Stomach Ulcer Treatment

With appropriate treatment, stomach ulcers typically heal within one to two months, though in some cases, they may persist longer.

The treatment approach depends on the underlying cause: (1)

• For ulcers caused by H. pylori bacteria: Treatment involves a combination of two or three antibiotics along with medications to reduce stomach acid and protect the stomach lining.
• For ulcers resulting from prolonged use of NSAIDs (e.g., ibuprofen, diclofenac, naproxen): Treatment requires stopping these medications and using Proton Pump Inhibitors (PPIs), which reduce stomach acid and aid in healing.

Treatment for Ulcers Caused by H. pylori

1. Triple Therapy:

This approach has become less common due to increasing antibiotic resistance. It typically includes: (1)

• Two antibiotics.
• A proton pump inhibitor (PPI) such as omeprazole, esomeprazole (Nexium), or lansoprazole (Lanzotec), among others.

2. Quadruple Therapy:

Currently, this is the first-line treatment. It involves: (1)

• Two antibiotics.
• A PPI.
• A fourth medication, which may be:some text
  • Bismuth subsalicylate: Protects the stomach lining and aids in eradicating H. pylori.
  • A third antibiotic.

Treatment Duration:

• Antibiotic therapy usually lasts 10–14 days.
• PPIs  may be continued for several weeks afterward until the ulcer fully heals. (1)

Treatment for Ulcers Caused by NSAIDs

Treatment involves two main steps: (2)

1. Discontinue NSAIDs:some text
   • Switch to a safer alternative for pain relief, such as acetaminophen (paracetamol).
2. Use of Proton Pump Inhibitors (PPIs):some text
   • PPIs such as omeprazole or lansoprazole are universally used for treating all types of stomach ulcers. They promote healing and protect the ulcer from stomach acid.

In cases where PPIs cannot be used, H2 receptor antagonists (e.g., famotidine or ranitidine) may be prescribed as an alternative.

Surgical Treatments

Surgical intervention is usually reserved for emergencies, such as bleeding or perforation caused by the ulcer. These procedures, often performed via endoscopy, may involve: (2)

• Cauterizing the ulcer.
• Injecting medications to stop the bleeding.
• Suturing perforation if present.

Follow-Up: Confirming Treatment Success 

1. Timing of the Follow-Up Test

Doctors usually recommend a test to confirm the eradication of H. pylori at least four weeks after completing antibiotic therapy.

If acid-suppressing medications (PPIs) are continued after antibiotics, they should be discontinued 14 days before the test to ensure accurate results, as PPIs can interfere with the detection of the bacteria. (3)

2. Recommended Test:

The urea breath test or stool antigen test are the most common methods for follow-up testing. While endoscopy is reserved for exceptional cases.

Why Choose Dr. Soliman Fakeeh Hospital for Stomach Ulcer Treatment?

• Expert Consultants: A team of top gastroenterology specialists supervises comprehensive care.
• Advanced Endoscopy Techniques: The latest technology ensures effective treatment and faster recovery.

FAQs

Can Stomach Ulcers Be Treated at Home?

Home remedies, such as herbal treatments, are not sufficient to heal stomach ulcers. It is essential to adhere to the medical treatment prescribed by your doctor. However, certain lifestyle changes are also essential to help alleviate symptoms and support the healing process: (3)

• Quit smoking completely.
• Avoid certain foods and beverages such as coffee, chocolate, tomatoes, and spicy or fatty foods.
• Eat smaller meals throughout the day and avoid eating at least three hours before bedtime.
• Lose weight if overweight.

What Causes Ulcer Treatment Failure?

While most stomach ulcers respond well to prescribed treatments, treatment failure or recurrence can happen due to: (3)

• Not following the prescribed treatment plan.
• Antibiotic resistance, particularly with triple or quadruple therapy for H. pylori.
• Continued use of NSAIDs.
• Underlying health conditions unrelated to H. pylori.

References

1. BINASSS - Peptic Ulcer Disease and H. pylori Infection: Common Questions and Answers
2. Medscape - Peptic Ulcer Disease Treatment & Management
3. Mayo Clinic - Helicobacter pylori (H. pylori) infection - Diagnosis & treatment - Mayo Clinic