Peptic Ulcer Disease: Management and Coping

If you have been diagnosed with a peptic ulcer or peptic ulcer disease, your healthcare provider will provide medications to reduce stomach acid. Lifestyle is also an important part of your treatment plan. Learning to reduce stress levels, eating healthy, and avoiding alcohol and certain medications, for example, can help to relieve symptoms and help ulcers to heal.

What Are Peptic Ulcers?

"Ulcer" means an open sore. "Peptic" means it's due to excess stomach acid.

Peptic ulcers are most often either gastric (in the stomach) or duodenal (in the first section of the small intestine, called the duodenum.) It's possible to have either one type or both.

The most common cause of ulcers is infection with Helicobater pylori (H. pylori) bacteria.

Symptoms

Symptoms of peptic ulcers include:

• Pain, often in the upper abdomen
• Food affects the pain (making it better or worse)
• Nausea
• Vomiting
• Bloating or feeling full

Many things can cause symptoms similar to peptic ulcers. Your healthcare provider can help you determine the cause of your abdominal symptoms.

Treatment and Management

If you have an H. pylori infection, treatment may include antibiotics as well as medicines that lower your stomach acid levels. Ulcers that don't heal with treatment may require surgery.

Management can be an important part of living with peptic ulcers. Stress management and lifestyle changes can make a big difference.

Stress Management

While peptic ulcers are caused by the H. pylori bacterium, stress may also play a role. A 2016 study of 17,525 residents of a community in Denmark found that people with the highest level of perceived everyday life stress were at greater risk for peptic ulcers.

This may be because people who are under stress may turn to unhealthy coping mechanisms, such as drinking alcohol, smoking cigarettes, or eating an unhealthy diet, all of which also increase the risk of peptic ulcers. These behaviors can also worsen symptoms in those who already have this diagnosis.

Meditation

Meditation is a good way to reduce your stress. Headspace.com offers free guided meditations to help calm the mind and body. In addition to the website, there is a free app and a paid version with more advanced options.

Breathing

The website Calm.com offers a guided breathing exercise featuring an expanding circle. As it expands, inhale, and as it contracts, exhale. There are also several free apps that can help you practice taking calming breaths. Search the app store to find the one that suits you best.

Therapy

If carving out time for an in-person therapy appointment isn't possible, online therapy can help. Reputable companies providing this service include such as Talkspace.com and Betterhelp.com.

Exercise

Many people find taking a weekly yoga or tai chi class can be helpful for stress reduction. In fact, research shows any type of exercise can combat stress by boosting endorphins, neurochemicals that serve as the body's natural antidote to stress.

Relax

If your go-to stress relievers trend toward unhealthy, find alternative ways to unwind after a hard day. Take a long bath or shower, go for a walk around the block, listen to music, engage in hobbies, or read a book.

Connect

Spending quality time with people who we enjoy can ease our daily burdens. Research shows sharing experiences with a best friend can measurably decrease levels of the stress hormone cortisol.

One particular study found the presence of a loved one can reduce situational stress through emotional load sharing—an effect investigators found is even stronger when people hold hands.

Lifestyle Changes

In addition to reducing stress, healthcare providers say making other lifestyle changes can help reduce symptoms of peptic ulcer disease. Many people with ulcers feel better when they avoid spicy, fatty, and acidic foods. In fact, prior to the introduction of medications that treat ulcers, a bland diet was the recommended course of treatment.

Some people with peptic ulcers find common triggers foods can cause stomach irritation, excessive acid production, and heartburn. Others may not experience symptoms related to specific foods but may react after eating at certain times of the day or eating too much in one sitting.

Lifestyle choices can also irritate and ulcer and lead to uncomfortable symptoms.

More, Smaller Meals

Eating six small meals instead of three big ones keeps your stomach from getting too full and reduces gastric pressure. Be sure to eat slowly as well.

Don't Eat For Two Hours Before Bed

If you take naps, try sleeping in a chair. Lying down with a full stomach can cause stomach contents to press harder against the lower esophageal sphincter (LES), increasing the chances of refluxed food. Gravity will help keep food and stomach acid in the stomach where it belongs.

Avoid Heartburn and Acid-Causing Foods

Several foods and beverages may cause symptoms. Get to know the foods most likely to cause problems for those with ulcers. If you aren't sure what foods trigger your symptoms, try keeping a food diary for a week.

Avoid Alcohol

Alcohol increases the production of stomach acid, which will irritate an ulcer and worsen symptoms. Alcohol also relaxes the LES, allowing stomach contents to reflux back up into the esophagus.

Don't Smoke

Smoking stimulates the production of stomach acid. It can also delay the healing of an ulcer and has been linked to a recurrence of ulcers.

Caution: Over-the-Counter Pain Relievers

Certain medications can irritate the stomach lining, including aspirin and non-steroidal anti-inflammatory drugs (NSAIDs). They can contribute to the development of ulcers in people with H. pylori.

In addition, taking NSAIDs in combination with some medications may compound the problem. These drugs include:

• Corticosteroids
• Anticoagulants
• Selective serotonin reuptake inhibitors (SSRIs)

If you need to take these medicines, your healthcare provider may prescribe another medicine to protect your stomach.

Helpful Tips

Living life and socializing with an ulcer may be tricky, but it doesn't have to be a problem. While sticking to your healthy eating plan by avoiding fatty and spicy foods and abstaining from alcohol is ideal for helping an ulcer heal, it can be difficult when socializing.

These tips can help:

• Try to not overdo it: The more you stray from your healthy eating plan, the more you're likely to have heartburn, indigestion, bloating, and pain.
• Take your medicine: Take your antacid medicine before you go out to try to head off symptoms. Carry antacids (Rolaids, Tums) in your purse or pocket.
• Avoid tight clothing: If you often have bloating, choose stretchy fabrics, elastic waistbands, or loose-fitting pants to help you stay comfortable.