An ulcer, also known as ‘peptic ulcer’ can form on the lining of the gastric (called stomach ulcer) and part of the intestine (called duodenal ulcer). Numerous types of treatment are available to cope with the disease. Typically, treatment is dependent on the underlying cause. The good news, this open sore is often successfully treated. But how do you know if it is completely healed?
Diagnosis and tests
Typically, the first things to look for are the symptoms of the disease. Though the symptoms can vary, abdominal burning or gnawing pain is the most common symptom. The pain can sometimes be severe enough to travel elsewhere in the body such as the neck and back. It usually flares up between meals (with empty stomach) and will relieve for a while when you eat certain foods that buffer your stomach acid.
Other symptoms include; heartburn (acid reflux), indigestion, changes in appetite, unintentional weight loss, general feeling of being sick, nausea, fatty food tolerance, and abdominal bloating. Sometimes there is no any symptom until the complications of the disease develop (internal bleeding from the ulcer, for example).
If your doctor thinks that your ulcer symptoms may be associated with H-pylori infection, he usually recommends urea breath test. In this procedure, you eat or drink something containing a chemical (a kind of radioactive carbon) that can be easily broken down by H-pylori bacteria in the stomach or intestines. Then your doctor will analyze your breath sample to determine whether or not you have H-pylori infection.
Other alternatives to identify the infection include blood and stool tests. But in many cases, the breath test is often accurate enough. And tell your doctor if you’re taking any medications before testing for H-pylori infection. This is important because particular medications (especially antacids) may cause false-negative results.
Since not all people with H-pylori infection develop ulcers, other tests are usually required. These include:
- Upper gastrointestinal imaging tests to get detailed images of your upper gastrointestinal system such as the esophagus, stomach, and also small intestine. This procedure involves the series of X-rays and at the same time you swallow liquid containing barium to make an ulcer become more visible.
- If necessary, your doctor may suggest upper gastrointestinal endoscopy and biopsy. During endoscopy, an endoscope (a flexible, hollow tube equipped with special camera) is slowly inserted through your mouth down into the esophagus, stomach, and upper section of small intestine. To make it comfortable, you are given a mild sedative injection and a local anesthetic. If an ulcer is discovered, small tissue samples are removed for closely examination in a lab.
Gastrointestinal endoscopy and biopsy are more recommended in elderly people and if there are any signs of internal bleeding or other serious symptoms such as difficulty swallowing and extreme weight loss.
There are a number of treatment options for peptic ulcers. The underlying cause of your ulcer usually plays a key role in determining the kind of treatment you need to take. For example, if the disease is caused by H-pylori infection, treatment is focused to cure the infection with antibiotic medications. If it’s triggered by frequent use of pain killers such as aspirin or NSAID, eliminating (if possible) or reducing that medication is required.
A number of treatments are also available to help make your ulcer heal more quickly. Some are as follows:
- Additional medications such as cytoprotective agents, to help give extra protection for your stomach and intestinal lining.
- Medications to help keep your stomach acid in balance. Options include reducing acid production (histamine (H-2) blockers) and blocking acid production (proton pump inhibitors).
How do you know that your ulcer is healed?
Some people with peptic ulcers may not seek medical help until the symptoms become very bothersome. The symptoms may come and go. Interestingly, sometimes the disease heals on its own. But this doesn’t mean that you can ignore it! Treatment is necessary even though the disease hasn’t caused any symptoms.
The disease may turn into serious if left untreated. Even with treatment, sometimes it returns. In worse scenario, the disease becomes resistant or fails to heal (this situation is also called ‘refractory ulcer’).
The following are some reasons that may lead to a refractory ulcer:
- If you’re a smoker and continue smoking during or after treatment. It’s thought that tobacco smoke might also have a role to irritate the tissues that cover the stomach and intestines.
- Not taking your medications as you have been told. For example, it’s important to take the entire course of antibiotics. If you stop taking your antibiotics early, this may cause antibiotic resistance and the infection is not completely healed.
- If you doesn’t discontinue or reduce particular pain medications (NSAIDs) that increase the risk of developing an ulcer.
- In less common cases, a persistent ulcer may be a consequence of an infectious reason other than H-pylori, Crohn’s disease (a condition that can cause ulcer-like sore), stomach cancer, or something else.
So along with using different medications and antibiotics, you need to eliminate any factors that may delay or affect your healing process otherwise you’re at high risk of having a refractory ulcer!
Fortunately most people with ulcers (especially if the disease has not caused its complications) usually have a complete recovery, regardless of the underlying cause.
And again, it’s important to treat the disease completely since there is a chance for the disease to come back and cause serious complications. For this reason, you may have a number of follow-up visits and tests after treatment to see whether your ulcer is completely healed, especially true if it was in the stomach.
For more guidance, ask your healthcare provider whether you should take follow-up tests after treatment!
If you’re at higher risk of developing the recurrence, you may need to take an endoscopy, breath test, or other additional tests after therapy. Typically, these follow-up tests are performed at least two weeks after treatment – otherwise test results may not be accurate enough.
The chance of developing the recurrence varies. But if H-pylori infection is successfully cured, the disease is less likely to return. Recurrence associated with reinfection of H-pylori bacteria is rare in the North America and Europe, except in overcrowded areas with poor sanitation.