Ulcers
Ulcers are caused by damage to the lining of the esophagus,
stomach or duodenum. It was thought for a very long time
that ulcers were due to excess acid production, stress, and
weakening of the lining of the stomach, esophagus, or duodenum.
Over the past 20 years, a bacterium, H. Pylori, has been blamed
as the cause of ulcers. We do not feel that the answer is
that simple, and have done extensive community based clinical
studies that do not support the notion that H. Pylori is the
main culprit. We believe it is due to a combination of
excess acid, stress, aspirin products, arthritis medications,
and in some cases (mostly foreign born patients) H. Pylori
presence.
Symptoms might include burning in the mid-abdomen, sharp pain,
nausea, fullness after eating, belching, and weight loss.
The burning can occur when the the stomach is empty and may
awaken one from sleep during the night.
Diagnosis is best made by endoscopy, an out-patient evaluation.
If bacteria are found with the ulcer (around 30% of the time),
antibiotics are given. Otherwise, suppression of acid is
begun with either H2 blockers (Tagamet, Zantac, Pepcid, Axid) or
proton pump inhibitors (Prilosec, Nexium, Prevacid, Protonix or
Aciphex). All treatments can heal ulcers. Biopsies
may be taken to ensure that the ulcers are benign. Ulcers
in the stomach rarely are malignant, but those in the duodenum
are almost always benign.
The other major cause of ulcers today is aspirin and arthritis
medications (nonsteroidal anti-inflammatory medications).
The treatment includes stopping these medicines and using the
same medications listed above.
To avoid ulcers:
1. Don’t take aspirin/arthritis medications on an empty stomach.
2. Decrease stressful circumstances as much as possible.
3. Do not drink alcohol in excess.
4. Seek medical advice if symptoms occur and are not easily resolved.
5. Avoid spicy and fried foods if you are already having symptoms.
6. Stop smoking.
Remember:
Ulcers can heal completely, and most patients will not have
ulcers repeatedly, if the measures listed above are followed.
