Treatment of Peptic ulcer

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H. Pylori is a bacterium, so it is normally treated with antibiotics to clear the infection. H. Pylori can be difficult to get rid of because it is hard to get high concentrations of antibiotics into the mucus lining. It is normal to take more than one type of antibiotic, as well as drugs to control the production of acid in the stomach.

If long-term treatment with aspirin or another non-steroidal anti-inflammatory drugs (NSAIDs) is the cause, ulcer healing drugs and additional drugs to protect the lining of the stomach and duodenum are advised.

Occasionally surgery is recommended if the ulcer does not respond to medication. This may include one of the following options:

Vagotomy: cutting the vagus nerve that links the stomach to the brain. This reduces acid production.
Antrectomy: removal of the lower part of the stomach that produces the hormone that causes the stomach to produce digestive juices.
Pyloroplasty: enlarging the opening into the duodenum and small intestine to allow the contents of the stomach to move more freely.

Severe blood loss from a bleeding or perforated ulcer is a medical emergency and requires immediate medical attention. A technique using heat (cauterisation) may be used to seal blood vessels during a gastroscopy to stop bleeding. Alternatively, an injection of drugs may be given. If bleeding is very severe or the ulcer has a hole in it, (a perforated ulcer) surgery and a blood transfusion may be necessary.

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