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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Need Treatment For Gastric Ulcers

My Mom has gastreic ulcer and she took Omeprazole 40 for a month, she has this ulcer for 4 months already, but the medicatin doesn t heal her ulcer, she did 4 times of EGD and 4 biopsies were taken, the pylorus and duodenum appreared to be normal, why the medication doesn t heal my mom s ulcer?
posted on Tue, 13 May 2014
Twitter Sat, 19 Jul 2014 Answered on
Twitter Mon, 21 Jul 2014 Last reviewed on
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  User's Response
Hi, thanks for posting your concern in the HCM. In case of gastric ulcer disease, the precipitating cause should be identified. Gastric ulcer occurs due to numerous reasons. Drugs (e.g. NSAID with or without corticosteroids), H. pylori infection, lifestyle factors including smoking, hypersecretary states (e.g. antral G cell hyperplasia, mastocytosis, leukemia, cystic fibrosis, hyperparathyroidism etc.), stress, liver disease, autoimmune diseases, some infections are the important causes. In case of long-standing ulcer, refractory to treatment H. pylori infection should be ruled out first. If there is no evidence of offending medication use or any other precipitating factor or disease, treatment against H. pylori infection is started and patient is asked to avoid stress, smoking, alcohol and NSAID. The recommended primary therapy to fight against H pylori infection is proton pump inhibitor–based triple therapy. Only PPI (e.g. omeprazole) may not be able to heal the ulcer. Cytoprotective agents like misoprostol or sucralfate may be added in case of non-healing ulcer. A repeat endoscopic visualization is needed after 6-8 weeks to check the healing status. For any further query please write back to us. Regards. Dr. Kaushik
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Need Treatment For Gastric Ulcers

Hi, thanks for posting your concern in the HCM. In case of gastric ulcer disease, the precipitating cause should be identified. Gastric ulcer occurs due to numerous reasons. Drugs (e.g. NSAID with or without corticosteroids), H. pylori infection, lifestyle factors including smoking, hypersecretary states (e.g. antral G cell hyperplasia, mastocytosis, leukemia, cystic fibrosis, hyperparathyroidism etc.), stress, liver disease, autoimmune diseases, some infections are the important causes. In case of long-standing ulcer, refractory to treatment H. pylori infection should be ruled out first. If there is no evidence of offending medication use or any other precipitating factor or disease, treatment against H. pylori infection is started and patient is asked to avoid stress, smoking, alcohol and NSAID. The recommended primary therapy to fight against H pylori infection is proton pump inhibitor–based triple therapy. Only PPI (e.g. omeprazole) may not be able to heal the ulcer. Cytoprotective agents like misoprostol or sucralfate may be added in case of non-healing ulcer. A repeat endoscopic visualization is needed after 6-8 weeks to check the healing status. For any further query please write back to us. Regards. Dr. Kaushik