Treatment - Stomach ulcer

With treatment, most stomach ulcers heal in a month or two. The recommended treatment depends on the cause of the ulcer.

If non-steroidal anti-inflammatory drugs (NSAIDs) cause your ulcer, your GP will usually prescribe a proton pump inhibitor (PPI).

If an H. pylori infection causes your ulcer, your GP will prescribe PPIs and antibiotics. This is also the treatment when both an H. pylori infection and NSAIDs cause your ulcer.

Your GP may recommend antacids to relieve your symptoms in the short term.

To help reduce your symptoms, avoid stress, alcohol, spicy foods and smoking.

If taking NSAIDs caused your stomach ulcer, your GP may recommend taking a different painkiller.

You may have a repeat gastroscopy after 4 to 6 weeks to check that the ulcer has healed.

Antibiotics

If you have an H. pylori infection, your GP will usually prescribe a course of 2 antibiotics. You must take these twice a day for 1 week.

The antibiotics most often used are amoxicillin, clarithromycin and metronidazole.

The side effects of these are usually mild and can include:

  • feeling and getting sick
  • diarrhoea
  • a metallic taste in your mouth

You'll have more tests at least 4 weeks after finishing your antibiotic course. These check to see if there are any H. pylori bacteria left in your stomach.

If there are, your GP may prescribe another course of different antibiotics.

Proton pump inhibitors (PPIs)

PPIs reduce the amount of acid that your stomach produces. This stops any more damage to the ulcer while it heals by itself. Your GP will usually prescribe a course of PPIs of 4 to 8 weeks.

The PPIs most often used are omeprazole, pantoprazole and lansoprazole.

The side effects of these are usually mild but can include:

  • headaches
  • diarrhoea or constipation
  • feeling sick
  • abdominal (tummy) pain
  • dizziness
  • rashes

The side effects should stop when you finish the treatment.

Antacids and alginates

It can take several hours before treatments for stomach ulcers start to work.

Your GP may recommend taking antacids. This medication neutralises your stomach acid. It provides immediate, short-term relief of your symptoms.

Some antacids also contain a medicine called an alginate. This produces a protective coating on the lining of your stomach.

You can buy antacids and alginates at pharmacies without a prescription. Talk to your pharmacist about which medicine is best for you.

You can take antacids when you have symptoms or when you expect them, such as after meals or at bedtime.

You should take antacids that contain alginates after meals.

The side effects of both medicines are usually mild and can include:

Reviewing NSAID use

If taking NSAIDs caused your stomach ulcer, your GP will review your use of them.

NSAIDs include:

  • ibuprofen
  • aspirin
  • naproxen
  • diclofenac

Your GP may recommend a different painkiller, such as paracetamol. Sometimes they may recommend a type of NSAID called a COX-2 inhibitor. This is less likely to cause stomach ulcers.

If you're taking low-dose aspirin to reduce your risk of blood clots, your GP will tell you if you need to keep taking it.

If you do need to keep taking aspirin, your GP may prescribe long-term treatment with a PPI. This is to stop you from getting another ulcer.

There are risks if you continue to use NSAIDs. You could get another stomach ulcer or a serious complication, such as internal bleeding.


Content supplied by the NHS and adapted for Ireland by the HSE

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This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

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