In a previous issue, we discussed the types of peptic ulcers and the rate of infection with the causes and factors leading to their formation, and today we talk about ways to detect and treat them, as ulcers are usually discovered in one of these two ways:

First: endoscopy, which is the most accurate, in which a long, narrow tube equipped with a camera is inserted into the throat and passed into the stomach and duodenum. With this device, the doctor will be able to see the upper part of the gastrointestinal tract and detect ulcers. In the event of an ulcer, the doctor may take minute samples of tissue near the ulcer, to be examined under a microscope to rule out stomach cancer. The biopsy also reveals the presence of the bacteria Heliobacter pylori in the stomach lining. Because duodenal cancer is so rare, your doctor rarely has to sample a duodenal ulcer. Second: It is also possible to take an x-ray of the upper stomach and intestines to show the stomach and duodenum (when the endoscope cannot be used). Sores, but not all.

In addition to sampling, there are three other tests that will determine whether Heliobacter pylori is responsible for the ulcer:

Blood analysis. This test checks for the presence of antibodies to the bacterium Heliobacter pylori, but it does not differentiate between a past and a current infection with the bacteria. Even after the bacteria are removed from the body, the test may still give a positive result.

Self test. This test may use a radioactive carbon atom to detect H. pylori bacteria. The patient first blows into a small plastic bag, which is sealed later, and then drinks a small cup containing a tasteless or colorless liquid that contains radioactive carbon that forms part of a substance (iodine) that will break it down Bacteria, if present. Thirty minutes later, the patient inflates again another bag, which is also sealed. If he is infected with Heliobacter pylori bacteria, the second breath sample will contain carbon in the form of carbon dioxide

If you are taking a drug called a proton pump inhibitor, it is essential that you stop the drug for at least three days before taking the breath test because it may interfere with the test results.

In fact, the breath test detects the presence of the bacterium Helicobacter pylori in approximately 90 percent of cases, and the blood analysis succeeds in the same proportion as well. But the breath test has the advantage of being able to show the effectiveness of the prescribed treatment to eliminate the bacteria, because it detects almost immediately when the bacteria are dead, but in the blood analysis, the antibodies to the bacteria remain for a year or more after the infection has cleared.

Stool antigen test: This newer test checks for the presence of Heliobacter pylori bacteria in stool samples and is effective in diagnosing bacterial infection and sometimes showing that treatment is effective.

treatment :

A patient cannot treat an ulcer on his own without a doctor’s help. Over-the-counter acid blockers and acid blockers can relieve necrotizing pain, but only for a limited time.

With the advice of a doctor, immediate pain relief can be obtained as well as lifelong healing of ulcers. Since most cases of ulcers are caused by the bacterium Heliobacter pylori, doctors adopt two approaches:

kill bacteria.
Lowering the acid level in the digestive system to relieve pain and aid healing.

To complete these two steps, two and sometimes three or four of the following medicines must be used:

Antibiotics:

There are several combinations of antibiotics that kill the bacteria Heliobacter pylori, and most of these drugs are equally effective and kill the bacteria in about 90 percent of cases, but for successful treatment, it is important to follow your doctor’s instructions carefully. Antibiotics commonly used to treat Heliobacter pylori include amoxicillin, clarithromycin, metronidazole or tetracycline.

Acid blocking drugs:

Also called histamine blocker (H-2), it reduces the secretion of hydrochloric acid in the gut to relieve ulcer pain and speed up healing. In normal cases, this acid does not harm the stomach and duodenum. When there is a defect in the mucous layer that covers the alimentary canal, the acid infiltrates the defect, producing ulcers.

Acid blockers work by blocking histamine from reaching histamine receptors. Histamine is a substance normally found in the body. When it interacts with histamine receptors, the receptors send a signal to the acid-secreting cells in the stomach to release hydrochloric acid.

Acid blockers, available in both prescription and nonprescription types, include ranitidine (Zantac), famotidine (Pepcid), nizatidine (Axid) and cimetidine (Tagamet). For ulcers, prescription acid blockers are more effective because they are more potent than nonprescription drugs.

Acid antagonists:

A doctor may include in a patient’s medication program an antacid that is taken in addition to or instead of an acid-blocking medication. Instead of reducing acid secretion, antacids neutralize the acid in the stomach and provide a quick pain reliever.

Proton pump inhibitors:

One of the most effective ways to reduce stomach acid is by turning off the “pumps” inside the acid-producing cells. Proton-sharking inhibitors lower the acid level by blocking the action of these tiny pumps. They include the following prescribed medications: omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix), but the cost of these drugs is twice the cost of acid blocking drugs, and their uncommon side effects include stomach pain, diarrhea, and headache.