H. Pylori Infection And Peptic Ulcer Disease
A peptic ulcer is an open sore in the lining of the stomach or duodenum (upper intestine). Peptic ulcer causes a dull ache or burning pain in the upper abdomen. It often starts 1-3 hours after a meal or occurs in the middle of the night. It is usually better with eating or taking antacids. Other symptoms include nausea, vomiting, loss of appetite and belching or bloating. Blood in your vomit or stools (red or black color) is a sign of bleeding from the stomach and requires immediate medical attention.
H. pylori is a bacteria that infects the stomach. It is the most common cause of peptic ulcer disease. However, H. pylori infection can also cause gastritis (stomach inflammation) without an ulcer.
The H. pylori bacteria is probably passed through contaminated food or water. It may also be passed in the saliva during kissing or sharing eating utensils. It can also be passed by contact with infected fecal matter from a person with poor hand-washing habits. About 25% of people in the U.S. have this infection, but most do not have symptoms. Once in the stomach, the bacteria damages the protective lining. This exposes the deeper tissues to stomach acid and makes it possible for an ulcer to form.
The diagnosis of H. pylori is made with a breath or stool test. The blood test for H. pylori is more convenient but may not distinguish between a current and past infection.
An H. pylori infection that causes a peptic ulcer is treated with a combination of acid blocking medicines and antibiotics. If symptoms are not improving, or in patients 55 or older, other tests may be advised.
There are two common tests that are used to evaluate these symptoms. An upper GI series is an x-ray taken after you drink a chalky liquid (barium). This coats your stomach and makes an ulcer visible. This test is easy to do, but may miss some ulcers. A more accurate (and more expensive) test is called endoscopy. You are given IV sedation. Then, a long thin tube is passed down your throat to your stomach. There is a small camera on the end which allows the doctor to see the cause of your symptoms.
Take the prescribed antibiotic medicine and acid blockers for the full course of treatment. Do this even if you begin to feel better sooner. If you stop early, the infection may return, and your risk of antibiotic-resistant H. pylori increases. Acid blocker medicines may take up to four days to have a full effect on your symptoms.
You may use antacids (such as Tums, Rolaids, Mylanta, and Maalox) for pain. This will be useful in the first few days of treatment, before the acid blockers begin to work. See label for the dosage. The liquid may work better than tablets. Antacids interfere with absorption of certain medicines. Specifically, do not take Tagamet (cimetidine), Zantac (ranitidine) or Carafate (sucralfate) within one hour of an antacid. Check with your pharmacist before taking this with your prescribed medicines.
Although foods do not cause an ulcer, symptoms may be worsened by certain foods. Avoid fatty, fried and spicy foods, coffee, chocolate, mint, and foods with high acid content (tomatoes and citrus fruit and juices such as orange, grapefruit, and lemon).
Avoid alcohol, caffeine, and tobacco, which can delay healing.
Avoid aspirin or anti-inflammatory drugs such as ibuprofen (Advil, Motrin), naproxen (Naprosyn or Aleve). Acetaminophen (Tylenol) is safe to use. Do not exceed the amounts described on the label.
with your doctor or as advised by our staff. Further testing may be needed. If you do not begin to improve over the next 4 days, contact your doctor.
Get Prompt Medical Attention
if any of the following occur:
Stomach pain worsens or moves to the right lower part of the abdomen
Chest pain appears or worsens, or spreads to the back, neck, shoulder, or arm
Frequent vomiting (can’t keep down liquids)
Blood in the stool or vomit (red or black color)
Feeling weak or dizzy, fainting, or having trouble breathing
Fever of 100.4ºF (38ºC) or higher, or as directed by your healthcare provider