When a person is diagnosed with a stomach ulcer, doctors will often prescribe a combination of medications to help eliminate the cause of the ulcer (H pylori) and reduce the amount of acid that comes into contact with the exposed area, which can reduce stomach ulcer symptoms.
Two different antibiotics may be used to kill off the H pylori bacteria. A proton-pump inhibitor (PPI) and an H2 blocker are also commonly prescribed during treatment to assist with reducing stomach acids. Each of these medications carries certain side effects. While many side effects are mild or not harmful over time, they can seem significant to individuals.
Severe side effects are the leading cause of failed stomach ulcer treatments. Stomach ulcer medication side effects can be intolerable and a new medication must be implemented before continuing treatment. This can be a big challenge for some patients because there isn’t always another medication that will work for the patient because of allergies or other health conditions.
Some of the most severe side effects of stomach ulcer medications include hallucinations, peeling and blistering skin, convulsions, and blindness. These are considered extreme side effects and are comparable to “severe allergic reactions” for most physicians and require the person to be taken off of the medication that causes the side effects. Severe allergic reactions include hives, rashes, swelling of the face, neck or tongue, severe vomiting, and respiratory symptoms.
While most severe side-effects are rare, there are a number of common side effects that simply interrupt life for many people. Constant nausea, dizziness, headaches, coordination problems, and pain can be medication side effects that are debilitating for some.
Below we have listed some of the major reactions that can cause a patient to cease treatment for stomach ulcers due to medication side effects. These are not complete lists of side effect and each medication carriers a long list of possible reactions.
Side Effects of Antibiotics Used to Treat Stomach Ulcers
There are four antibiotic drugs that are most often employed when treating stomach ulcers. These are Metronidazole, Tetracycline, Clarithromycin and Amoxicillin.
Metronidazole side effects include severe allergic reactions, decreased coordination, numbness, tingling, seizures, severe diarrhea, severe or persistent dizziness or headache, speech problems, stomach pain or cramps, and vision loss.
Tetracycline side effects include severe allergic reactions, black hairy tongue, blurred vision, diarrhea, difficulty swallowing, headache, inflammation or redness of tongue, joint pain, sensitivity to sunlight, stomach pain, and swelling and itching of the rectum.
Calrithromycin side effects include severe allergic reactions, confusion, depression, dizziness, mood changes, fast or irregular heartbeat, hallucinations, loss of taste or sense of smell, muscle weakness, nightmares, seizures, severe diarrhea, severe stomach pain, jaundice, severe or persistent nausea, loss of appetite, tremors, and trouble sleeping.
Amoxicillin side effects include severe allergic reactions, confusion, red, swollen, blistered, or peeling skin, seizures, severe diarrhea, stomach pain, unusual bruising or bleeding, and jaundice.
Side Effects of H2 Blockers Used to Treat Stomach Ulcers
There are four H2 blockers that are most commonly prescribed to treat stomach ulcers. These are Famotidine, Cimetidine, Ranitidine, and Nizatidine.
Famotidine side effects include severe allergic reactions (difficulty breathing, tightness in the chest, swelling of the mouth, face, lips, or tongue), seizures), and irregular heartbeat.
Cimetidine side effects include severe allergic reaction, agitation, anxiety, breast lumps, confusion, depression, disorientation, hallucinations, hair loss, joint and muscle pain, sexual difficulties, and slow or fast heartbeat.
Ranitidine side effects include severe allergic reactions, confusion, red, swollen, blistered, or peeling skin, seizures, severe stomach pain, unusual bruising or bleeding, and jaundice.
Nizatidine side effects include severe allergic reactions, abdominal pain, jaundice, headache, insomnia, and dizziness.
Side Effects of Proton-Pump Inhibitors Used to Treat Stomach Ulcers
There are three proton-pump inhibitors (PPIs) that are usually prescribed to treat stomach ulcers. These are Omeprazole, Lansoprazole, and Pantoprazole.
Omeprazole side effects include severe allergic reactions, bone pain, chest pain, irregular heartbeat, red, swollen, blistered, or peeling skin, seizures, severe diarrhea, severe stomach , unusual bruising or bleeding, vision changes, and jaundice.
Lansoprazole side effects include severe allergic reactions, chest pain, confusion, depression, fainting, fast or irregular heartbeat, mood changes, numbness of an arm or leg, red, swollen, blistered, or peeling skin, ringing in the ears, seizures, severe headache, dizziness,; severe stomach pain, severe nausea, severe vomiting, shortness of breath, unusual bruising or bleeding, joint pain, muscle pain, vision, hearing, or speech changes, vomit that looks like coffee grounds, and jaundice.
Pantoprazole side effects includes severe allergic reactions, bone pain, chest pain, fast or irregular heartbeat, red, swollen, blistered, or peeling skin, unusual bruising or bleeding, unusual tiredness, vision changes, and jaundice.
Stomach ulcer self-tests are available at many online health stores to help determine if you might have a bacteria in your body that is known to cause stomach ulcers. While only a doctor can determine the presence of ulcers with complete certainty, stomach ulcer self-tests can help to confirm the need to visit a doctor about your condition.
If you feel a gnawing pain in your abdomen or a burning sensation around your stomach, you might have stomach ulcer symptoms. There are a few reasons that this may happen, but the most common reason is found in 90% of all people who have stomach ulcers.
Bacteria known as H pylori live in the gut of a third of the world’s population. These bacteria can remain dormant and have little impact on most people for very long periods of time or even an entire lifetime. However, a bacterial infection that causes the over production of acids and stomach ulcers does develop in many people.
The bacterial infection causes gastritis, or chronic swelling of the stomach. This swelling leads to the over production of stomach acids that, in turn, eat away the lining of the stomach and causes sores – also known as stomach ulcers.
Stomach Ulcer Self-Tests
Stomach ulcer self-tests are used to detect the H pylori bacteria in a person’s body. The test works by detecting antibodies in your blood that are created by the immune system in response to the presence of H pylori bacteria colonies.
Most stomach ulcer-self tests use a small drop of blood, similar to the amount used when a diabetic is testing blood-sugar levels. The self-test contains a small strip and a cassette. Once the blood is on the strip, it is placed in the cassette which will reveal either a positive or negative result for the antibodies that fight H pylori.
Important Info about H pylori or Stomach Ulcer Self-Tests
H pylori testing kits are a good way to find out if a person has this bacteria living in the body. Gastric swelling is a common effect of H pylori infection and can lead to stomach ulcers, even if you aren’t currently dealing with one.
Gastric swelling can also cause us to feel bloated and increases the amount of stomach acids we produce. This can cause significant acid-reflux related symptoms that damage the esophagus and other parts of the digestive system.
Stomach ulcer self-tests are not always accurate and can sometimes show negative results in people that have are carrying the bacteria. However, this type of test can help you decide to seek medical attention if the test shows a positive result for the antibodies.
An important thing to remember when using stomach ulcer self-tests is that they do not confirm the presence of a stomach ulcer, even though they may be named as such. Even though the majority of people with stomach ulcers do have an H pylori infection, the majority of people with H pylori antibodies (and therefore, H pylori bacteria) do not have stomach ulcers.
If we look at the numbers involved, we can see that H pylori related stomach ulcers really should be diagnosed by a doctor. As of 2010, there were nearly seven-billion people in the world. One third of those people are likely carrying the H pylori virus; that’s about 2-billion people.
Among these 2-billion people, only 10% will develop stomach ulcers (200 million). This means that there are more than one-billion, five-hundred million people who do NOT develop stomach ulcers because of H pylori bacteria. That is a big number!
Consult a Doctor Following Stomach Ulcer Self-Tests
While you might have the H pylori virus and it might be causing gastritis (chronic stomach swelling) that will eventually lead to a stomach ulcer, it isn’t conclusive evidence that a person actually has a stomach ulcer.
There are many symptoms associated with stomach ulcers that are caused by a plethora of other conditions. This is why a doctor needs to be involved in diagnosing the condition. What’s more, a doctor will conduct the same H pylori test (or similar test) to confirm what the self-test concluded.
Doctors have three options in confirming the results of a stomach ulcer self-test: another blood test, a fecal test, and a breath urea test. Once H pylori is confirmed and even when the bacteria is not found, there are other testing procedures a doctor can use to check for stomach ulcers.
An endoscopic procedure is the standard method by which medical professionals will check to see if a person has developed stomach ulcers. By inserting a camera into the stomach, through the mouth, they can see visual signs of sores in the stomach lining and accurately diagnose stomach ulcers.
Following this diagnosis, doctors generally prescribe a course of antibiotics in combination with acid reduction medications. The antibiotics, up to two varieties, are used to kill off the bacteria. The acid reducers will create a less acidic environment and allow the stomach ulcers to heal. Additionally, they may prescribe medications or recommend over the counter products that soothe the stomach and relieve the symptoms of a stomach ulcer.
For those that suffer from stomach ulcers, it is a good idea to avoid tea that contains caffeine because it promotes the secretion of stomach acids. Stomach acid is often the cause of ulcers and can cause make stomach ulcer symptoms worse and delayed healing of existing stomach ulcers.
There are other kinds of tea that do not contain caffeine and do not irritate stomach ulcers. Some of these types of teas are considered to be herbal remedies for all sorts of digestive conditions, including gastritis, stomach ulcers, and other related acid reflux disorders.
The Positive and Negative Effects of Tea on Stomach Ulcers
Since caffeine causes increased production of stomach acids, teas that contain the agent also cause an increase in stomach acids. Additionally, caffeinated teas are often mixed with sugar or lemon to add sweetness and flavor. As a fatty food, sugar can increase stomach acid production and as an acidic food, the same is true for lemons.
There are four components in tea that directly impact stomach acids and therefore, stomach ulcers. These four components are: caffeine, tannin, catechin, and flavonoids.
Caffeine and Tannin in Tea Can Harm Stomach Ulcers
A natural element in tea, tannin, creates varying levels of acidity when entering the stomach. Tannin gets stronger when tea is over-brewed, which means that brewing time is really an important factors to consider in relation to stomach ulcers and tea consumption.
Strong tea that is brewed for a long time tends to taste bitterer. That bitter flavor is tannin. Tannin is also the element that makes red wine taste dry or makes our mouth pucker when we eat sour fruit. It might be one of the reasons that people who suffer from stomach ulcers experience an increase in symptoms after eating some fruits (except citrus), nuts, spices, and even chocolate that contains tannin or tannic acid.
Tannin is a type of polyphenol, a plant-based molecule that helps to bind the nutrients found in tea leaves. While many believe that tea also contains tannic acid, a form of tannin, it actually is void of this direct acid. Instead, tea interacts with the stomach (especially if it contains caffeine) and causes acid production in the organ.
Many herbal teas that contain no caffeine can be beneficial in the treatment (and prevention) of stomach ulcers because they are caffeine free and have low acidity, but still contain beneficial properties.
As long as teas are not over-brewed, even darker teas can be inconsequential to stomach ulcers. The trick is to make the cup of tea as weak as possible, eliminated most of the caffeine and tannins.
Catechins in Tea May Help Stomach Ulcers
Catechins have been known to reduce the amount of acids that come into contact with stomach ulcers and are naturally present in many kinds of tea. (Though there is no evidence that it prevent acid secretion from gastritis.) The antioxidant properties in catechins might help with this.
These compounds may also promoted healing of stomach ulcers by neutralizing some of the components in stomach acid. At least one study found that cathechin in tea helps to protect the stomach lining and prevent stomach ulcers from forming by increasing the amount of mucus in the stomach lining.
Flavonoids in Tea May Help Stomach Ulcers
Flavonoids are well studied in the medical community. Teas that contain flavonoids can help to prevent stomach ulcers by adding to the mucosal lining that protects the soft tissue of the stomach from the extra acids secreted when gastritis forms.
Much like catechins, flavonoids are great antioxidants and protect cells from damage as well. Over a long-term battle with stomach ulcers, teas might help prevent cancer cause by cell mutations in the stomach ulcer area. Flavonoids in tea and other plants may also prevent stomach ulcers from becoming worse and are being considered for incorporation into the main-stream treatment methods for stomach ulcers.
Types of Teas to Avoid with Stomach Ulcers
For regular-brewed tea, there are some types of tea leaves a person with stomach ulcers should avoid.
Orange and black pekoe tea is the most common type of tea containing caffeine. Tea bags from the grocery store made available by Lipton and other brand names contain orange and black pekoe tea leaves.
This is type of tea you will drink if you order tea from a restaurant, drink pre-bottled “sweet tea”, and is the tea used in Brick, Nestle, and other commercially available tea products.
As a general guide:
Black Tea contains 23 – 110 mg of caffeine per cup
Oolong tea contains 12-33 mg of caffeine per cup
Green tea contains 8 – 36 mg of caffeine per cup
White tea contains 6 – 25 mg of caffeine per cup
If you drink these types of tea, try a cool brewing method. Also, most caffeine is leeched from the leaves and into the water within half a minute during brewing. To drastically reduce the amount of caffeine in a cup of tea, simply brew for 30 seconds, toss the tea water, and brew again in fresh water using the same leaves or tea bag.
Types of Teas that are Okay with Stomach Ulcers
Herbal teas that are steeped properly as described above can be beneficial to stomach ulcers. The leaves of many different types of plants contain flavonoids, catechins, and many other natural properties that soothe stomach ulcers and reduce acids in the stomach.
There are too many to list and a person with stomach ulcers must always consider possible interactions with medications that are prescribed to treat stomach ulcers. But in general, the following plants may be brewed into a tea that is beneficial to stomach ulcers.
Bael Leaf Tea
Flax Seed Tea
Black Liquorice Tea
Pomegranate Tea (Be careful with this one since pomegranate is a notable fruit containing tannin. and avoid over-brewing.)
Many home remedy experts taught the general benefits of green tea, too. However, it is important for a person with stomach ulcers to remember that caffeine is an enemy and green tea does contain caffeine.
It also contains antioxidants that are good for a healthy system, but new studies show that in doses that are too high, green tea can have a reverse effect and cause oxidation. Oxidation stress has been linked to ulcer aggravation in some studies.
Stomach ulcers are affected by the things we consume. Some foods irritate the stomach or cause an increase in acids that make stomach ulcer symptoms worse. Other foods are beneficial to stomach ulcers and ease some of the irritation we feel.
Stomach ulcers are small holes in the protective lining of the stomach, duodenum, or pyloric channel that can cause gnawing abdominal pain and burning. They can be caused by H pylori induced gastritis (swelling), the over use of NSAIDs (pain medicine), and in rare cases are cause by malignant tumors.
However they are caused, stomach ulcers can grow to become very painful and often require treatment with multiple prescription medications if left unchecked. With the aid of drugs that kill any infection causing bacteria and those that reduce stomach acids, we can help stomach ulcers heal by avoiding certain foods.
Soda Beverages Should be Avoided
Of the foods that are known to aggravate stomach ulcers, soda-based beverages are among the worst offenders. Most soda beverages contain caffeine, an agent that is known to cause an increase in the production of stomach acids.
Stomach acids are useful in the digestion of foods, but can become a problem when they are secreted in large volumes. Stomach ulcers develop because of a break in the lining of the stomach, often caused by too much acid.
To make things worse, these acids continue to wash over the break in the protective lining and cause raw spot, or sore, that we call a stomach ulcer. As the spot is continually washed with stomach acids, the ulcer becomes worse and becomes more painful.
So, soda beverages that contain caffeine can make ulcer pain worse by increasing the amount of stomach acid that comes into contact with the ulcer. The carbonation in soda beverages can irritate stomach ulcers, as well. This also promotes the production of stomach acid. (Carbonation also promoted gastric pressure, which can lead to heartburn if there is also a large amount of acid in the stomach.)
What are Some Other Stomach Ulcer Irritants?
In addition to soda, there are some other foods that contribute to painful symptoms of stomach ulcers by prompting the stomach to create extra acids for digestive purposes. Any food that is high in fat or prepared with high-fat ingredients can be avoided to reduce stomach acids.
Examples of high-fat foods include breads like biscuits and croissants, because of their ingredients. Whole milk, chocolate, cream, and buttermilk are also high in fat and cause more stomach acids to be produced for digestion. Anything fried in oil is also likely to set-off the stomach ulcer symptoms we want to avoid.
Food that is very seasoned and soups containing a large amount of fats should also be avoided. Caffeine, as mentioned above, will cause more acid as well. Avoid coffee, tea, and dark chocolate.
Finally, alcohol and smoking should be avoided if you have a stomach ulcer because both of these irritate stomach acids and can lead to stomach ulcer pain. Smoking prevents healing, too.
The Good Soda for Stomach Ulcers
A different type of soda, sodium bicarbonate, can be beneficial in dealing with stomach ulcers. Sodium bicarbonate, or baking soda, may be found in some of the antacids we use to help control the symptoms of heartburn.
As a treatment for the symptoms of stomach ulcers, baking soda helps to neutralize stomach acids and reduces the main cause of ulcer pain. It may also help stomach ulcers heal faster since the acid is less caustic to the delicate tissue after it is neutralized by the baking soda.
It is a good idea to discuss the use of baking soda with a doctor before using it to treat stomach ulcers. Baking soda is generally safe, but it can interact with some medications and has the potential to cause adverse health effects.
A doctor can tell you about drugs that contain baking soda and are specifically design to help with acid problems, such as stomach ulcers. The proper dose must also be used to avoid any complications and to ensure that the baking soda will be effective as a therapy.
In general, baking soda can be taken through the use of antacids or effervescent tablets dissolved in water to assist with stomach ulcer pain and healing. Most people find that it is most beneficial if consumed right before bedtime or shortly following a meal.
A stomach ulcer endoscopy is a procedure which allows medical professionals to see the inside of a person’s digestive system. This is usually a painless procedure that is recommended when a person is showing the signs of a digestive issue and when a stomach ulcer or other digestive disorder is suspected.
An endoscopy procedure employs the use of an endoscope, a special tool for viewing the inside of the body. The endoscope can look for stomach ulcers in the stomach, the esophagus, and the duodenum. It can allow doctors to collect tissue samples from a stomach ulcer and aid in small, non-invasive surgical procedures.
It can also look in the small intestine, large intestine and colon, respiratory system, urinary tracts, reproductive systems, and more. In short, this is a well-tested method of diagnosis and is very useful for exploring the internal organs when a stomach ulcer is suspected.
A stomach ulcer may be suspected if a person frequently passes blood in their stool, vomits blood, has a gnawing or burning sensation in the chest or abdomen, abdominal pain, loss of appetite, bloating, waterbrashing (flood of saliva following regurgitation), chronic acid reflux, or when a person experiencing any of these symptoms tests positive for h. pylori bacteria, regardless of the presence of H pylori symptoms.
People with gastritis (swelling of the stomach lining) are also especially at risk of developing stomach ulcers.
Why Endoscopy and Diagnosing Stomach Ulcers is Important
Even though less than half of the people who have stomach ulcers seek treatment, stomach ulcers can pose significant health risks over time – even to otherwise healthy individuals.
The first formidable result of long-term stomach ulcers is stomach cancer. Over time, stomach ulcers can become malignant. As cells are damaged over a long period of time, they are at risk of mutation.
Mutation to cancer is when the DNA in a cell starts telling the cell to divide and multiply when normally it wouldn’t. Once we reach a certain stage of development, these cells are supposed to stop replicating. Enlarging the stomach lining can cause organ dysfunction, which is how cancer becomes lethal in most cases. People who have a family history of cancer are especially at risk of this outcome.
Stomach ulcers can also cause perforations in the stomach or duodenum in case of a duodenal ulcer. A perforation occurs when a stomach ulcer has been active for so long that the acids in the stomach erode a hole completely through the mucous layer, exposing the delicate tissues beneath and, in some cases, the body cavity to gastric acids.
The structures outside of the stomach lining are not protected by the same type of mucous lining that helps prevent stomach ulcers. This condition in which gastric acids leek into the body cavity is known as chemical peritonitis and is a medical emergency that must be treated immediately.
People who are over 45, have a history of acid production problems and stomach ulcers are the most at risk of developing perforations.
Any sudden pain in the breastbone, stomach, or upper abdomen should be cause to seek emergency medical care. As the stomach acids spread, the pain will spread. This is because the gastric acids are significantly eroding surrounding tissues that may include the lungs and all other digestive organs.
What to Expect during an Endoscopy
To view the inside of the stomach, doctors use a special tool called an endoscope that is inserted directly into the stomach. An endoscope is a small camera and a light source attached to one end of a thin tube. The camera might be a lens or a bundle of fiber-optic leads.
This tube is inserted through the mouth and gently fed down the throat and into the stomach. Since the endoscope tube is usually made to be flexible and outfitted with controls on the end that the doctor will hold, he or she can turn the camera to view all parts of the stomach.
The camera’s images are usually displayed on a screen in the same room that the procedure takes place to allow doctors to see the lesions we know as stomach ulcers, but some endoscopes utilize and eyepiece through which the doctor views the inside of the stomach.
In cases where a doctor is unsure of the reason for a stomach ulcer discovered through the procedure, the endoscopy may include a tissue sample. During this procedure, known as a biopsy, a doctor cuts away a very small portion of tissue so that is can be closely examined under a microscope.
This is accomplished with the help of a small cutting tool in the thin tube, just like the camera. Some endoscopic cameras are equipped with biopsy extraction tools and others have a special space through which the tool can be inserted.
A stomach ulcer is a raw area, or sore in the lining of the inside of the stomach that is about the size of a quarter in some cases. Ulcers can also occur just below the stomach in the duodenum.
Both of these types of ulcers, known generally as peptic ulcers, can cause a variety of symptoms in addition to constipation including nausea, burning sensations or gnawing pains. You might feel these symptoms in the chest or upper abdomen and they may last for a couple of hours.
Stomach ulcers are caused by acids in the stomach (gastric acids) that eat away at the mucous layer that lines the stomach. Once the acids are in direct contact with the tissues that make up the internal lining of the stomach, they begin to erode the surface and leave raw areas that are painful as new acids flow over them.
Constipation occurs when a person has fewer than three bowel movements in a week and is typified by the slow movement of stool through the colon. You may also be experiencing constipation if you have trouble passing stools, the stool is hard, or you are unable to pass all stools more than 25% of the time.
Some of the reasons may have stomach ulcers and constipation include common triggers including inadequate fiber intake and a disruption in routine; stress for example. Dairy products can also cause stomach ulcers to produce more symptoms such as constipation.
Antacids that are often taken by stomach ulcer sufferers contain aluminum, agents of which can cause constipation. Aside from the immediate relief these antacids might bring for stomach ulcer pain, the symptoms quickly return following their use. Long-term use of antacids for stomach ulcer symptoms is not recommended because of complications like constipation and blood poisoning.
What Other Things do Stomach Ulcers and Constipation Have in Common?
Stomach ulcers and constipation may be caused by the same types of foods, in the broad view of things. Peptic ulcers are often caused by a poor diet, though they are also caused by taking over the counter NSAID medications such as aspirin and ibuprofen. Constipation is often caused by a poor diet as well, but may be a side effect of medication or other condition.
On the subject of diet, stomach ulcers and constipation share the following triggers and causes:
Meats – Too many animal proteins can cause constipation. Meats also carry a lot of fat, something that causes the stomach to produce a lot of acid for digestion.
Fiber – Too little fiber in one’s diet causes constipation. Likewise, eating processed fibers (bleached flour, for example) instead of whole fibers can reduce the mucous layer in the stomach that protects the tissues from stomach acids that cause ulcers.
Spicy Foods – Heavily seasoned food is dehydrating – the most common cause of constipation. Spicy foods also increase stomach acid production that can lead to ulcers.
Stress, Anxiety, and Depression – These psychological states cause the stomach to produce acid that leads to stomach ulcers and can cause constipation.
Treating Constipation Caused by Stomach Ulcers
Keep in mind the cause of constipation in general – lack of hydration, large amounts of fats and animal proteins, lack of exercise or disruption in normal routines. Sometimes medications may cause side effects that include constipation and this should be discussed with a doctor if it becomes a problem. Also, stomach ulcers aren’t the only cause of constipation and may not be the reason a person is constipated.
Barring a neurological disorder or medication side-effect, there are a few techniques for dealing with constipation:
Drink plenty of water. Dehydration is the leading cause of constipation.
Eat plenty of whole fibers. Avoid processed fiber like flour – it can make stomach ulcers worse and makes stool harder.
Avoid eating large amounts of dairy products and animal proteins in general. Not only do these cause stomach ulcers and make it hard to pass stool, they contribute to almost all digestive conditions.
Do not over use laxatives. Over time, they weaken bowel muscles. Laxatives should be used in cases where you are in pain or can’t remedy the problem in another way.
Do not over use antacids for stomach ulcer symptoms. Instead, consider another type of medication like a PPI or H2 blocker that will accomplish acid reduction instead of acid treatment.
Avoid taking too many non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin. They tear away the mucosa in the stomach and can lead to ulcers. Also be wary of narcotics, antidepressants, and iron pills because they can harden stool.
The seemingly innocuous tropical fruit may indeed be a fruit to cross off of your list if you have a stomach ulcer, as its effect on digestion could potentially be a negative influence for those with stomach ulcer symptoms.
Bromelain, an enzyme found primarily in pineapples, has been the topic of recent study for its wide-ranging and powerful effects on the human digestive system. This enzyme breaks down the bonds that hold proteins together and acts as an anti-inflammatory inside the human body.
In a very recent study was examining the effect of pineapple on the effect of bromelain on digestion, researchers mentioned that bromelain (which is found in pineapples) inhibits the secretions of the digestive tract (1).
If the magnitude of this is not yet sinking in, NSAIDs like aspirin, ibuprofen, and naproxen are the primary factor behind non-Helicobacter pylori ulcers. They act in the same way; NSAIDs are a class of anti-inflammatories that happens to have the side effect of reducing stomach secretions. This in turn makes the stomach lining vulnerable to its own acid, which in turn leads to ulceration.
Practical Application – Should I Eat Pineapples?
You will want to take all information such as this with a grain of salt. It is not likely that eating pineapples will give you an ulcer, as we would have likely noticed this long ago. However, you have to consider that pineapple is not a dietary staple in modernized countries.
It is possible that high quantities of bromelain may not be ideal. It is also possible that people with preexisting ulcers find their symptoms worsen after eating pineapple. If you have an ulcer and are not sure, use your own pain as a guide; if you eat pineapple and it makes your stomach hurt, you will want to avoid that in the future, at least for your own personal comfort if nothing less.
More importantly though, some people do get bromelain in supranatural quantities through supplementation. Bromelain supplements have become very popular over the last decade, especially in the holistic and alternative medicine communities.
Given that we know that ulcers can be caused by regular usage of NSAIDs (which reduce stomach secretions), it is possible that people who take large quantities of bromelain or other “anti-inflammatory plant enzymes” could suffer a similar fate through the same mechanism.
I do not mean to throw these supplements under the bus, but you do have to remember that supplements go on the market without any testing for their long-term effects, so really we have no way of knowing if there are still long-term effects for these enzymes.
Just because they come from a plant does not mean they are healthy – we know very large quantities of isoflavones from soy can have all sorts of side effects (due to its estrogen-mimicking effects), so do not think something untested is safe just because it comes from a plant.
Pineapple and Ulcers Conclusion
There is no real evidence to suggest that people eating normal amounts of pineapple in their diet (i.e. occasionally) will be more likely to suffer from ulcers or have heightened symptoms.
However, using supranatural amounts of bromelain through supplementation does decrease intestinal secretions (at least in mice) (1). This may make bromelain supplements unsafe for people who have a current or past history of peptic ulcer(s).
1. Borrelli, F. Inhibitory effects of bromelain, a cysteine protease derived from pineapple stem (Ananas comosus), on intestinal motility in mice. Neurogastroenterol Motil. 2011 Jun 21. [Epub ahead of print]
Since the dawn of the discovery of peptic ulcers, many homegrown remedies have traditionally involved the recommendation of adding milk to the diet in order to coat the stomach and soothe the ulcer.
However, does modern science support that notion? Not at all. Below, you will find out why milk is no longer advised as part of a stomach ulcer diet.
Cause of Ulcers
Back when milk was recommended as a remedy for ulcers (circa de 1940-1970), doctors initially attributed this to lifestyle (smoking, stress, drinking) and diet (spicy and fatty foods). The idea was that milk was a wholesome, healthy, food that would coat the lining of the stomach and protect it from acid. Milk was also a popular heartburn remedy at this time.
However, since the early days of ulcers, our understanding of what causes ulcers has rapidly changed. We now know that the vast majority of ulcers are caused by H pylori infection (a bacteria which lives in the stomach and small intestines) rather than diet or lifestyle choices. The vast minority of remaining ulcers is related to the regular use of NSAIDs (aspirin, naproxen, and ibuprofen).
Milk does nothing to battle H pylori, and certainly cannot reverse the harmful effects of NSAIDs, and as such it is not effective as an ulcer remedy. It turns out that milk and ulcers have no real relationship and milk is not even effective at reducing stomach ulcer symptoms.
Does Diet Have Any Influence on Ulcer Healing?
While milk and ulcers have no real relationship, now that we better understand what causes ulcers, there are a few things we can do to help out ulcers via diet.
In particular, people should aim to eat real food and a diet rich in vegetables, fruits, and protein. Antioxidants in vegetables and fruits help minimize inflammation in the stomach, and protein is needed to provide the raw materials for the body to use to repair the stomach lining.
However, these are only mild aids to ulcer recovery. The medications used to treat H pylori are necessary. These medications, collectively known as triple therapy, include two antibiotics to fight H pylori and either a proton-pump inhibitor or H2-blocker to reduce acid production and promote ulcer healing.
One further supplement you might considering adding to your stomach ulcer diet is some sort of probiotic, particularly after triple therapy is finished. The antibiotics used to treat H pylori are extremely harsh and wipe out much of the beneficial flora in the gut. Adding in a simple probiotic can help restore these bacteria which become the victim of collateral damage. This may help improve digestion and speed ulcer healing times as well, but is again not a substitute for medical treatment.
Milk and Ulcers Conclusion
Using milk for ulcers is just an old home remedy that has been passed down from generation to generation and is simply not current with our modern understanding of ulcers. Medical treatment is necessary for the healing of ulcers.
A diet consisting of plenty of fresh fruits and vegetables and some solid sources of protein may help bolster ulcer healing, but is no replacement for triple therapy.
If you have a peptic ulcer (commonly known as a stomach ulcer), you will need to see a doctor eventually to get it treated. Ulcers do not typically go away on their own and medical treatment is necessary.
So, where do you turn? In this article, you will find a handy guide for picking the right doctor for your stomach ulcer.
Primary Care Physicians versus Specialists
Your first decision you need to make is whether you want to see your primary care physician (PCP) or see a specialist first. There are pros and cons to each approach when it comes to looking at ulcers.
Reasons to See Your Primary Care Physician First
For many people (though this may vary by country), many insurance policies dictate that you must see your primary care physician first and get a referral before seeing a specialist. Naturally, you will need to take this route if you are required by your insurance company to do so.
However, the real reason you might want to see your primary care physician first is if you have pre-existing health conditions, have allergies, or take other prescription medications. Also, it is always a good idea to run your stomach ulcer symptoms by a doctor first, as self-diagnosis is prone to error, and getting an appointment with your PCP is much easier and faster than getting one with a specialist.
A specialist may not have the time to go over your medical health history like a primary care physician might. The PCP’s real strength is helping coordinate the recommendations of specialists so that there are no harmful interactions and your health history is firmly considered before making any treatment recommendations.
Finally, some primary care physicians have the equipment to perform an urea breath test, the standard test for H pylori. In this case, having the procedure (which is very simple) performed at your PCP’s office is much more convenient and less expensive.
For these reasons, it is recommended you see your primary care physician first, even if you elect to ultimately take the opinion of a specialist.
Reasons to See a Specialist
If you have an ulcer, you may want to see a gastroenterologist. Gastroenterologists (often abbreviated GI) are doctors who specialize in the digestive tract.
There are a lot of good reasons to see a GI. Gastroenterologists will have access to more specialized equipment (such as the equipment needed to perform H pylori testing) and are much more likely to be up to date on the latest research and treatment techniques.
For example, according to a 1998 study, 50% of surveyed general care practitioners were treating ulcers with H2-blockers and proton-pump inhibitors without testing for H pylori (1). In fact, the surveyed doctors never even recommended testing for H pylori or used triple therapy, despite H pylori testing being considered the gold standard for ulcer treatment amongst the vast majority of health organizations in North America!
In the same survey, just over 1/4 of specialists followed this same practice, whereas the vast majority of specialists had started testing for and treating H pylori (1).
Now, remember this survey was done back in 1998, and since then, H pylori testing has come more mainstream. There are very few specialists left in the country that do not perform H pylori testing. Given that you want H pylori testing, this is a good thing.
The point is that your PCP may or may not be up to date on the latest ulcer treatment techniques. There are many, many diseases and treatment recommendations and technological advances are changing all the time. This is why we have specialists.
Choosing a Doctor and Preparing for your Appointment
For many of us, at least in the United States, there are only so many choices for doctors due to insurance policy programs.
With that said, it is a good idea to visit your PCP first so they can confirm whether your symptoms are indeed that of an ulcer and whether they might think it is something else. If your doctor suspects an ulcer, he will likely refer you to a specialist for testing (unless he or she owns the equipment for testing).
If you do see a specialist and are going in for an urea breath test, you should call ahead to ask what type of test they want to perform. Some urea breath tests are fasted whereas others are not. Some tests can be performed as little as twenty minutes after eating (2).
Choosing a Doctor for Your Stomach Ulcer – Conclusion
In the end, if you have a stomach ulcer you will likely want to see both your primary care physician and a specialist.
Your primary care physician will be able to not only cross-check your symptoms, but may be able to point out possible drug, allergy, or medical history interactions that could be useful for the specialist to know.
A specialist is likely to be up to date on the latest treatment procedures and have the specialized equipment needed to test for H pylori.
By visiting both types of doctors, you give yourself the best chance for obtaining an accurate diagnosis as well as getting a safe and effective treatment plan.
1. Malaty, H.M., el-Zimaity, H.M., Genta, R.M., Klein, P.D., & Graham, D.Y. Twenty-minute fasting version of the US 13C-urea breath test for the diagnosis of H. pylori infection. Helicobacter. 1996 Sep;1(3):165-7.
2. Breuer, T., Goodman, K.J., Malaty, H.M., et al. How do clinicians practicing in the U.S. manage Helicobacter pylori-related gastrointestinal diseases? A comparison of primary care and specialist physicians. Am J Gastroenterol. 1998; 98:553-61.
While modern research has shown that diet is not a cause of ulcers, certain foods may aggravate or increase stomach ulcer symptoms. Below, you will find a list of these stomach ulcer foods to avoid.
There are three different ways foods can irritate ulcers: by increasing the production of stomach acid, by directly irritating the ulcer, and by causing inflammation (gastritis) of the stomach lining.
Foods that Increase the Production of Stomach Acid
Any food that increases the production of stomach acid is at the top of stomach ulcer foods to avoid. There are certain foods which do actually increase stomach acid production and these can irritate an existing ulcer. Here is a list:
Milk – While milk initially buffers acid in the stomach, the stomach may start producing acid to compensate for this, especially with full-fat milk.
Peppermint and Spearmint – Mints of all sorts seem to increase the production of stomach acid. Despite the soothing flavor, mint flavored foods can make your stomach turn.
Caffeine – Like most stimulants, caffeine can increase the production of stomach acid. Common sources of caffeine in the modern diet are coffee, tea, soda, and energy drinks.
Coffee – Even decaffeinated coffee seems to increase stomach acid production, so coffee of all types may irritate your ulcer.
Nicotine – Nicotine is the active ingredient in all tobacco products and as a stimulant, it is thought to stimulate the production of stomach acid.
Foods that Irritate Ulcers Directly
An ulcer is not unlike an open wound in the skin. Think of an ulcer like you would a canker sore (mouth ulcer) or even an open wound on the skin; anything which would irritate these wounds is likely to irritate an ulcer. These include:
Spicy food: Food is spicy because it activates nociceptors (nerve receptors that detect “noxious” or unpleasant stimuli). Nociceptors also report pain. This is why spicy food or sauces sting if you have a cut on your hand or in your mouth. Spicy food will not cause ulcers, but may be painful for an ulcer that already exists.
Citrus and other acidic foods: Very acidic juices, such as orange juice or lemon juice may irritate ulcers.
Alcohol: Alcohol may also irritate ulcers, especially hard liquor. Again, think of the open wound example: if you have a cut on your hand and spill beer on it, it will not hurt; but if you clean out a wound with alcohol, it will sting. Regardless, alcohol can lead to gastritis (see next section) and as a result should be avoided if you have an ulcer.
Note that the irritation these foods cause to ulcers will not mimic the exact pain of a similar irritation for a mouth ulcer or cut on the skin. Ulcer pains are less specific and usually more mild simply because the nerve endings in the stomach are not nearly as fine or sensitive as the nerve endings in the mouth or skin.
Foods that Cause Gastritis
There are not many foods that cause gastritis, but the few things we may eat that lead to inflammation may significantly worsen ulcer symptoms and even slow healing times. As a result, you want to make an effort to avoid everything on this list:
Alcohol – Alcohol can lead to inflammation of the stomach, especially if consumed in large quantities.
Nicotine and tobacco products – Nicotine also may lead to inflammation of the stomach, exacerbating symptoms and slowing healing time.
Food allergies – If you have certain food allergies, you want to make a concerted effort to avoid these foods. Consuming foods which you are allergic to may irritate the stomach and your ulcer as well.
Stomach Ulcer Foods to Avoid Conclusion
By avoiding these foods, you can avoid inadvertently increasing your peptic ulcer symptoms. However, avoiding these foods is not enough for stomach ulcer treatment; proper medical channels still should be followed.
You should know that modern research has shown us that while these foods may irritate and aggravate ulcers, foods that increase the production of stomach acid do not cause ulcers in their own right.
Nearly all ulcers are caused by H pylori infection or as a side-effect of certain medications, such as NSAIDs. However, there are some foods that may benefit ulcers. Read our article on the best H pylori diet for tips on diets that may fight the ulcer-causing H pylori bacteria and our article on millet for information on the shocking discovery that remote cultures around the world who consume millet have much lower rates of stomach ulcers than anywhere else in the world.