For people with ulcers, some helpful general advice includes:

• Avoiding certain foods and beverages (such as caffeine in coffee, tea and colas, as well as alcohol). Caffeine stimulates acid production and can make pain worse.
• Refraining from using milk to bring relief. The stomach still has to digest milk; as soon as acid increases, symptoms will recur.
• Stop smoking.  Smoking increases acid production; it can delay ulcer healing and contribute to an ulcer returning.

A variety of tests may be carried out to determine if you have an ulcer, and if so, where. Which tests are ordered depends on a number of factors, including your age, medical history and any medications you may be taking.


Tests used to diagnose the presence of ulcers are:

Upper GI (Gastrointestinal) Series, or Barium-Swallow Radiograph: This test involves taking an x-ray of the esophagus, stomach and duodenum. Prior to the test, patients need to drink a substance called barium, which enables the x-ray to show an ulcer. (Click here to learn more.)

Endoscopy: More accurate than the barium x-ray, endoscopy can be performed in the hospital or doctor's office. The patient is given a local anesthetic and sometimes an intravenous sedative; the doctor then gently inserts an endoscope (a small, flexible device with a camera on the end) through the mouth, down the esophagus into the stomach and duodenum. The patient may experience slight discomfort during the procedure. Performing an endoscopy enables the doctor to diagnose problems, take photographs and retrieve tissue samples (or biopsy) for further analysis. (Click here to learn more.)


Tests used to diagnose the presence of H. pylori are:

Blood Tests: Tests such as the Enzyme-Linked Immunosorbent Assay (ELISA) are used to measure the antibodies in the blood produced to fight the H. pylori bacteria.

Urea Breath Test: Patients swallow a fluid or capsule containing urea and carbon, then breathe into a measuring device that gauges the amount of urea left. Because H. pylori breaks down urea, the amount of urea remaining in the exhaled breath is a reliable indicator of whether or not H. pylori is present in the stomach.

Saliva Test/polymerase chain reaction (PCR): These tests are relatively new methods of diagnosing the presence of H. pylori. PCR analyzes cells from the patient's gums or stool sample and creates many copies of the H. pylori DNA (genetic material) until the bacteria is easily detected.


Ulcers are effectively treated using a variety of medications:

Antibiotics
If you have H. pylori and an ulcer, the goal of treatment is to completely wipe out the bacteria. Your doctor will usually prescribe one week (sometimes two) of antibiotics, the most effective being clarithromycin, metronidazole and amoxicillin. These medications are usually combined with a proton pump inhibitor (PPI) (such as pantoprazole, omeprazole, lansoprazole and esameprazole) or bismuth to suppress acid production and relieve symptoms while the antibiotics kill the bacteria.

Proton pump inhibitors (PPIs)
A group of medications (including pantoprazole, omeprazole, lansoprazole, esameprazole and raberprazole) that work by binding the H+/K+ ATPase (an enzyme present in the stomach). PPIs are the most effective pharmacological treatment for inhibiting acid production.

H2-Blockers
These drugs inhibit histamine (a substance released by the stomach lining) induced acid production in cells. H2 blockers include medications such as ranitidine, cimetidine, famotidine and nizatidine.

Bismuth
Similar in action to antacids, bismuth was often used as a medication for stomach disorders in the past and is effective against Helicobacter pylori (H.pylori) if used in combination with specific antibiotics.