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Stomach Ulcer Facts and Self-Care During Medical Treatment

Linda Crampton is an experienced teacher with a first-class honors degree in biology. She writes about the scientific basis of disease.

A stomach, gastric, or peptic ulcer can be very painful.

A stomach, gastric, or peptic ulcer can be very painful.

What Is a Stomach Ulcer?

A stomach ulcer is a sore on the inside of the stomach. The majority of stomach ulcers are caused by a bacterium named Helicobacter pylori, or H. pylori. Most of the remaining cases are caused by excessive use of medications called nonsteroidal anti-inflammatory drugs, or NSAIDs. Aspirin, ibuprofen, and naproxen are examples of NSAIDs. Health experts say that stomach acid and stress don't cause ulcers, but they may make existing ones more painful.

Stomach ulcers can be very painful, especially when acid has been released into the stomach cavity to help food digestion. They need to be medically treated, but the treatment will probably need to be taken for four to eight weeks in order to be completely effective. While an ulcer is healing, it's important to treat it gently.

Specific self-care steps should reduce pain from a stomach ulcer while waiting for the prescribed treatments to work. A nutritious diet that includes certain foods, the elimination of foods that trigger pain, a healthy lifestyle, and stress reduction should all help to relieve the pain. I discuss stomach ulcers and self-care techniques below.

Warning

The information in this article is given for general interest. Anyone with unexplained stomach pain or questions about relieving the pain should visit a doctor for a diagnosis, treatment, and advice. In addition, while self-help techniques can be very useful for dealing with a stomach ulcer, they are not a substitute for medical attention.

Stomach, Gastric, and Peptic Ulcers

Stomach ulcers are sometimes called gastric ulcers. The term "peptic ulcer" is also used, but this term refers to either a stomach ulcer or a duodenal one. The duodenum is the first part of the small intestine and is a common site of ulcer formation.

Often, pain from a stomach ulcer is worse soon after eating as acid production increases in the stomach. Pain from the dudodenal version may be worse two to three hours after eating when the food has left the stomach and entered the duodenum.

Occasionally, an ulcer develops in the lining of the esophagus, which is the tube that travels from the throat to the stomach. A muscle called the lower esophageal sphincter normally prevents stomach contents from entering the esophagus. Sometimes the sphincter doesn't close the passageway properly, allowing material to move from the stomach into the esophagus. Irritants entering the esophagus from the mouth can also cause esophageal ulcers.

Helicobacter pylori is the cause of many stomach ulcers.

Helicobacter pylori is the cause of many stomach ulcers.

What Causes a Stomach Ulcer?

The stomach lining is protected from damage by a layer of mucus. This mucus prevents the hydrochloric acid and digestive enzymes in the stomach cavity from irritating the stomach lining. The acid is required for digestion to take place because it activates pepsinogen in the stomach cavity, which then becomes an enzyme called pepsin. Pepsin digests proteins. Hydrochloric acid also kills bacteria that have entered the stomach. Unfortunately, Helicobacter pylori is often able to avoid the stomach’s defence mechanisms.

Helicobacter pylori

H. pylori is a bacterium that hides in the mucus layer covering the stomach lining and is protected from an attack by acid and enzymes. In some people, the bacterium is present but causes no problems. In others, its presence leads to a weakened mucus layer, inflammation, and an ulcer. As might be expected, many researchers are exploring the reasons for these different outcomes.

The bacterium has multiple extensions called flagella (singular: flagellum) extending from one end of the cell, as can be seen in the photo above. The moving flagella propel the microbe through its habitat. The flagella group is often likened to the propellor of a helicopter.

NSAIDS (Non-Steroidal Anti-Inflammatory Drugs)

Aspirin, ibuprofen, naproxen, and other nonsteroidal anti-inflammatory drugs can also cause ulcers when taken at a high dose for a long time. They reduce the production of protective mucus in the stomach. In addition, they may irritate the stomach lining and make it bleed.

If a doctor has prescribed an NSAID, a patient shouldn't stop taking the drug without their physician's advice. They might want to ask their doctor if the dose and predicted duration of the medicine’s use could have undesirable consequences, however.

Possible Medical Treatments

It's important that someone with stomach pain visits a doctor to find the cause of the problem. A variety of medications are available to treat a stomach ulcer. The doctor will prescribe a suitable treatment regimen based on the cause of the problem.

If the person has a Helicobacter pylori infection, a specific antibiotic may be prescribed. Other drugs may be prescribed to reduce acid production in the stomach or to neutralize acid that has already been produced. A drug to protect the lining of the stomach may also be prescribed. All of the medications should be taken as recommended. The self-care tips that I include below are meant to accompany the medical treatment. They don't replace them.

Food Choices

Some foods may trigger stomach pain in people with ulcers. What causes pain in one patient may not hurt another patient. It's important that a person doesn't eliminate or restrict the ingestion of a healthy food unless they're sure that it makes their pain worse.

Follow a Healthy Diet to Help Relieve Pain

Following a healthy diet will help to strengthen the immune system, which may aid the healing of a stomach ulcer. Some healthy foods may directly fight an ulcer and help to relieve the pain that it causes.

Vegetables, legumes or pulses (beans, lentils and peas), fruits, and whole grains are generally recommended as the main components of a good diet. Plant foods are rich in beneficial nutrients. Cabbage and other cruciferous vegetables such as broccoli, Brussels sprouts, cauliflower, and kale may be especially useful in treating an ulcer. Cranberries and cranberry juice may fight Helicobacter pylori. Cranberry juice often contains lots of sweetener, though it is possible to buy the unsweetened product.

Foods from plants are high in fiber, which has been shown to reduce the risk of peptic ulcer development. Both soluble and insoluble fiber are important in the diet, but the soluble type seems to be the most useful type with respect to peptic ulcers. Foods rich in soluble fiber include oats, barley, beans, peas, and lentils.

Healthy fats include the omega-3 fatty acids in oily fish and the monounsaturated fatty acids in olive oil. Lean protein is also an important component of the diet. Extra virgin olive oil and unsweetened yogurt containing live probiotics (good bacteria) are both excellent foods. There is some evidence that they are helpful for an ulcer, but they should probably be eaten in small to moderate quantities. An excessive amount of fat or protein may be irritating for some patients.

Wild salmon is a good source of omega-3 fatty acids.

Wild salmon is a good source of omega-3 fatty acids.

Avoid Food and Drinks That Increase Pain

It should be noted that you may not need to eliminate the following foods and drinks from your diet. Some people find that they irritate a stomach ulcer, though. If this is the case for you, you should probably avoid them until your ulcer has healed.

Some possible causes of ulcer irritation include:

  • foods that are high in fat
  • spicy foods
  • acids from citrus fruits (such as oranges, lemons, limes, and grapefruit)
  • beverages with a high caffeine level, such as coffee
  • carbonated beverages
  • decaffeinated coffee
  • chocolate
  • alcohol

A patient could keep a food diary and record any pain that results after eating the food. This may make it easier to choose an appropriate diet and avoid the risk of eliminating a healthy food unnecessarily. If someone knows that a food irritates their stomach even when they don't have an ulcer, it would probably be a good idea to at least temporarily eliminate it from their diet.

Citrus fruits are nutritious, but they irritate some ulcers.

Citrus fruits are nutritious, but they irritate some ulcers.

Try Eating Small Servings of Some Foods

Try eating red meat and other very high-protein foods in small servings. When protein is eaten, hydrochloric acid is released into the stomach cavity to convert pepsinogen into pepsin. Protein is an important nutrient and needs to be part of the diet. Foods that are concentrated sources of protein require a larger amount of acid for digestion than foods containing a smaller amount, however.

People with a stomach ulcer are often advised to eat small or moderately sized meals instead of large ones. When a smaller meal is eaten, less stomach acid should be produced. In addition, a very large meal can stretch the stomach and make an ulcer more painful. Patients are also frequently advised to avoid eating close to bedtime in order to reduce acid secretion during the night.

Beverages are important to consider as well as solid food. The old idea that milk can soothe the discomfort of an ulcer has now been discarded. In fact, an excessive quantity of milk may increase discomfort because it's quite high in protein and stimulates acid production.

Role of Smoking

Researchers have no doubt that H. pylori (in some people) or an excessive intake of NSAIDS can cause stomach ulcers. They also know that smoking is apparently harmful for ulcers, but they are still studying the details about why.

Quit Smoking (With Help if Necessary)

Smoking is thought to increase the chance of an ulcer developing and slow or prevent the healing of one that is already present. Research suggests that it increases the amount of stomach acid that is produced and decreases the amount of sodium bicarbonate made in the small intestine. The bicarbonate neutralizes the acid that enters the intestine from the stomach, so when less bicarbonate is present there is more acid to irritate an ulcer in the intestine.

Though quitting smoking may sound like a sensible idea, the process may be difficult, especially when a person already has a stomach ulcer. Quitting smoking may be a major undertaking at a time when a person is already stressed by the presence of an ulcer. A doctor's advice and help should be sought in this situation.

Be Careful With Medications

Take your prescribed medication at the correct time and don't miss any doses in order to heal your ulcer. If you want to take any over-the-counter pain relievers or antacids, discuss whether this is advisable with your doctor and also ask which medications are best.

Acetaminophen (called paracetamol in some countries) may be appropriate as a pain reliever, since it isn't an NSAID. Since NSAIDs can stimulate ulcer development under certain conditions, taking one when an ulcer already exists might cause the problem to get worse. Concerns exist about the excessive use of acetaminophen. These should be investigated.

If you have an ulcer, remember to tell your doctor about all the medications that you take without his or her knowledge, including herbal medicines and supplements. Some medications can irritate ulcers, and some can interact with prescribed medicines. This problem applies to certain herbal medicines as well as pharmaceutical ones.

Looking at flowers in nature or a park can be a good way to relax.

Looking at flowers in nature or a park can be a good way to relax.

Try to Reduce Stress

Today it’s believed that stress doesn’t cause ulcers, but it may make them worse. If you are living a stressful life, it's important to think about ways in which you could eliminate or reduce the stress. This should be helpful whether or not you have an ulcer.

Talking to friends, relatives, or a counselor could help you relax. They may have some creative ideas that haven't occurred to you. It's also important to find relaxation techniques that help you manage any stress that can't be eliminated. The list below gives some potentially helpful methods that I find useful.

Walking in pleasant and interesting surroundings may help to relieve stress.

Walking in pleasant and interesting surroundings may help to relieve stress.

Tips for Relieving Stress

One or more of the following activities may help you relax and forget about any stress that you can't avoid, at least temporarily. You could:

  • exercise vigorously (as long as it doesn't hurt your ulcer)
  • exercise meditatively, as in yoga, Tai Chi, or a contemplative walk
  • explore an interesting place while walking or cycling
  • take your dog for a walk
  • observe nature
  • do gardening
  • read a book that interests you
  • listen to music that engrosses or relaxes you
  • watch a movie that interests you
  • socialize with friends or go to a fun event with them
  • do creative writing
  • draw or paint
  • go on a photography walk
  • work on a craft
  • play a musical instrument

Some people find that thinking about their spiritual beliefs or religion or learning new information related to these topics relieves their stress.

Interacting with my dog helps to relieve my stress.

Interacting with my dog helps to relieve my stress.

An Ulcer Poll

Get Help From a Doctor

If you have unexplained stomach pain that is prolonged or repeated, you need to visit a doctor for a diagnosis. If you discover that you have an ulcer or another health problem, it's important to get medical treatment and advice. Untreated stomach conditions can cause additional problems, which may be serious as well as painful.

If your problem is an ulcer and you're waiting for prescribed medications to work, dietary and lifestyle changes could be a big help in relieving your pain and perhaps in preventing another ulcer from forming. The strategies are certainly worth trying. Any time that a diet is changed, some thought should be given to the foods and drinks that are going to be eaten or drunk and those that are going to be eliminated. A nutritious diet is always a good idea, whether we are healthy or whether we are sick.

References and Resources

The references below come from reliable medical sources. They are all worth reading. Nevertheless, your own doctor should be consulted about your specific situation.

  • Helicobacter pylori information from John Hopkins Medicine
  • Stomach ulcer treatment from the NHS (National Health Service)
  • Facts about peptic ulcers from the Mayo Clinic
  • Peptic ulcer treatment from the NIH (National Institutes of Health)
  • Everyday pain relief for ulcers from WebMD
  • Healthy eating guidelines for people with peptic ulcers from HealthLinkBC (a Government of British Columbia website)

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2013 Linda Crampton

Comments

Linda Crampton (author) from British Columbia, Canada on February 11, 2018:

Thanks, Manatita. I appreciate your comment, as always.

manatita44 from london on February 11, 2018:

Nice article on ulcers and the cause, treatment and suggestions. Some great suggestions noted.

Linda Crampton (author) from British Columbia, Canada on August 29, 2015:

Thank you very much for the comment, FaithL. I'm glad that the article helped you and that you've found relief.

FaithL on August 29, 2015:

I have a peptic ulcer and started drinking protein shakes (30 g) for breakfast for about a week. I had to go to urgent care because of the stomach cramps and pain. I had no idea that large amounts of protein increases acid production in the stomach. The article saved me.

Linda Crampton (author) from British Columbia, Canada on March 08, 2013:

I'm glad that you husband's ulcers disappeared, Dianna. Decaffeinated coffee doesn't actually cause ulcers, but it can make them more painful in some people. Thanks for the visit!

Dianna Mendez on March 08, 2013:

My husband had ulcers when we were first married. THankfully, through change in lifestyle an diet, he rid himself of them for good. Also, I didn't know decaf coffee caused them - how interesting.

Linda Crampton (author) from British Columbia, Canada on March 01, 2013:

Thank you, torrilynn. I appreciate the comment and the vote!

torrilynn on March 01, 2013:

Hi Alicia,

really great hub here on the best tips

to help with stomach ulcers.

thanks, voted up

Linda Crampton (author) from British Columbia, Canada on March 01, 2013:

Thank you very much for the comment and the vote, Eddy. Have a great day!

Eiddwen from Wales on March 01, 2013:

So interesting and very useful Alicia.

A great share and I vote up.

Enjoy your day.

Eddy.

Linda Crampton (author) from British Columbia, Canada on February 28, 2013:

Thank you, Vicki. I appreciate your comment very much!

Vickiw on February 28, 2013:

Hi Alicia, a very interesting Hub, as usual. I have never suffered from this problem, thank goodness, but it must be quite painful. I really appreciate the thoroughness of your Hubs!

Linda Crampton (author) from British Columbia, Canada on February 28, 2013:

Thank you very much, pstraubie48. I apreciate your visit. I'm glad that you were able to get your ulcers under control!

Patricia Scott from North Central Florida on February 28, 2013:

Thanks for sharing all of this info. I had ulcers about ten years ago and was told many of the things you have metnioned. I had to change many things especially reduce stress to get them under control.

Sending you many Angels this evening. :) ps

Linda Crampton (author) from British Columbia, Canada on February 28, 2013:

I'm so sorry about your mother's ulcers and the situation with your father, Deb. This sounds like a sad situation. Thank you very much for the comment.

Deb Hirt from Stillwater, OK on February 28, 2013:

My poor mother was filled with ulcers before she died. Looks like she did a lot of the wrong things, but then again, she was married to my father...Anyway, this is fantastic information, and very well done.

Linda Crampton (author) from British Columbia, Canada on February 28, 2013:

Thank you very much for the comment, Martie. I appreciate it. I hope that your doctor or chemist can give you another medication that relieves your pain but doesn't have the potential to cause ulcers. Good luck!

Martie Coetser from South Africa on February 28, 2013:

Alicia, you just never disappoint. Such important information in here.

I must add that I once thought that cholecystitis I had was a stomach ulcer, so I've taken medicine for the latter, which was exactly what I was not supposed to do. At present I have to take 400mg ibuprofen per day, and I am not at all happy about this. I wonder if my chemist will give me something else with less devastating contra indications?

Thanks for this most informative hub about stomach ulcers.

Linda Crampton (author) from British Columbia, Canada on February 28, 2013:

I've never tried hydrocodone. It does sound like a nasty medication! Thanks for the warning, Austinstar.

Lela from Somewhere near the heart of Texas on February 28, 2013:

He has chronic degenerative discosis in his back too, so he masks a lot of pain with Hydrocodone.

I had to take myself off of hydrocodone. That stuff is nasty. Feels good at the time, but the side effects are crazy bad. You have to take another one to deal with the side effects! It's bad.

I won't even take codeine anymore unless I have to.

Linda Crampton (author) from British Columbia, Canada on February 28, 2013:

Good luck with dealing with your husband's pain, Austinstar. He really should see a doctor, but I know what you mean about stubborn people who won't visit a doctor unless they're very sick!

Lela from Somewhere near the heart of Texas on February 28, 2013:

My husband gets frequent heartburn and stomach upset, especially at night. I'm pretty sure he has an ulcer, but he just won't see a doctor. Men are so stubborn that way.

I'm gradually changing our diet to include fish and vegetables. He's a meat and more meat eating kind of guy.

Linda Crampton (author) from British Columbia, Canada on February 27, 2013:

Thank you so much for the votes and the share, Mary! I'm glad to hear that you have such a strong stomach. I hope it continues that way!

Linda Crampton (author) from British Columbia, Canada on February 27, 2013:

Thank you for another lovely comment, drbj! I appreciate your visits very much.

Mary Hyatt from Florida on February 27, 2013:

My Daddy used to say he had ulcers so he had to drink goat's milk. It was my job twice a day to milk the Nanny goat to get his milk.

I am blessed with a "cast iron" stomach so far and have no prolems.

Informative and interesting Hub. I voted UP, etc. and will share.

drbj and sherry from south Florida on February 27, 2013:

Hi, Alicia - This is another thorough medical examination - this time concerning stomach ulcers and stress reduction. Excellent explanations. Voted up, y'know.

Linda Crampton (author) from British Columbia, Canada on February 27, 2013:

Thanks Bill. I appreciate your visit and comment, as I always do!

Bill Holland from Olympia, WA on February 27, 2013:

I haven't run into one of these bad boys yet, but thanks for the info if it should ever happen. You do know your medical facts. Well done once again.