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Gastritis Versus Ulcer (No Antibiotic Tx)

The symptoms of gastritis and peptic ulcer are very similar. Both can cause a dull ache or burning pain in the upper abdomen. Other symptoms include nausea, vomiting, loss of appetite, and belching or bloating. Blood in the vomit or stools (red or black) is a sign of bleeding in the stomach. This requires immediate medical attention.

A Peptic Ulcer is an open sore in the lining of the stomach or duodenum (upper intestine). The most common cause of peptic ulcer disease is a bacterial infection (H pylori) in the stomach. Another common cause is taking anti-inflammatory medications (such as ibuprofen, prednisone, and aspirin).

Gastritis is an irritation of the stomach lining. It can be acute (recent) or chronic (lasting a long time). Gastritis can be caused by overuse of alcohol or anti-inflammatory medications (such as aspirin, ibuprofen, prednisone). H pylori infection can also cause chronic gastritis.

Tests for H pylori are used to screen for bacterial infection. If no infection is found, ulcer and gastritis can be treated by stopping the cause, such as anti-inflammatory medications, alcohol, caffeine, and tobacco, and treating with antacids plus an acid blocker medication. If H pylori infection is found, antibiotics will be prescribed along with an acid blocker. Persons 55 years and older may undergo other tests before treatment is started.

Two common tests are used to evaluate your symptoms. An upper GI series is an x-ray taken after you drink a chalky liquid called barium. This coats the stomach and allows an ulcer to show up on the x-ray. Another test is called endoscopy during which a long thin tube called an endoscope is passed down your throat to the stomach. A camera at the end of the scope allows the doctor to view inside the stomach to check the cause of your symptoms.

Home Care:

  • Take the prescribed acid blocker medication for the full course of treatment even if you begin to feel better sooner. This medication can take up to several days to fully control your symptoms. If you can’t afford the prescribed medication, you can try over-the-counter acid blockers, such as Pepcid AC, Tagamet, Zantac, or Aciphex. If these do not relieve your symptoms, a stronger acid-blocker can be tried, such as Prilosec OTC.

  • If you have been prescribed an antibiotic to treat H pylori infection, finish the full course of medication. Do so even if you begin to feel better sooner. If you stop the medication too soon, the infection can return and be harder to treat.

  • You can use antacids, such as Tums, Rolaids, Mylanta, or Maalox, for pain. This will be useful the first few days after starting acid blockers when the blockers haven’t started working yet. Follow the directions on the label. Liquid antacids may work better than tablets. Note that antacids can interfere with absorption of certain medications. Specifically, do not take Tagamet (cimetidine), Zantac (ranitidine), or Carafate (sucralfate) within 1 hour of taking an antacid. Talk with your pharmacist if you have any questions.

  • Although foods do not cause an ulcer, symptoms can be worsened by certain foods. Limit or avoid fatty, fried, and spicy foods, as well as coffee, chocolate, mint, and foods with high acid content such as tomatoes and citrus fruit and juices (orange, grapefruit, lemon).

  • Avoid alcohol, caffeine, and tobacco, which can delay healing.

  • Avoid aspirin and anti-inflammatory medications such as ibuprofen (Advil, Motrin) and naproxen (Naprosyn, Aleve). Acetaminophen (Tylenol) is safe to use. Do not take more than the amount listed on the label.

Follow Up

with your doctor or as advised. Further testing may be needed. If you do not begin to improve over the next 4 days, contact your doctor. If you had tests, you’ll be notified of any new findings that affect your care.

Get Prompt Medical Attention

if any of the following occur:

  • Stomach pain gets worse or moves to the lower right abdomen (appendix area)

  • Chest pain appears or gets worse, 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 in color)

  • Feeling weak or dizzy, fainting, or trouble breathing

  • Fever of 100.4ºF (38ºC) or higher, or as directed by your healthcare provider


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