming a protective covering on the ulcer. This gives relief from the ulcer pain, but antacids have no role to play in the healing of the ulcer. Side effects include constipation or diarrhea.
  • Histamine blockers (H2 blockers) are also prescribed. They act by blocking the action of histamine, which is a powerful stimulator of gastric acid secretion. This results in reduced acid secretion, which gives relief from the ulcer pain and promotes healing. Examples include ranitidine (Zantac), cimetidine (Tagamet) famotidine (Pepcid), and nizatidine (Axid).
  • Proton pump inhibitors like omeprazole block the secretion of the acid in the stomach, thereby giving ulcer pain relief.
  • Cytoprotective agents are prescribed in some cases. These drugs act by forming a protective coat on the inner wall of the esophagus, stomach, and duodenum. This provides protection to the ulcer from the acidic secretion and any other irritants. Bismuth subsalicylate is a non-prescription example, which acts in a similar fashion. Prescription medicines include sucralfate (Carafate) and misoprostol (Cytotec).

Drugs for peptic ulcer cure from H. Pylori

Any combination of two antibiotics from the following is given for H. Pylori for a duration of two weeks. Three may be given in resistant cases. The antibiotics given are:  [a] Tetracyclines  [b] Amoxicillin [c]Metronidazole  [d] Clarithromycin.

Once the H. Pylori infection is cleared there is no time lost in the healing of the ulcer. Metronidazole also helps in treating any amoebic infection that may be present in the gastrointestinal tract.

Surgical procedures for peptic ulcer

Peptic ulcer surgery is a procedure for treating a stomach ulcer. The surgery is indicated when the complications of the ulcer develop and cause pain or bleeding that does not respond to conservative therapies.

Surgery for perforated ulcers is an emergency life-saving intervention. Symptoms caused by the perforated ulcer will improve after this surgery.

Stomach ulcer surgery may be done in one of the following ways:

  • Laparotomy is an open procedure with a large abdominal incision
  • Minimally invasive laparoscopic surgery involves taking a small abdominal incision and inserting a camera-equipped surgical device for visualization and repair of the ulcer
  • Endoscopic procedure. In this procedure, a flexible tube is inserted through the throat down into the stomach to repair the ulcer with the help of a camera and surgical tools.
  • Surgical procedures like vagotomy are now obsolete.
  • Cauterization of a bleeding ulcer is done through the endoscope to stop the bleeding.
  • Graham Patch surgery for a perforated stomach ulcer is performed as an emergency procedure in case of a perforated ulcer.
  • Partial Gastrectomy involves surgical removal of a small part of the stomach where the gastric ulcer is located. This procedure is used when the ulcer is large and deep.

Peptic ulcer treatment during pregnancy

Peptic ulcer disease (PUD) is very rarely seen during pregnancy, its incidence being reported as 0.005 %. This is because gastric acid secretion decreases during pregnancy, and an existing peptic ulcer improves.

PUD risk factors during pregnancy include smoking, alcohol, stress, and H. pylori infection. NSAIDs are contraindicated in pregnancy and therefore rarely contribute to the risk.

H2-receptor antagonists such as cimetidine, ranitidine, and famotidine form the first choices of treatment for peptic ulcer disease during pregnancy to treat the ulcer pain.

Lansoprazole has been reported to be safe in pregnancy. It belongs to a group of drugs called proton pump inhibitors and gives relief from ulcer pain by decreasing the acid secretion in the stomach.

Treatment to cure H. pylori infection should be given after the pregnancy and lactation period because the drugs and antibiotics used for this purpose are contraindicated during this period.