Health Centres - Peptic ulcers - treatment
A lot has happened in the treatment of ulcers in the past few years. Ulcer disease used to be a major disease of recurrent ill health with many relapses and which required long-standing medical treatment. Surgery was often necessary.
Today, it is a condition that can be cured within a few weeks. However, it is important that the cause of the ulcers is accurately diagnosed.
What causes ulcers?
Most peptic ulcers develop as a result of:
-
bacteria in the stomach (
- the use of antirheumatic medicine, NSAIDs, or aspirin - less common.
-
stomach cancer - rare.
- there are other types of peptic ulcers but these are very rare.
How are ulcers treated when the cause is
The treatment is targeted at eradicating the bacterial infection; the ulcer then heals and relapses are prevented. Generally, three different medicines are taken two to three times daily for a short course - usually seven days.
They are a combination of:
- one proton pump inhibitor, lansoprazole, pantoprazole, rabeprazole or esomeprazole).
- two antibiotics, clarithromycin
or metronidazole).
Possible combinations could be:
- omeprazole + amoxicillin + clarithromycin.
- omeprazole + metronidazole + clarithromycin (if penicillin allergic).
-
HeliClear – a one-pack treatment now available on prescription that contains all the necessary treatments in a one-week course.
A less common type of treatment is three to four different types of medicine four times daily for a total of 14 days (proton pump inhibitor + bismuth subcitrate + amoxicillin + metronidazole). This treatment form is only used under special circumstances.
The treatment types listed above are both effective and not too difficult to take.
Can
- you cannot feel if the bacteria has been eliminated, and the physician cannot find out by taking a blood test because Helicobacter antibiotics persist even after the infection is cured.
- to check effectively would involve another gastroscopy for more samples from the stomach's lining, or a 'breath-test'.
Will the ulcer heal after one week of treatment?
In many cases, one week of treatment is sufficient. It is enough time to remove all the ulcer bacteria.
In some cases, the wound is not fully healed and it is necessary to continue for a few weeks with further acid-inhibiting treatment.
Does the ulcer treatment have to be monitored?
If the ulcer is located in the stomach, there is a slight possibility that it is stomach cancer.
It is therefore necessary to perform another gastroscopy after four to six weeks of treatment. It is then possible to confirm that the ulcer is healing and, at the same time, take repeat biopsies from the area affected.
If the ulcer is located in the duodenum (the outlet from the stomach), then it is not necessary to monitor the healing of the ulcer because ulcers in this area are virtually never cancerous. Only if the symptoms reappear should an examination be considered.
How are ulcers treated when aspirin or NSAIDs have caused them?
- First of all, it is necessary to stop taking these medicines.
- Under special circumstances, the physician may find it necessary for the patient to continue with NSAIDs (see next section).
- If
If there are no signs of
Stomach ulcers are examined again with gastroscopy after six weeks.
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