What to Know About Telehealth for Peptic Ulcer Disease

Peptic ulcers are open sores that develop on the inner lining of the stomach and upper section of the small intestine. Getting a diagnosis of peptic ulcer disease may require some testing that must be done in person. However, some management of a peptic ulcer might be done via telehealth.

During the public health emergency of COVID-19, being able to access healthcare professionals through a phone call or video chat has become commonplace and has proven to be helpful. A family physician, primary care provider, internal medicine physician, or gastroenterologist may be accessible via telehealth to treat peptic ulcers.

When to Use Telehealth for Peptic Ulcers

Peptic ulcers are usually diagnosed after completing various tests, such as blood work, breath tests, stool tests, imaging tests, and endoscopic procedures.

Completing these tests and procedures to determine whether you have peptic ulcers will require visiting a medical facility or going to a lab to drop off a sample. However, after peptic ulcer disease is diagnosed, it might be managed through the use of telehealth.

While being evaluated for a peptic ulcer, it's worth asking healthcare professionals if and when a telehealth appointment might be available and useful, as in the following ways.

• Nutritional consultations: It's a myth that ulcers can be caused by spicy foods. They are most often caused by Helicobacter pylori (H.pylori) infection or the overuse of nonsteroidal anti-inflammatory drugs (NSAIDs). However, a telehealth consultation with a dietitian can offer guidance on how to structure an eating plan to help repair damaged tissue and recommend foods that will reduce acid buildup and inflammation.
• Lab work results: You may need to visit a lab or clinic for blood tests. Also, the stool test used to detect H. pylori may need to be dropped off or performed at a commercial lab. Telehealth visits, though, can effectively be used to go over the results of these tests.
• Procedure results: Several types of procedures may be needed to diagnose and evaluate peptic ulcers. These can include a urea breath test, upper endoscopy, upper GI (gastrointestinal) series, or a computed tomography (CT) scan. These all are tests that will need to be done in person, but when the results are ready, they can be discussed over a telehealth visit.

Benefits and Challenges

There will be positives to utilizing telehealth for peptic ulcer disease, but there will also be times when it can't be used or when there are drawbacks. Some patients might find that while their peptic ulcer is being managed, a mix of in-person and telehealth appointments is useful.

Some of the benefits of telehealth appointments can include:

• Convenience: Ulcers can be painful, so not having to travel to a doctor's appointment can be helpful in preventing undue discomfort.
• Saving time: Telehealth can reduce the need to take time off from work or school to travel to and from in-person appointments.
• Frequency: It may be easier to schedule more frequent appointments with telehealth visits compared to in-person visits.
• Cost: With some insurance carriers eliminating co-pays for such visits during the pandemic, meeting for a telehealth appointment may be more affordable than an in-person one. Telehealth may also be an affordable option for those who don't have health insurance or don't have proper coverage as there are companies that offer telemedicine for a flat fee. Costs may vary among providers and geographic areas, so check before booking. Medicaid and Medicare recipients should contact their plan provider to learn more about coverage.

There are also challenges to utilizing telehealth appointments, which can include:

• Technology: Patients will need access to a strong Internet connection as well as a digital device (cell phone, tablet, or computer) they can use for the appointment. Some telehealth services may also require a download of software or an app.
• Privacy: For those who live with others or need to use a public place to access the Internet, it may not be possible to find a quiet space that provides enough privacy to take a telehealth call.
• Paperwork: Not having a printer, scanner, or fax machine may prevent patients from returning the documents needed to be signed and sent in prior to or following the visit.

How to Prepare for a Telehealth Visit for Peptic Ulcer Disease

There are several ways to prepare for a telehealth appointment, including concerning the following:

• Find a provider: Not all doctor's offices offer telehealth services, so it may be necessary first to find a provider that offers them. Your current doctor or insurance company may help you locate telehealth providers.
• Prepare documents: Any paperwork that needs to be completed should be filled out and turned in to the office ahead of time.
• Download apps or software: A new app or software might be needed to attend a telehealth appointment. Practicing with the app beforehand is also a good idea.
• Test device compatibility: Ensuring that necessary software is downloaded and that the microphone and camera on your device are working properly will make everything go smoother. The staff at your provider's office or the technical support staff from the telehealth service can answer questions about how to use the tool.
• Prepare questions: Having a list of questions ready for the appointment will help focus the discussion on what's most important and what needs to be addressed right away versus what can wait.
• Look for privacy: Find a private, quiet space that can be used for the appointment without being interrupted.
• Check the lighting: A brightly lit area can help both providers and patients see each other better and be able to share anything on their screens.
• Record vitals: A provider may ask for height, weight, temperature, pulse, and blood pressure. That might mean having access to a thermometer, scale, blood pressure cuff, or pulse oximeter and using them before a visit. For patients who don't have the tools needed to record these readings, alternate ways of getting the information can be discussed with the provider.

What Happens During the Visit?

Every provider will have their own way of conducting telehealth visits, but visits generally are similar to in-person appointments. The part that will be missing is the physical exam, although some providers may ask patients to do some of the basics themselves (such as taking a pulse). Telehealth procedures may include:

• Virtual waiting rooms: Patients might first speak with a nurse or other staff member who will take some basic information. This might include asking about the reason for your visit, your vitals (including height and weight, temperature, and blood pressure, if necessary), symptoms, current medications, preferred pharmacy, and other housekeeping questions.
• Giving consent: There might also be a need to give consent for the visit, either verbally or electronically within the software or app.
• Signs and symptoms: Once the provider comes on the call, you may be asked again about any signs and symptoms of the ulcer, especially anything that's new since your last visit. You also may be asked whether your prescriptions or any over-the-counter medicines are being taken on time and if they're causing any adverse effects.
• Going over test results: During the visit, the provider will go over any available test results and talk about next steps for treatment and management.
• Patient input: Time often is reserved toward the end of a visit for you to ask any questions you have prepared or that have come up in the visit.
• Ending the visit: There may be a staff member who comes back on the call at the end of the visit (or providers may handle this themselves). They may discuss setting up a next appointment, arranging for prescriptions to be called in to a pharmacy, or making a referral to another healthcare professional or for testing, if needed.

A Word From Verywell

For some patients, a peptic ulcer may be diagnosed and treated without too many roadblocks. For those ulcers that are caused by NSAIDs, stopping those medications will be part of the treatment.

For ulcers caused by H. pylori, antibiotics will be prescribed. It's important to take all of this medication as directed by your physician. If the ulcer clears and doesn't return, there may not be a need for ongoing care. Stool tests or a urea breath test might be repeated at the end of treatment to ensure that the infection has cleared.

Some people, however, may have chronic ulcers. In this case, there will be a need for long-term care, especially for those who need to quit smoking or make other lifestyle changes to prevent the ulcer from returning.

A mix of telehealth and in-person visits could be helpful in managing chronic ulcers to cut down on costs, the time needed to attend in-person appointments, and the discomfort of leaving the house.