Stress alone can cause stomach ulcers
Gastric / intestinal ulcer: therapy
Gastric and intestinal ulcers sometimes heal on their own within 2-3 months without treatment. However, the relapse rate in untreated patients is 40-80%. Modern drugs can shorten the healing process to 1-3 weeks and reduce the high relapse rate.
In the case of mild complaints, general measures can help the patient. This includes a stomach-friendly diet consisting of mild, well-tolerated dishes. In addition, those affected should refrain from alcohol and cigarettes and only drink coffee in moderation. Rest and relaxation can also alleviate the symptoms in the case of severe psychological stress.
Short-term self-treatment with non-prescription drugs from the pharmacy can also be beneficial. So-called antacids have acid-inhibiting and acid-binding effects and are thus able to alleviate pain.
Herbal remedies such as a roll cure with chamomile tea as well as other medicinal herb applications (for example from fennel, aniseed, liquorice root extract) help calm the mucous membrane and relieve pain.
If the symptoms do not go away or even worsen within a few days with this treatment, the internist will recommend medication to treat the patient depending on the cause of the ulcer. Above all, these should eliminate the pathogen Helicobacter pylori and neutralize stomach acid.
Helicobacter pylori infection
If the internist finds the bacterium Helicobacter pylori during an endoscopy, he can combine several drugs to treat the ulcer: acid blockers to reduce stomach acid and antibiotics to kill Helicobacter pylori in the stomach.
The internist often uses a triple combination of an acid inhibitor and two different antibiotics. Proton pump inhibitors and histamine H2 receptor blockers (H2 blockers) are the most common acid inhibitors. They both block acid production in the stomach, but proton pump inhibitors are more effective than H2 blockers.
The medication must be taken for about 7-10 days. If you have a stomach ulcer, patients should take the acid inhibitor four weeks longer to allow the ulcer to heal completely. The internist can check the success of the antibiotic treatment with a special test, the 13C urea breath test.
After such treatment, in most cases, the ulcer will go away. If the relapse occurs, the internist will re-administer medication. However, relapses are very rare.
Has a stomach or duodenal ulcer been caused by pain relievers such as If, for example, acetylsalicylic acid (aspirin) or rheumatoid drugs (e.g. non-steroidal anti-inflammatory drugs) are triggered, it is important to stop these drugs first so that the gastric or duodenal mucosa is no longer irritated. At the same time, the doctor will administer an acid-inhibiting preparation, e.g. B. a proton pump inhibitor to support the regeneration of the mucous membrane. Generally, ulcers will heal within 1-2 weeks with this therapy.
If the patient cannot stop taking his pain or rheumatic medication, he must take an acid inhibitor permanently. Otherwise, there is a risk that the ulcer will continue to progress and lead to serious complications.
Treatment of complications
In the case of profuse bleeding from a gastric ulcer, the patient must keep strict bed rest. He continues to receive proton pump inhibitors and blood transfusions to make up for the loss of blood.
In addition, the gastroenterologist tries to stop the bleeding as quickly as possible and to keep blood loss to a minimum. To do this, he searches for the location of the bleeding with the endoscope. He can often obliterate the damaged blood vessel with an electric shock or close it with a special clip. In the rare cases in which this is not possible, the patient must be operated on and the blood vessel sewn shut.
Gastric or intestinal perforations are life-threatening and must be operated on immediately. Even if the stomach outlet is narrowed, only surgery can usually help.
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