Side Effect: Stomach Ulcers

What are stomach ulcers?

Stomach ulcers, also known as peptic ulcer disease (PUD), are painful sores that develops in the lining of the stomach or the first part of the small intestine, called the duodenum. These sores develop due to damage to the tissues that line the stomach or parts of small intestine.

What does a stomach ulcer look like?

Stomach ulcers can vary in appearance, but they generally appear as a small, round, crater-like lesion in the lining of the stomach or duodenum. They can range in size from a few millimeters to several centimeters and are on the tissue surface or deep into the tissues. Typical symptoms of stomach ulcers include burning stomach pain that occurs two to five hours after meals or on an empty stomach or burning stomach pain that occurs at night and is relieved by eating a meal or taking antacids or stomach acid suppressing medications.

Who gets stomach ulcers?

The two most common causes of stomach ulcers are infections with the bacteria Helicobacter pylori (H. pylori) and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). H. pylori bacterium is found in the stomachs of about half of the world's population and is the most common cause of stomach ulcers. Regular use of NSAIDs such as aspirin, ibuprofen (Advil®, Motrin®), naproxen (Aleve®), celecoxib (Celebrex®), or meloxicam (Mobic®) can irritate the stomach lining and increase the risk of ulcers.

In addition to the above risk factors, smoking cigarettes can increase the risk of stomach ulcers and interfere with the healing process. Excessive alcohol consumption can increase the risk of stomach ulcers as well.

How do you prevent stomach ulcers?

Preventing stomach ulcers involves reducing the risk factors mentioned above. Avoiding or limiting the use of NSAIDs, quitting smoking, and reducing alcohol consumption can all help reduce the risk of stomach ulcers. In addition, treating an H. pylori infection can help prevent ulcers from developing.

How are stomach ulcers treated?

Treatment of stomach ulcers may involve medications to reduce stomach acid and antibiotics to treat an H. pylori infection if present. In some cases, endoscopic procedures may be used to stop bleeding or remove the ulcer. Typically, a course of proton pump inhibitors (PPIs) or bismuth subsalicylate (Pepto Bismol®) is recommended to suppress stomach acid.

Over the counter PPIs:

• Omeprazole (Prilosec®)
• Lansoprazole (Prevacid®)
• Esomeprazole (Nexium®)

Prescription only PPIs:

• Pantoprazole (Protonix®)
• Dexlansoprazole (Dexilant®)
• Rabeprazole (Aciphex®)

If an infection with H.pylori is present, an acid suppressing agent and combination of antibiotics are used to eradicate the infection and allow the ulcers to heal. Commonly used antibiotics in the treatment of H.pylori are:

• Amoxicillin
• Tetracycline
• Levofloxacin (Levaquin®)
• Metronidazole (Flagyl®)
• Clarithromycin (Biaxin®)
• Tinidazole (Tindamax®)

In some cases, sucralfate (Carafate®) may be utilized. This medication acts as a protective coating for the ulcer and helps protect it from further damage by stomach acid.