Duodenal ulcer

Alternative names:

peptic ulcer; peptic ulcer disease; ulcer; ulcer - duodenal; ulcer - peptic

Treatment:

If the ulcer is caused by H. pylori treatment may include a combination of antibiotics that kill the bacteria, H₂-blockers and proton pump inhibitors that reduce stomach acids, and medications that protect the lining of the stomach and intestines. For example, "triple therapy" used to treat this type of ulcer consists of a two-week course of two antibiotics plus an acid-suppressing drug or a drug that coats the lining of the stomach and intestines.

The antibiotics used to kill H. pylori bacterium include metronidazole, tetracycline, clarithromycin, and amoxicillin. H₂-blockers to reduce stomach acids include cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid), and nizatidine (Axid). Proton pump inhibitors, which block the mechanism by which acids enter the stomach, include omeprazole (Prilosec) and lansoprazole (Prevacid). Bismuth subsalicylate, an ingredient in Pepto-Bismol, and sucralfate (Carafate) are two medications that help coat the ulcer, allowing the ulcer to heal.

When the ulcer is caused by NSAIDs, NSAID use is usually discontinued and the symptoms may be treated with H₂-blockers, proton pump inhibitors, and bismuth subsalicylate or sucralfate.

Surgical intervention is sometimes necessary to manage ulcer complications (for example, bleeding, perforation, or obstruction) that do not respond to other treatments.

Self-help measures include:

• Avoiding smoking.
• Avoiding tea, coffee, and caffeine-containing soft drinks.
• Avoiding alcohol.
• Avoiding aspirin and NSAIDs.

Expectations (prognosis):

More than 90% of ulcers caused by H. pylori are effectively treated with antibiotics and ulcer-healing medications and do not recur.

Most NSAID-induced ulcers resolve after NSAID use is discontinued and ulcer-healing medications are administered.

Recurrent ulcers can lead to complications. Contact your health-care provider right away if symptoms persist or recur or new symptoms develop.

Complications:

• Hemorrhage.
• Perforation of the intestine and peritonitis.
• Bowel obstruction.

Calling your health care provider:

Call your health care provider if ulcer symptoms worsen, do not improve with treatment, or new symptoms develop.

The following symptoms can be life threatening. Contact your health-care provider immediately if you have any emergency symptoms such as:

• Sharp, sudden, persistent stomach pain.
• Bloody or black stool.
• Bloody vomit or vomit that looks like coffee grounds.