What is an ulcer?

An ulcer is a break or hole in the lining of the stomach (gastric ulcer) or upper intestine(duodenal ulcer). Not too many years ago we thought that ulcers were caused by certain foods, acid that your stomach produces or from stress. We now know that the majority of ulcers are caused by an infection caused by bacteria called Helicobacter pylori (H. pylori).

What are the symptoms of an ulcer?

Most patients have a burning or gnawing feeling in their abdomen. This burning or gnawing often occurs when the stomach is empty like between meals or early in the morning. It can also can happen at other times. The burning or gnawing feeling may last just a few minutes or may take several hours to go away. Food and antacids like Maalox®, Tums® and Mylanta® may make the feeling go away.

How is the infection with H. pylori diagnosed?

There are several tests that can help make the diagnosis. The most commonly used is a blood test to identify antibodies to H. pylori. Your body makes this antibody as it tries to fight the infection. This test is very sensitive, but not specific; it may stay positive for years after someone has been successfully treated for H. pylori. The stool antigen test looks for pieces of actual H. pylori bacteria in a stool sample. This test is helpful to determine if treatment was successful. A less commonly used test is a urea breath test, which also looks for active infection.

The last way that H. pylori can be diagnosed is during an endoscopy. You will be sedated for this test. A doctor will thread a small tube through your mouth and into your stomach. There is a camera at the end of the tube so that the doctor can look for ulcers or other problems. Small samples of your stomach lining (a biopsy) can be taken during the endoscopy and tested for H. Pylori.

How is this infection treated?

While medicines like Prilosec® (or other proton pump inhibitors) or Zantac® or Tagamet® may make you feel better, they will not cure you of the infection. It is very likely that the ulcer symptoms will come back at some time in the future. Antibiotics are used to cure the infection and as a result cure the ulcer. There are several different antibiotic combinations that can be used. Some need to be taken for a week and some for up to 3 weeks to cure the infection. All of these different combinations have a better than 90% chance of curing you of the H. pylori infection and your ulcer symptoms will go away for good. The antibiotics are usually given in combination with a drug that will help with your symptoms. It is very important for you to take the medication until it is gone, even if you felt better after a couple of days. If you don't take all of the medication, the infection won't be cured and your symptoms will come back. If you are having side effects from the antibiotic combination which make it hard for you to finish, you should call your doctor or nurse practitioner. Don’t simply stop taking them.

This document is intended to provide health related information so that you may be better informed. It is not a substitute for your care team's medical advice and should not be relied upon for treatment for specific medical conditions.

© 2017 The General HospitalCorporation.

Primary Care OfficelnSite

developed by the MGH Laboratory of Computer Science and Division of General Internal Medicine

Click the link for more information on Gastroenterology Clinical Service