Managing Peptic Ulcers

Peptic ulcers are open sores that develop on the lining of the stomach or upper intestines. Symptoms include burning stomach pain, heartburn, a feeling of fullness and bloating, indigestion, and nausea.

If you have been diagnosed with a peptic ulcer or peptic ulcer disease, your doctor will provide medications, including antibiotics to kill Helicobacter pylori bacterium, the underlying cause of peptic ulcers, and proton pump inhibitors (PPI) to reduce stomach acid.

In addition to medication, lifestyle modifications can help you heal. Smoking, drinking alcohol, eating spicy foods, and excessive stress can exacerbate an ulcer once it has formed, and lead to a worsening of symptoms.

Learning to reduce stress levels, eating healthy, and avoiding alcohol and certain medications can help to relieve symptoms and help ulcers to heal.

While peptic ulcers are caused by the H. pylori virus, the old adage that you can worry yourself into an ulcer may still be true. A 2016 study of 17,525 residents of a community in Denmark found people with the highest level of perceived everyday life stress were at greater risk for peptic ulcer.

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.

The following tools can help you to reduce stress:

• Meditation: Headspace.com offers free guided meditations to help calm the mind and body. It is available online and as a free app, along with 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 one-on-one 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 helpful for stress reduction. If you can't get to a class, you can find free tutorials on YouTube. Try Jet Li's Taiji Zen Online Academy's beginning tai chi video or SaraBeth Yoga 10 minute morning yoga for beginners.

In addition to relaxation exercises, doctors say changing the way you eat can be most beneficial in reducing symptoms.

In the past, experts advised people with ulcers to avoid spicy, fatty, and ​acidic foods. However, recommendations were updated in 1991 to note that due to the introduction of medications to manage the condition, it is not necessary to follow a bland diet.

Some people who have peptic ulcers can eat whatever they want with no problems. For many others, however, eating certain foods can cause irritation, excessive acid production, and heartburn. The following tips and resources can help:

• Eat 6 small meals instead of 3 big meals: This keeps your stomach from getting too full. This will also reduce gastric pressure. Another tip is to eat slowly.
• Don't eat or drink anything for at least 2 hours before going to 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 foods that trigger excessive acid production or heartburn:
  There are several foods and beverages that may cause symptoms. Understand the most common foods to avoid, the foods most likely to cause problems for ulcer sufferers. You can also check out a chart of recommended foods for ulcer sufferers. If you aren't sure what foods trigger your symptoms, try keeping a for a week.
• Avoid alcohol: Alcohol increases the production of stomach acid, which will irritate an ulcer and worsen symptoms. Alcohol also relaxes the lower esophageal sphincter (LES), allowing stomach contents to reflux back up into the esophagus. If you still want to consume alcohol, find out how and when to consume alcohol when you suffer from heartburn.

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. Overindulging in rich foods is a recipe for regret. The more you stray from your healthy eating plan, the more you will pay for it with symptoms including heartburn, indigestion, bloating, and pain.
• Take your medicine. If you suffer from heartburn or acid reflux, take your antacid medicine before you go out to try to head off symptoms. Also, carry extra antacids, such as Rolaids or Tums, in your purse or pocket in case symptoms arise while you are out.
• Avoid tight clothing. If bloating is a common symptom for you, choose forgiving fabrics, elastic waistbands, or loose fitting pants to help you stay comfortable after your meal.
• Go easy on alcohol. If you choose to drink, alternate alcoholic drinks with non-alcoholic ones, such as water.

Living with a peptic ulcer can be made easier with some lifestyle modifications. Things you can do to help keep pain and symptoms at bay include:

• Don't smoke: Smoking stimulates the production of stomach acid. It can also delay the healing of the ulcer, and has been linked to a recurrence of ulcers. Find out the other reasons it's good to stop smoking if you suffer from heartburn.
• Relax: Many people believe that stress causes ulcers. While critically ill patients who are on a breathing machine are at risk of so-called “stress ulceration,” everyday stress at work or home doesn't appear to cause peptic ulcers. However, while stress hasn't been linked directly to the development of ulcers, it may lead to behaviors that can trigger ulcer symptoms.
• Avoiding certain over-the-counter pain relievers: Certain medications that irritate the stomach lining—including aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) other than Tylenol, and medications taken along with NSAIDs, including steroids, anticoagulants, and selective serotonin reuptake inhibitors (SSRIs)—can contribute to the development of ulcers in people with H. pylori. If you need to take these medicines, your doctor may prescribe another medicine to protect your stomach.