The discovery of Helicobacter pylori and its role in ulcers turned traditional medical concepts on ulcers on its head, and also won its discoverers the Nobel Prize in medicine. Till then, the traditional treatment for ulcers was rest and a bland diet along with antacids. Now, with a bacteria being proved responsible in some cases, good old antibiotics could do the trick, just like any other bacterial disease.
“At first, when I decided to get myself checked, very few doctors had heard of Helicobacter pylori,” says Kocchar. “So, when I didn’t get better for a year, I decided to do a little bit of research on the subject on my own, and then spoke to the doctor about this possibility.”
Kocchar was right—a test proved that she did indeed have that bacterial infection, and a course of two antibiotics along with certain drugs helped her recover completely.
That doesn’t work for everyone, though. Ranju Nair, a 50-year-old Delhi-based senior executive, frequent traveller and a food lover, got an ulcer without any bacterial infection. The pain below her chest came and went after meals. She had once loved experimenting with food, but her physical situation soon robbed her of her passion for exotic cuisine. Antacids became almost a regular part of her diet. Eventually, she disciplined her lifestyle, cut down on travel, and has got the discomfort somewhat under control.
Generally, for someone with common symptoms of pain and nausea, doctors will confirm the presence of an ulcer through a gastrointestinal series, i.e., x-rays of the affected parts of the digestive tract, or an endoscopy. In this, a tube-like instrument is passed through the mouth into the stomach of a sedated patient to enable the doctor to see the stomach lining or even take a sample for testing. This is the only way to confirm the presence of an ulcer.
See: Causes, treatment and prevention
The next step is to determine whether it is the bacteria or drugs that are responsible. A blood, stool or even a breath test can provide this information. If it is indeed Helicobacter pylori, then a course of two antibiotics, and another strong medicine called a proton pump inhibitor, which can stop acid production, usually do the trick, and the ulcer heals for good.
If the cause is something else, apart from the proton pump inhibitors, which are for more severe cases, another group of medicines—called H2 blockers—are available. These include well-known drugs such as ranitidine and cimetidine, which are effective for most people, and can be obtained over the counter. The ulcer could, however, recur once the medicines are stopped.
There are other, far less common, factors that cause ulcers. “Rarely, it is due to a virus, or Crohn’s disease. Or, it could be a sign of gastric cancer, though that is less than 5% of the cases,” says Dr Singh. “It could also be Zollinger-Ellison Syndrome, a very rare disorder.” Here, a tumour in the pancreas secretes a hormone which stimulates the stomach to produce more acid, thereby leading to ulcers.
Simple precautions