Treatment:

For people with Helicobacter pylori infection, the main goal is to get rid of the bacteria that causes the infection. Many different medicines work. They usually include either an H2 receptor antagonist such as famotidine (Pepcid) or nizatidine (Axid) or a proton pump inhibitor such as omeprazole (Prilosec) or esomeprazole (Nexium) to suppress acid, combined with two antibiotics.

After you finish your medicines, your doctor will likely order a test to make sure that the H. pylori infection is gone.

Those who do not have an H. pylori infection may be prescribed ulcer-healing medications such as antacids, H2 receptor antagonists, or proton pump inhibitors. Long-term treatment may be needed.

If the ulcer bleeds, endoscopy can control bleeding in most cases.

Surgery may be recommended for persons who do not respond to medicines or endoscopy. Surgical procedures for gastric ulcers include:

• Vagotomy -- cuts the vagus nerve, which controls the stomach's production of gastric acid
• Partial gastrectomy -- removes part of the stomach

Self-help measures include eating several small meals a day at regular time periods and avoiding the following:

• Smoking
• Tea, coffee, and soft drinks containing caffeine
• Alcohol
• Aspirin and NSAIDs

Expectations (prognosis):

Most ulcers heal with medication in 6 to 8 weeks. Recurrence is common, but is less likely if H. pylori infection is treated and acid-blocking medications are continued.

Complications:

• Bleeding from the ulcer
• Perforation (hole) in the stomach
• Blockage in the stomach that prevents movement of stomach contents

Complications can often be corrected by medication, endoscopy, or (in rare cases) with surgery.

Calling your health care provider:

Call your health care provider if symptoms of gastric ulcer develop.