5 strategies for treating and preventing ulcers

Though stress may make the lining in your gastrointestinal tract more vulnerable, we now know that ulcers are actually caused by bacteria. We'll go over 5 strategies to help combat a nasty ulcer and reduce your risk in the first place.

• Drugs such as omeprazole, lansoprazole, and esomeprazole can heal ulcers and relieve symptoms such as burning and pain. They work by reducing the amount of acid your stomach produces.
• One analysis of 32 trials found that these drugs healed all ulcers (both stomach and intestinal) in more than 95 percent of patients within four weeks.
• Another analysis of 24 trials found that PPIs reduced the risk of bleeding after patients had already had a bleeding ulcer by 51 percent and the need for surgery following a bleeding ulcer by 39 percent.
• Stick to four weeks of treatment; there's no evidence that using PPIs longer than that makes any difference.

• If you have an ulcer and are infected with H. pylori (the bacteria that causes ulcers), you need to not only heal the ulcer, but also get rid of the bacteria. That's where triple therapy comes in.
• 7 to 14 days of treatment with a PPI combined with the antibiotics clarithromycin and amoxicillin or metronidazole typically wipes out the bacteria.
• Eradicating the bacteria slashes your risk of another intestinal ulcer from 67 to 6 percent and of getting another stomach ulcer from 59 to 4 percent.

• These drugs — which include cimetidine, famotidine, and ranitidine — work by blocking the production of stomach acid, but proton-pump inhibitors generally work better.
• Since H2 blockers work differently, doctors sometimes prescribe one of these drugs along with a PPI.

• There is some evidence that garlic supplements can keep H. pylori under control, but according to studies, it won't get rid of the bacteria.
• Milk and cottage cheese won't do anything for your ulcer. In fact, milk appears to increase stomach acid.
• There is some evidence that spicy foods like hot peppers can help eradicate or at least damp down H. pylori. If these foods irritate your ulcer though, you should just avoid them.
• The "good" bacteria found in supplements and yogurt with active cultures won't heal or prevent ulcers, according to an analysis of nine studies. They can, however, reduce the risk of diarrhea associated with the use of antibiotics.

• Go easy on the aspirin, ibuprofen and naproxen. Overuse of these drugs is a leading cause of ulcers along with H. pylori infection.
• If you must take a painkiller regularly, talk to your doctor about also taking a proton-pump inhibitor (PPI), which reduces the risk of ulcers when taking these drugs.

Ulcers are extremely painful and debilitating. Follow these pointers to help reduce your risk of developing an ulcer and to treat them if they do appear.