Ulcer
Ulcer
15 Soothing Treatments
Just a few years ago, doctors might as well have told patients with ulcers to surrender their taste buds because they were already asking them to completely give up just about every food they could taste.
Chili, pizza, and tacos were out. Toast, crackers, and the rest of the bland band were in. It was anything but sweet music to the ears of people who were trying to live with recurring, raging infernos in the depths of their stomachs.
Now specific anti-ulcer diets, including those widely prescribed bland regimens, are out, says Steve Goldschmid, M.D., an assistant professor of medicine in the Division of Digestive Diseases at Emory University Hospital in Atlanta, Georgia. "There is no proof of a therapeutic benefit from altering your diet," he says.
MEDICAL ALERT
Be Wise to These Symptoms Much of the time an ulcer is just a literal pain in the gut. But a bleeding ulcer can become serious, even life threatening. A bleeding ulcer can drain you of enough blood to drastically lower blood pressure and stop vital organs from functioning, says Steve Goldschmid, M.D. "If you have an ulcer and get really nauseated and suddenly throw up blood or what looks like old coffee grounds, see your doctor immediately," he says. Other symptoms of serious trouble include passing a stool that is black or one containing bright red blood. A person with a bleeding ulcer also may become dizzy and pass out. |
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What doctors currently recommend recalls that old doctor/patient conversation that, today, might go like this: "Hey Doc, whenever I eat rocky road ice cream covered with kiwi sauce, it feels like there's a blowtorch in my belly."
"Well," says the doctor, "don't eat rocky road ice cream covered with kiwi sauce."
In other words, listen to your ulcer and use common sense—whether you have a gastric ulcer (on the lining of your stomach) or a duodenal ulcer (on the duodenum, the part of the small intestine nearest the stomach).
Scientists have yet to say what, specifically, causes ulcers. But stomach acid is the prime suspect and certain bacteria and stress are viewed as possible accomplices.
Certainly ulcers are not rare—an estimated 5 million Americans have them, says John Kurata, Ph.D., an epidemiologist and associate adjunct professor at the University of California, Los Angeles, and research director of the San Bernardino County Medical Center in California.
Unfortunately, ulcers are also stubborn. "Ulcer disease is really a chronic disease," Dr. Goldschmid says. "Ulcers come and go." So here are some tips for living with ulcers that will hopefully make them go sooner.
The Alternate Route
Pepto-Bismol to the Rescue The next best thing to a cure for ulcers already may be in your medicine cabinet—Pepto-Bismol. So claims Australian researcher Barry Marshall, M.D., who tested hundreds of patients with duodenal ulcers and found that they had one thing in common: most carried the same type of bacteria. His conclusion: Bacteria, not stomach acid, may cause ulcers. When Dr. Marshall treated his patients with bismuth (an ingredient in Pepto-Bismol that kills the bacterial invader in the stomach), the bacteria tended to disappear, and so did the ulcers. No one, however, is going so far as to claim that Pepto-Bismol is a cure for ulcers. And some, such as Michael Kimmey, M.D., are even skeptical about the bacteria theory. "The bacteria research is interesting," Dr. Kimmey says, "but it's not been proven that bacteria cause ulcers." But Pepto-Bismol could be worth a try, says David Earnest, M.D. "It might be useful," he says, "in certain cases where a person continues to relapse and the bacteria are shown to be present." But ask your doctor about the side effects of taking large doses of Pepto-Bismol over a long period. Pepto-Bismol does not have the approval of the Food and Drug Administration as an ulcer medication. |
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Avoid the arsonists. Whether it's an ice cream sundae or a pepperoni pizza, if it starts a fire in your stomach, don't eat it. "The foods that bother people seem to vary with each individual," says David Earnest, M.D., a professor of medicine at the University of Arizona College of Medicine Health Sciences Center and chairman of the Committee on Patient Care for the American Gastroenterological Association. "But obviously spicy foods may bother some people."
The Stress Connection Can stress cause ulcers? Many doctors are skeptical. "Most of us think there is a lack of good evidence to show stress causes ulcers," says John Kurata, Ph.D. "But if you already have an ulcer, stress may worsen the disease." Consider this, however: The incidence of duodenal ulcers in New York City is greater proportionally than it is in surrounding areas, according to Steve Goldschmid, M.D. And is there anyone who'll argue that New York City is less stressful than, say, New Rochelle? Also worth considering: the case of Richard Maschal, art and architecture critic for the Charlotte Observer. He discovered he had a gastric ulcer during a period of "extreme stress on the job," he says. "I didn't see eye-to-eye—actually, detested—the person who was supervising my area." And he let it drive him crazy. He became tense! It's not so much the stressful event that happens to us, but how we interpret it and react or overreact to it, explains Georgianna S. Hoffmann, coordinator of the Family Stress Clinic in the Department of Family Practice at the University of Iowa College of Medicine. With that in mind, here are a few suggestions for handling stress—and the ulcer it may be aggravating. Think pleasant thoughts and talk to yourself. Maschal has a new boss, and that's helped a lot, as has the medication his doctor prescribed. But he also still catches himself heading toward tension. And only he can stop it. "Now," he says, "I take time to talk myself down." Breathe slowly and deeply. Three or four deep breaths provide the most immediate feeling of calmness anywhere, anytime. Exercise. "Moderate physical exercise is a very good coping mechanism," Hoffmann says. Practice relaxation techniques. "When you relax the body, you relax the mind," Hoffmann says. "And when you relax the mind, you relax the body." Meditation, yoga, imagery, or listening to relaxation tapes, done regularly, are among the relaxation techniques you might want to explore. |
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Take it easy with milk. Long thought to be a great soother for a burning ulcer, milk's rebound effect is now well established. "Although it buffers acid for a while [and thus provides brief relief]," Dr. Goldschmid says, "it actually stimulates more stomach acid secretion" and causes more pain later.
Use over-the-counter antacids. They may not cure an ulcer, "but they are a good treatment for symptoms," says Dr. Earnest.
Don't take too many pain relievers. Aspirin has the bad reputation, but nonsteroidal anti-inflammatory drugs—which have become very popular—are at least as hard on the stomach lining as aspirin is, says Thomas Brasitus, M.D., a professor of medicine and director of gastroenterology at the University of Chicago Pritzker School of Medicine.
Don't light up. Yes, smoking even gets indicted for contributing to ulcers. Although there is no evidence that smoking causes ulcers, they are less likely to heal in smokers than nonsmokers, says Dr. Brasitus.
Let it out. "Some evidence suggests that people who are frustrated and don't express their feelings very well are more likely to get ulcers," says Michael Kimmey, M.D., an assistant professor of medicine at the University of Washington School of Medicine.
Double your meals. Although many doctors are saying three normal-size meals are fine, some people may have less ulcer upset if they eat six smaller meals, says Dr. Brasitus. Food neutralizes stomach acid.
Don't pump iron. "Iron is a gastric irritant," Dr. Goldschmid says. "People who take iron supplements might have a lot of upset if they have a gastric ulcer."
Live by the moderation motto. Too much of one food or beverage could upset an ulcer. Alcohol, by the way, is not necessarily an irritant. "Moderate drinking probably does not increase the risk of developing new ulcers," says Dr. Kurata.
Give it time. Sometimes that's all you can do. "Ulcers have cycles," Dr. Brasitus says. "A lot of them will burn out within a few years."
PANEL OF ADVISERS
Thomas Brasitus, M.D., is a professor of medicine and director of gastroenterology at the University of Chicago Pritzker School of Medicine in Illinois.
David Earnest, M.D., is a professor of medicine at the University of Arizona College of Medicine Health Sciences Center in Tucson. He also is chairman of the Committee on Patient Care for the American Gastroenterological Association.
Steve Goldschmid, M.D., is an assistant professor of medicine in the Division of Digestive Diseases at Emory University Hospital in Atlanta, Georgia.
Georgianna S. Hoffmann is coordinator of the Family Stress Clinic in the Department of Family Practice at the University of Iowa College of Medicine in Iowa City.
Michael Kimmey, M.D., is an assistant professor of medicine at the University of Washington School of Medicine in Seattle.
John Kurata, Ph.D., is an epidemiologist and associate adjunct professor at the University of California, Los Angeles. He also is research director at San Bernardino County Medical Center in California.
