How Are H. pylori Peptic Ulcers Treated

H. pylori peptic ulcers are treated with drugs to kill the bacteria, to reduce stomach acid, and to protect the stomach lining. Antibiotics are used to kill the bacteria. Two types of acid-suppressing drugs might be used: H2-blockers and proton pump inhibitors.

H2-blockers work by blocking histamine, which stimulates acid secretion. They help reduce ulcer pain after a few weeks. Proton pump inhibitors suppress acid production by halting the mechanism that pumps the acid into the stomach. H2-blockers and proton pump inhibitors have been prescribed alone for years as treatments for ulcers. But used alone, these drugs do not eradicate H. pylori, and therefore do not cure H. pylori-related ulcers. Bismuth subsalicylate, a component of Pepto-Bismol, is used to protect the stomach lining from acid. It also kills H. pylori. Treatment usually involves a combination of antibiotics, acid suppressors, and stomach protectors.

1. Antibiotics: metronidazole, tetracycline, clarithromycin,amoxicillin.

2. H2-blockers: cimetidine, ranitidine, famotidine, nizatidine.

3. Proton pump inhibitors: omeprazole, lansoprazole.

4. Stomach-lining protector: bismuth subsalicylate.

At this time, the most proven effective treatment is a 2-week course of treatment called triple therapy. It involves taking two antibiotics to kill the bacteria and either an acid suppressor or stomach lining shield. Two-week triple therapy reduces ulcer symptoms, kills the bacteria, and prevents ulcer recurrence in more than 90 percent of patients.

Unfortunately, patients may find triple therapy complicated because it involves taking as many as 20 pills a day. Also, the antibiotics used in triple therapy may cause mild side effects such as nausea, vomiting, diarrhea, dark stools, metallic taste in the mouth, dizziness, headache, and yeast infections in women. (Most side effects can be treated with medication withdrawal.) Nevertheless, recent studies show that 2 weeks of triple therapy is ideal.

Early results of studies in other countries suggest that 1 week of triple therapy may be as effective as the 2-week therapy, with fewer side effects.

Another option is 2 weeks of dual therapy. Dual therapy involves two drugs: one antibiotic and one acid suppressor. It is not as effective as triple therapy.

Two weeks of quadruple therapy, which uses two antibiotics, an acid suppressor, and a stomach lining shield, looks promising in research studies. It is also called bismuth triple therapy.

After Treatment

To be sure that treatment has killed all H. pylori, the doctor will do a follow-up endoscopy or breathe test 6 to 12 months after treatment to check for the bacterium.

Can H. pylori Infection Be Prevented?

No one knows for sure how H. pylori spreads, so prevention is difficult. Researchers are trying to develop a vaccine to prevent infection.

Why Don’t All Doctors Automatically Check for H. pylori?

Changing medical belief and practice takes time. For nearly 100 years, scientists and doctors thought that ulcers were caused by stress, spicy food, and alcohol. Treatment involved bed rest and a bland diet. Later, researchers added stomach acid to the list of causes and began treating ulcers with antacids.

Since H. pylorus was discovered in 1982, studies conducted around the world have shown that using antibiotics to destroy H. pylori cured peptic ulcers. The National Institutes of Health released a consensus statement in 1994 confirming that H. pylori causes peptic ulcers. Despite the evidence, however, the medical community continues to debate H. pylori’s role in peptic ulcers. If you have a peptic ulcer and have not been tested for H. pylori infection, talk to your doctor.

Points to Remember

1. A peptic ulcer is a sore in the lining of the stomach or duodenum.

2. Most peptic ulcers are caused by the H. pylori bacterium. None are caused by spicy food or stress.

3. H. pylori may be transmitted from person to person through contaminated food and water.

4. Always wash your hands after using the bathroom and before eating.

5. Antibiotics are the most effective treatment for H. pylori peptic ulcers.

Constipation

Definition & Causes of Constipation

Constipation is passage of small amounts of hard, dry bowel movements, usually fewer than three times a week. People who are constipated may find it difficult and painful to have a bowel movement. Other symptoms of constipation include feeling bloated, uncomfortable, and sluggish.

Many people think they are constipated when, in fact, their bowel movements are regular. For example, some people believe they are constipated, or irregular, if they do not have a bowel movement every day. However, there is no right number of daily or weekly bowel movements. Normal may be three times a day or three times a week depending on the person. In addition, some people naturally have firmer stools than others.

At one time or another almost everyone gets constipated. Poor diet and lack of exercise are usually the causes. In most cases, constipation is temporary and not serious. Understanding causes, prevention, and treatment will help most people find relief.