Ulcers

Before 1992, most ulcers were treated with a regimen of diet and medication. Patients were advised to A clinical photograph of a large duodenal ulcer after surgical resection (removal). The ulcer is the prominent triangular crater at center. © Dopamine-CNRI, National Audubon Society Collection/Photo Researchers, Inc. Reproduced by permission. take over-the-counter antacids and to control their intake of irritating foods and substances, such as alcohol, caffeine, and fried foods. In the 1980s, drug researchers developed sophisticated medications that target the stomach's acid production mechanism. The patient must take these medications for at least a month, and sometimes years, to suppress the stomach's acid secretion. These drugs only treat the symptoms of ulcers; they do not cure them. Unfortunately, most ulcers recurred despite these state-of-the-art drugs.

Since the discovery of Heliobacter pylori, new treatments for ulcers that target the bacteria have been implemented in ulcer patients, with good results. Tests can confirm whether or not a patient has Heliobacter pylori. In one of these tests, a tube with a tiny camera on the end is snaked through the patient's esophagus into the stomach and duodenum. An instrument can be passed through the tube to pinch a bit of the intestinal lining. If Heliobacter pylori bacteria are found in the sample, the patient is put on a course of antibiotic drugs that kill the bacteria, effectively curing the ulcer. In addition, researchers have found that bismuth subsalicylate—the active ingredient in the over the counter medication Pepto Bismol—is also effective against these bacteria. Some evidence suggests that a medication regiment combining antibiotics and bismuth subsalicylate may be the best treatment for bacterial ulcers.