Peptic ulcer disease - discharge
Ulcer - peptic - discharge; Ulcer - duodenal - discharge; Ulcer - gastric - discharge; Duodenal ulcer - discharge; Gastric ulcer - discharge; Dyspepsia - ulcer - discharge
What to expect
You have peptic ulcer disease (PUD). 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).
You may have had tests to help your doctor diagnose your ulcer. One of these tests may have been to look for a 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 your doctor 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
- 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.
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
- These medicines may cause nausea, diarrhea, and other side effects. Do not just stop taking them without talking to your doctor first.
If you have an ulcer without an H. pylori infection, or one that is caused by taking aspirin or NSAIDs, your doctor will likely prescribe a proton pump inhibitor for 8 weeks.
Taking antacids as needed between meals, and then at bedtime, may help healing also. Ask your doctor about taking these medicines.
Talk to your doctor 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 doctor may or have you take a drug called misoprostol or a PPI to prevent future ulcers.
You will have follow-up visits with your doctor to see how your ulcer is healing.
Your doctor may want to perform an upper endoscopy after treatment to make sure healing has taken place.
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 doctor 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
Eichenseher, J. Peptic ulcer disease. In: Rakel D, ed. Integrative Medicine. 3rd ed. Philadelphia, PA: Saunders Elsevier; 2012:chap 42.
Lanza FL, Chan FK, Quigley EM: Practice Parameters Committee of the American College of Gastroenterology. Guidelines for prevention of NSAID-related ulcer complications. Am J Gastroenterol. 2009;104:728-738.
Vakil, Nimish . Peptic ulcer disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, PA: Saunders Elsevier; 2010:chap 52.
Chan FKL, Lau JYW. Peptic ulcer disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, PA: Saunders Elsevier; 2010:chap 53.
George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.