How to Treat Ulcers

Ulcers are sores or lesions in your stomach or the upper part of your small intestines. Ulcers develop when the acids that digest foods damage the stomach or intestinal walls. Connected to a variety of causes like stress, diet, and lifestyle, scientists now know that many ulcers are caused by a type of bacteria called Helicobacter pylori, or H. pylori. Left untreated, most ulcers will continue to get worse, so it's important to receive a proper diagnosis and make the dietary and lifestyle changes that will allow you to heal fully.

EditSteps

EditReceiving Medical Treatment

Identify the symptoms of ulcers. Abdominal problems are often difficult to diagnose, since the symptoms of any one problem are reminiscent of lots of different kinds of issues, including gastritis, pancreatitis, Crohn's disease, and a variety of other problems.^[1] It's important to see your doctor and receive a proper diagnosis if you think you may have an ulcer, so you can receive the proper care. Ulcer symptoms include:
- Persistent or reoccurring stomach or abdominal pain that interferes with sleep
- Nausea and vomiting
- Blood in vomit or stool
- Gas and bloating
- Less of appetite
- Weight loss
Talk to your doctor about your symptoms. If you're having stomach problems, it's not necessarily an ulcer. Your doctor will talk to you about the history of your symptoms, your diet, and will conduct a physical exam.
- The doctor may start you on medication to reduce stomach acidity before doing further testing, if your symptoms are mild.
- Return to the doctor if blood is present in your bowel movements or vomit, or if your symptoms worsen or do not respond to the medication, so you can undergo further testing.
Get a diagnosis. Your general practitioner may recommend that you visit a GI specialist, during which time you may go through any of the following tests which can be used to properly diagnose any kind of digestive ulcer:
- Upper gastrointestinal (GI) x-ray series. After drinking a chalky substance called barium, you will have x-rays taken to look for signs of ulcers in your stomach.
- Endoscopy. While you are under sedation, the doctor will insert a thin tube with a small camera at the end down your throat and into your stomach. The camera allows the doctor to see inside of your digestive track and tack a tissue sample. This is a simple and almost painless procedure.
- Blood and stool tests. These will be performed to check for antibodies to H. pylori, a bacteria commonly associated with gastritis and ulcers. A breath test may also be performed, after drinking a substance called urea.
Receive a recommendation for treatment from your doctor. Ulcers need to be healed by addressing the particular cases and conditions of the ulcer specific to you. That's why it's important to get a proper diagnosis and follow through with your doctor's recommended treatment if your tests confirm the presence of an ulcer. Most treatments involve medication, eliminating the cause of the ulcer, and allowing it to heal.
- Often, an H. pylori infection is to blame, in which case the doctor will prescribe an antibiotic to eradicate it. In some cases, you may be prescribed an proton-pump inhibitor like omeprazole (Prilosec) or an H2 agonist (Pepcid), which blocks the production of acid in your stomach and allows your stomach to heal.^[2]
- In most cases, dietary and lifestyle changes will be recommended, which are discussed in the following sections.
- In extreme cases, surgery may be necessary for very serious ulcers, or if complications develop as a result of ulcers that go too long without treatment. Most of the time, dietary changes and waiting will heal ulcers completely.
Avoid taking NSAIDs and aspirin. Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) can cause ulcers, and will exacerbate the symptoms. Avoid taking NSAIDS while you have an active ulcer, and for extended periods of times thereafter.
- If you need to take medication to deal with pain symptoms, ask a doctor about your options. In some cases, you might be able to take a NSAID along with an acid reducer, or pursue alternative pain treatments.
Use over-the-counter antacids to control your symptoms. Often, an ulcer will feel a lot like some combination of indigestion and heartburn, with burning and nausea in the upper abdomen under the ribs. Antacids can be used to provide temporary help for symptoms, but will not cure ulcers in and of themselves. Some antacids may interfere with the effectiveness of prescription medications, so talk to your doctor before taking them. Over the counter antacids choices include:
- Calcium carbonate, found it products like Tums and Rolaids, is probably the most common OTC antacid. Sodium bicarbonate products such as Alka-Seltzer and Pepto Bismol (Bismuth Subsalicylate) can also be used to soothe the lining of the stomach, and are widely available.
- Magnesium hydroxide is also common recommended, marketed as Phillips' Milk of Magnesia. A mix of aluminum hydroxide and magnesium hydroxide is sold as Maalox, Mylanta and other brands.
- Less common antacids include aluminum hydroxide, sold under the brand names AlternaGEL and Amphojel, among others.

EditChanging Your Diet

Avoid any foods that aggravate your symptoms. Ulcers vary from person to person, so it's hard to say what foods are good for ulcers and what foods are bad. For some people, spicy food may cause no problems, but olives or pastries may drive them crazy with pain. Try to eat a relatively bland diet while your ulcer heals and identify the things that make it worse.
- Often, high-sugar foods, processed foods, fried foods, salted meats, alcohol, and coffee make ulcers worse.^[3]
- Try keeping a food journal and write down everything that you eat in a day, so that you can have a record of what makes it bad, if you start getting a flare up of pain.
- Be judicious about what you cut out in the short term to heal up in the long term. A little discipline now will help your stomach heal quickly and let you get back to a less restricted diet and lifestyle.
Eat more fiber. Some estimates show that the average consumer gets about 14 grams of fiber a day. Try to get upward of 28-35 grams of fiber a day to treat your digestive tract right.^[4] A high-fiber diet that contains a lot of fresh fruits and vegetables helps to reduce your chances of getting an ulcer, and helps existing ulcers heal.^[5] Try getting fiber from the following sources:
- Apples
- Lentils, peas, and beans
- Brussels sprouts, broccoli, and other brassica
- Berries
- Avocados
- Bran flakes
- Whole wheat pasta
- Barley and other whole grains
- Oatmeal
Eat lots of foods that contain flavonoids. Some research suggests that foods containing naturally occurring flavonoids can help to heal ulcers more quickly.^[6] Flavonoids occur naturally in many fruits and vegetables, making them good for you to consume on two levels. Good sources include:
- Apples
- Celery
- Cranberries
- Blueberries
- Plums
- Spinach
Try licorice root. Teas and supplements containing licorice root can help to heal ulcers and keep them from coming back.^[7] It's important to distinguish between sugary licorice candy, which can make stomach troubles worse, and natural licorice root, which is used in supplements and teas. Only use the latter as an additional treatment for ulcers.
Avoid spicy foods, if they bother you. If you find that your ulcer pain increases after eating foods that contain hot peppers or spicy seasonings, cut back or eliminate those foods from your diet.
- Although doctors now believe that spicy foods do not cause ulcers, some people with ulcers do report that their symptoms worsen after eating them.^[8]
Avoid citrus, if it bothers you. Acidic fruit drinks, including orange juice, grapefruit, and other citrus juices can make the symptoms of ulcers much worse. For some people, it may not be a problem, but it can be extremely painful for others. Limit your citrus-intake, if it seems to bother your ulcer.
Cut back on coffee and carbonated drinks. Coffee is highly acidic, which can exacerbate the symptoms of ulcers. Carbonated soft drinks and colas likewise can irritate your stomach lining and make your symptoms worse. Try to cut out your morning cup of coffee in the short-term, if you're suffering from an ulcer, to Try to heal up.
- Caffeine in and of itself doesn't make ulcers worse, but acidic soft drinks, some strong teas, and coffee do. Try switching to more gentle herbal teas, if you have an ulcer. If you need a little caffeine kick, try adding some guarana to your tea.^[9]

EditMaking Lifestyle Changes

Stop smoking. Smoking increases the chances of ulcers developing and makes it more difficult for existing ulcers to heal. Smokers are twice as likely to develop ulcers as non-smokers, making it critical that you quit smoking if you want to allow your ulcer to heal properly.^[10]
- Smokeless tobacco and other forms of tobacco come with the same, and even increased, risk of stomach problems.^[11] Try your best to quit tobacco altogether, if you have an ulcer.
- Talk to your doctor about tapering methods, including using prescription medication to help you ease off of a nicotine dependence. Over the counter patches and nicotine supplements are also available, which can help.
Avoid all alcohol until your ulcer is completely healed. Alcohol irritates the stomach lining, and it takes a while for the stomach to heal completely. If you're recovering from an ulcer, or any kind of stomach trouble, it's important to avoid alcohol while you're recovering. Even a beer or two can aggravate your ulcer.^[12]
- Alcohol in moderation may be alright after all treatment has ended, but you should discuss it with your doctor before resuming drinking in any capacity.
Sleep with your head slightly elevated. For some people, ulcers can get a lot worse at night. Laying flat on your back can cause certain ulcers to become more painful, and nighttime is the worst time to be in pain. Try sitting with your head and shoulders elevated slightly off the mattress, to keep yourself at an inclined position. Some people have success sleeping more soundly like this, when ulcers are bothering them.^[13]
Eat smaller meals at regular times. Eating a big meal in the middle of the day can make an ulcer worse. Instead, try to time your meals at regular times throughout the day, and have more small meals, as opposed to a few really big ones. This will help your stomach to process smaller amounts of food more easily.
- Avoid eating food too close to bedtime, which can cause nighttime pain that will keep you from sleeping more soundly.
- Some people find that the symptoms of ulcers are made worse after eating, while others find that eating can soothe the ulcer pain.^[14] Experiment some with your diet to see what works for you.
Be careful about what medication you take. Any time you go to the doctor from here on out, you need to let them know that you've dealt with ulcers in the past, and you'd like them to consider your history of stomach troubles when prescribing medication. Even if you've been ulcer free for many years, certain medications can irritate your stomach and make it much worse. Always consult your doctor before switching medications or taking something new.
Give it time. The stomach can take quite a while to heal completely, and most doctors recommend that you take a fairly rigorous approach to your recovery, and allow a period of at least 2-3 months before you consider yourself "healed." Even then, a return to a diet or lifestyle that resulted in your ulcers flaring up in the first place can cause your ulcers to come back, perhaps stronger this time. It's important to commit to your health and give your stomach the time it needs to heal.
- Some people may heal faster than others, but it's important to continue your dieting and lifestyle changes well beyond when your symptoms subside. Don't celebrate having no stomach pain with a couple drinks, or the pain could return.