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Peptic ulcer disease - discharge

Ulcer - peptic - discharge; Ulcer - duodenal - discharge; Ulcer - gastric - discharge; Duodenal ulcer - discharge; Gastric ulcer - discharge; Dyspepsia - ulcer - discharge; Peptic ulcer discharge

A peptic ulcer is an open sore or raw area in the lining of the stomach (gastric ulcer) or upper part of the small intestine (duodenal ulcer). This article describes how to care for yourself after you have been treated by your health care provider for this condition.

What to Expect at Home

You have peptic ulcer disease (PUD). You may have had tests to help diagnose your ulcer. One of these tests may have been to look for bacteria in your stomach called Helicobacter pylori (H pylori). This type of infection is a common cause of ulcers.

Most peptic ulcers will heal within about 4 to 6 weeks after treatment begins. DO NOT stop taking the medicines you have been prescribed, even if symptoms go away quickly.

Diet and Lifestyle

People with PUD should eat a healthy balanced diet.

It does not help to eat more often or increase the amount of milk and dairy products you consume. These changes may even cause more stomach acid.

  • Avoid foods and drinks that cause discomfort for you. For many people these include alcohol, coffee, caffeinated soda, fatty foods, chocolate, and spicy foods.
  • Avoid eating late night snacks.

Other things you can do to ease your symptoms and help healing include:

  • If you smoke or chew tobacco, try to quit. Tobacco will slow the healing of your ulcer and increase the chance that the ulcer will come back. Talk to your doctor about getting help for quitting tobacco use.
  • Try to reduce your stress level and learn ways to better manage stress.

Avoid drugs such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn). Take acetaminophen (Tylenol) to relieve pain. Take all medicines with plenty of water.

Medicines

The standard treatment for a peptic ulcer and an H pylori infection uses a combination of medicines that you take for 5 to 14 days.

  • Most people will take two types of antibiotics and a proton pump inhibitor (PPI).
  • These medicines may cause nausea, diarrhea, and other side effects. DO NOT just stop taking them without talking to your provider first.

If you have an ulcer without an H pylori infection, or one that is caused by taking aspirin or NSAIDs, you will likely need to take a proton pump inhibitor for 8 weeks.

Taking antacids as needed between meals, and then at bedtime, may help healing also. Ask your provider about taking these medicines.

Talk to your provider about your medicine choices if your ulcer was caused by aspirin, ibuprofen, or other NSAIDs. You may be able to take a different anti-inflammatory drug. Or, your provider may have you take a drug called misoprostol or a PPI to prevent future ulcers.

Follow-up

You will have follow-up visits to see how your ulcer is healing especially if the ulcer was in the stomach.

Your provider may want to perform an upper endoscopy after treatment if the ulcer was in your stomach. This is to make sure healing has taken place and there are no signs of cancer.

You will also need follow-up testing to check that the H pylori bacteria are gone. You should wait at least 2 weeks after therapy is completed to be retested. Test results before that time may not be accurate.

When to Call the Doctor

Get medical help right away if you:

  • Develop sudden, sharp abdominal pain
  • Have a rigid, hard abdomen that is tender to the touch
  • Have symptoms of shock, such as fainting, excessive sweating, or confusion
  • Vomit blood
  • See blood in your stool (maroon, dark, or tarry black stools)

Call your provider if:

  • You feel dizzy or light-headed
  • You have ulcer symptoms
  • You feel full after eating a small meal portion
  • You experience unintentional weight loss
  • You are vomiting
  • You lose your appetite

References

Chan FKL, Lau JYW. Peptic ulcer disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 53.

Kuipers EJ, Blaser MJ. Acid peptic disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 139.

Vincent K. Gastritis and peptic ulcer disease. In: Kellerman RD, Rakel DP, eds. Conn's Current Therapy 2019. Philadelphia, PA: Elsevier 2019:204-208.

  • Peptic ulcer

    Animation

  •  

    Peptic ulcer - Animation

    If you've got stomach pain and nausea, any number of gastrointestinal problems could be to blame. When these symptoms don't go away, one possibility is that you have a peptic ulcer. Let's talk about peptic ulcers. A peptic ulcer is a defect in the lining of your stomach or the first part of your small intestine, the duodenum. When the defect is in your stomach, it's called a gastric ulcer. A defect in your duodenum is called a duodenal ulcer. Your stomach is filled with strong acid, which breaks down and digests the foods you eat. If you've ever seen a strong acid at work, you know that it starts to burn away anything it touches. That's why your stomach and intestines are equipped with a special lining to protect them. But if that lining breaks down for any reason, acids can start eating their way through. When acids burn a hole all the way through the stomach or duodenum, it's called a perforation, and that's a medical emergency. You may joke that your boss is giving you an ulcer, and it's possible that stress does play some part in ulcers. More likely, your ulcer is caused by a stomach infection with a type of bacteria called H. pylori. Other common ulcer risks include smoking cigarettes, drinking a lot of alcohol, or regularly using NSAID pain relievers like aspirin and ibuprofen. If the ulcer is small, you may have no idea that you have it because there are no symptoms. Larger ulcers can cause abdominal pain, a feeling of fullness in the stomach, and nausea. If you have any of these ongoing symptoms, your doctor will look inside your GI tract to see what's going on. One way to do this is with an upper endoscopy, a thin tube with a camera on one end that takes pictures as it moves through your stomach and small intestine. A lower GI is a series of x-rays that are taken after you drink a radioactive substance called barium. Your doctor will also test you for the H. pylori bacteria that may be causing your ulcer. Treatment for peptic ulcers works in two ways. If you have an H. pylori infection, you'll have a medication regimen to kill the bacteria. You'll also get a medicine called a proton pump inhibitor, such as Prilosec or Prevacid, which reduces the amount of acid in your stomach. Try to avoid taking NSAID pain relievers for long periods of time, especially if you have a problem with H. pylori. Use Tylenol instead. If you do have to take NSAIDs, also take an acid-blocking drug to protect your sensitive stomach. Also avoid tobacco smile and excess alcohol. Follow your doctor's instructions carefully for treating a peptic ulcer. If you don't follow your treatment as directed, your ulcer could come back. Call your doctor right away if you have sharp stomach pain, you're sweating a lot or feeling confused, or your stomach feels hard to the touch. These could be signs of a serious ulcer complication that needs immediate medical help.

  • Peptic ulcer

    Animation

  •  

    Peptic ulcer - Animation

    If you've got stomach pain and nausea, any number of gastrointestinal problems could be to blame. When these symptoms don't go away, one possibility is that you have a peptic ulcer. Let's talk about peptic ulcers. A peptic ulcer is a defect in the lining of your stomach or the first part of your small intestine, the duodenum. When the defect is in your stomach, it's called a gastric ulcer. A defect in your duodenum is called a duodenal ulcer. Your stomach is filled with strong acid, which breaks down and digests the foods you eat. If you've ever seen a strong acid at work, you know that it starts to burn away anything it touches. That's why your stomach and intestines are equipped with a special lining to protect them. But if that lining breaks down for any reason, acids can start eating their way through. When acids burn a hole all the way through the stomach or duodenum, it's called a perforation, and that's a medical emergency. You may joke that your boss is giving you an ulcer, and it's possible that stress does play some part in ulcers. More likely, your ulcer is caused by a stomach infection with a type of bacteria called H. pylori. Other common ulcer risks include smoking cigarettes, drinking a lot of alcohol, or regularly using NSAID pain relievers like aspirin and ibuprofen. If the ulcer is small, you may have no idea that you have it because there are no symptoms. Larger ulcers can cause abdominal pain, a feeling of fullness in the stomach, and nausea. If you have any of these ongoing symptoms, your doctor will look inside your GI tract to see what's going on. One way to do this is with an upper endoscopy, a thin tube with a camera on one end that takes pictures as it moves through your stomach and small intestine. A lower GI is a series of x-rays that are taken after you drink a radioactive substance called barium. Your doctor will also test you for the H. pylori bacteria that may be causing your ulcer. Treatment for peptic ulcers works in two ways. If you have an H. pylori infection, you'll have a medication regimen to kill the bacteria. You'll also get a medicine called a proton pump inhibitor, such as Prilosec or Prevacid, which reduces the amount of acid in your stomach. Try to avoid taking NSAID pain relievers for long periods of time, especially if you have a problem with H. pylori. Use Tylenol instead. If you do have to take NSAIDs, also take an acid-blocking drug to protect your sensitive stomach. Also avoid tobacco smile and excess alcohol. Follow your doctor's instructions carefully for treating a peptic ulcer. If you don't follow your treatment as directed, your ulcer could come back. Call your doctor right away if you have sharp stomach pain, you're sweating a lot or feeling confused, or your stomach feels hard to the touch. These could be signs of a serious ulcer complication that needs immediate medical help.

    A Closer Look

     

     

    Review Date: 3/27/2019

    Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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