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#1
Old 10-28-2006, 09:16 AM
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Tell me about your experiences with stomach ulcers

I'm going to see a doctor on Tuesday because I suspect I'm developing an ulcer.

Do these things "cure"? How long? What kinds of lifestyle changes were necessary? Any other helpful details?
#2
Old 10-28-2006, 10:34 AM
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Join Date: Jul 1999
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Posts: 33,150
Quote:
Originally Posted by 11811
I'm going to see a doctor on Tuesday because I suspect I'm developing an ulcer.

Do these things "cure"? How long? What kinds of lifestyle changes were necessary? Any other helpful details?
Lifestyle changes? It was discovered some time ago that most peptic ulcers caused by h pylori and curable with a a course of antibiotics. Just go get the drugs and get better.

Quote:
A major causative factor (75% of gastric and 90% of duodenal ulcers) is chronic inflammation due to Helicobacter pylori, which appears spiral, but is not a spirochaete, rather a bacillus, that colonizes (i.e. settles there after entering the body) the antral mucosa. The immune system is unable to clear the infection[2], despite the appearance of antibodies. Thus, the bacterium can cause a chronic active gastritis (type B gastritis), resulting in a defect in the regulation of gastrin production by that part of the stomach, and gastrin secretion is increased. Gastrin, in turn, stimulates the production of gastric acid by parietal cells. The acids erodes the mucosa and causes the ulcer.

Another major cause is the use of NSAIDs (see above). The gastric mucosa protects itself from gastric acid with a layer of mucous, the secretion of which is stimulated by certain prostaglandins. NSAIDs block the function of cyclooxygenase 1 (cox-1), which is essential for the production of these prostaglandins. Newer NSAIDs (celecoxib, rofecoxib) only inhibit cox-2, which is less essential in the gastric mucosa, and roughly halve the risk of NSAID-related gastric ulceration.

Glucocorticoids lead to atrophy of all epithelial tissues. Their role in ulcerogenesis is relatively small
#3
Old 10-28-2006, 10:35 AM
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Join Date: Jun 2006
Location: Mullet, TX
Posts: 1,140
Ulcers ain't fun. It's best to get diagnosed and take care of them as soon as you suspect you have one.

After more than a decade of upset stomachs and acid reflux, I was diagnosed first with a hiatal hernia, then with an ulcer caused by a bacterium called helicobacter pylori.

The test for h. pylori, incidentally, was a simple blood test using a pinprick thingy. I didn't have to unload a vial of blood to find out.

Anyhow. The good news, in my case, is that treating the ulcer itself is relatively easy. Since it's caused by a bacterium, antibiotics can kill it while giving medications a chance to help the ulcer heal. I'm on a months-long treatment using Nexium, after taking Nexium and an antibiotic (Cipro, I believe) for a month. I can now eat breakfast, and garlic and onions don't bother me as much (yay!). I guess this means garlic and onion omelettes are back on the menu. (Yay!)

As for the length of the Nexium treatment, we're evaluating it every 3-6 months. Concievably, I could be on this medicine for a year or more. But I started seeing positive effects within a week.

The bad news is this. The hiatal hernia, which was likely caused by having an ulcer at the top of my stomach for so long, will never completely heal without surgery. I need to be careful about how much I swallow at a single time. Even a well-chewed piece of meat can cause a blockage at the top of my stomach, causing me to immediately vomit everything I try to eat or drink - it's a bit like choking, but involving food, and without the benefit of passing out from lack of oxygen. I've had a blockage lasting nearly an entire day, more than once. Ain't fun, nosiree.

The moral of the story is: take control of this thing in your gut, and fast.
__________________
I've spent the last few years building up an immunity to bullets. - Angus McGuire
#4
Old 10-29-2006, 12:58 AM
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Join Date: Mar 2000
Location: Between pole and tropic
Posts: 7,544
Quote:
Originally Posted by 11811
What kinds of lifestyle changes were necessary?
Of course, you should consult your doctor and what I write below is just a generic comment about some people with some types of ulcers.

Although the stereotype of an ulcer sufferer often includes some reference to avoiding spicy foods and the soothing effect of milk, reality is different. Spicy foods (and, likewise, "acidy" things) do not contribute to the development, perpetuation, or recurrence of ulcers. As noted above, most ulcers are due to either infection with H. pylori or the use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin), aspirin, etc. While it is true that some people's symptoms may worsen with spicy food, it is not because because of any effect they have on ulcers. The relationship of coffee drinking to ulcers is, similarly, not causal in nature although, once again, coffee may aggravate some people's ulcer symptoms (or, what is perhaps even more likely, can cause a totally unrelated abdominal process to occur, the pain of which is misinterpreted by the brain as being from "my ulcer".)

That being said, however, there are at least two "lifestyle" changes that may help to reduce the risk of ulcers. Alcohol can worsen or initiate ulcers and so can cigarette smoking. Both should be avoided (and, of course, for reasons that extend way beyond the effects on ulcers). For people who have hiatus hernia, and more specifically, "reflux", it is often beneficial for them not to have anything to eat or drink (beyond water) within three hours of bedtime.

What about "stress", you ask. There is no doubt that major physical stress, such as that associated with overwhelming infection, severe burns, major trauma, and, especially, head injury is associated with increased stomach acid secretion and the development of ulcers.

On the other hand, the effect of psychological stress is less clear. Here is an abstract that lists some of the reasons for the dispute.

Finally, in terms of milk, yes, it can relieve some ulcer symptoms (milk is a good neutralizer of acid). Still, there may be a rebound oversecretion of stomach acid as a result leading to a vicious circle. More importantly, unlike the 'good old days', there are now lots of other non-prescripion treatments for ulcers.
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