{"id":60797,"date":"2025-09-24T16:59:08","date_gmt":"2025-09-24T16:59:08","guid":{"rendered":"https:\/\/cdhf.staging.not4prod.com\/?p=60797"},"modified":"2025-09-24T17:48:48","modified_gmt":"2025-09-24T17:48:48","slug":"peptic-ulcers-insights-and-tips","status":"publish","type":"post","link":"https:\/\/cdhf.ca\/en\/peptic-ulcers-insights-and-tips\/","title":{"rendered":"Peptic Ulcers : Insights and Practical Tips for Patients &amp; Caregivers"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">While today\u2019s treatments can successfully heal most peptic ulcers (stomach ulcers) and lower the risk of recurrence (coming back), they aren\u2019t effective for everyone. Some patients continue to struggle, and in some cases, ulcers appear without any clear underlying cause.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">To close these gaps, researchers are pushing the science forward. Here are just a few of the areas they\u2019re actively exploring in the area of peptic ulcers. And at the end of this article, we\u2019ll also share practical tips for patients and caregivers to better manage life with peptic ulcers.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"0-identifying-causes-other-than-h-pylori-and-nsaids-\"><strong>Identifying causes other than <em>H pylori <\/em>and NSAIDs<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cWe\u2019re not sure why, but we see more ulcers than in the past that are not <em>Helicobacter pylori<\/em> related, and not NSAID or Aspirin related, and there is research looking into that,\u201d says Dr. Veldhuyzen van Zanten, an Emeritus Professor of Medicine in the Division of Gastroenterology at the University of Alberta in Edmonton.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It\u2019s likely that there\u2019s more than a single culprit behind unexplained peptic ulcers. However, scientists have homed in on one of the potential suspects. Some research suggests that, \u201csome of the antidepressants may increase the risk,\u201d notes Dr. Veldhuyzen van Zanten. The medications in question are SSRIs, which include sertraline (Zoloft), fluoxetine (Prozac), and escitalopram (Lexapro).&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"1-finding-answers-for-antibiotic-resistant-infections-\"><strong>Finding answers for antibiotic-resistant infections<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Roughly 90% of H pylori infections can be cured with a course of a combination of two or three antibiotics given for two weeks. However, the remaining 10% don\u2019t respond to treatment, \u201cpresumably due to antibiotic resistance,\u201d says Dr. Keith McIntosh, an Associate Professor of Medicine at Western University and Gastroenterology Site Director at St. Joseph\u2019s Health Care London (Ontario). \u201cSo then we have to look for an alternative antibiotic regimen. The question of what the best antibiotic regimen is in these cases is an ongoing knowledge gap.\u201d&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"2-why-symptoms-sometimes-persist-after-successful-treatment-for-h-pylori-infection-\"><strong>Why symptoms sometimes persist after successful treatment for<em> H pylori<\/em> infection<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cSome people say, well, the Helicobacter is gone, all of my problems should be gone. We thought that might be the case, but unfortunately, it isn\u2019t,\u201d notes Dr. Veldhuyzen van Zanten. \u201cSome people, even if we cure H pylori, may need lifelong proton-pump inhibitors (medications that block the production of acid in the stomach) to treat dyspepsia, he says.&nbsp;Dyspepsia is the medical term for symptoms that occur in the upper part of the stomach. These include pain or discomfort located just below the breastbone, sometimes associated with a burning feeling.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"3-how-best-to-manage-patients-on-blood-thinning-medications-\"><strong>How best to manage patients on blood-thinning medications<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cWe now have a lot more patients on blood thinners than in the past, and there are a lot of new blood thinners,\u201d explains Dr. McIntosh. Not only can these medications make it more challenging to stop bleeding from an ulcer, they increase the odds of serious bleeding and getting another bleeding ulcer in the future.&nbsp;And it isn\u2019t yet entirely clear whether there are differences in bleeding risk among the different blood thinners for people with a history of peptic ulcers.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cThat layer of complexity, and the fact that we have so many patients on blood thinners, is probably what\u2019s keeping the rate of bleeding ulcers as high as it is,\u201d Dr. McIntosh notes.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cHow to treat patients who are on blood thinners and come in with bleeding, and which are the best blood thinners to be on,\u201d for those with a history of bleeding ulcers, \u201cis an evolving area of research,\u201d Dr. McIntosh says.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"4-further-refining-endoscopic-tools-\"><strong>Further refining endoscopic tools<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">During a gastroscopy (the test used to diagnose bleeding ulcers), a flexible tube with a tiny camera on the end is passed from the mouth down into the stomach. \u201cOur cameras have gotten smaller, and resolutions (level of detail we can see) have gotten so much better that we\u2019re doing pretty well diagnostically, but there may be room for improvement,\u201d when it comes to treating bleeding ulcers endoscopically, says Dr. McIntosh. \u201cOur endoscopic tools are good, but they\u2019re not perfect. We\u2019re operating in a small space with a small scope, and if the ulcer is in a very awkward location, it can sometimes be a challenge,\u201d he adds. Researchers are investigating ways of further refining existing endoscopic tools and techniques.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"5-whether-new-generation-medications-may-be-more-effective-than-ppis-\"><strong>Whether new-generation medications may be more effective than PPIs<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cThere are some exciting new medications that are coming out that may be more effective than some of the PPIs,\u201d Dr. McIntosh explains. These drugs, called potassium-competitive acid blockers (P-CABs), \u201cmight have a role in future, both for the treatment of ulcers or the treatment of H pylori as well,\u201d he says.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Treatment and prevention of peptic ulcers and peptic ulcer bleeding is constantly evolving. If you have any questions about your personal risk factors, talk to your health care team.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"6-blood-thinners-\"><strong>Blood thinners<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Many people are on long-term treatment with medications that interfere with blood clotting to reduce their risk of heart attack and stroke. These blood-thinning medications fall into two categories.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">These include:<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"7-antiplatelet-medications-make-platelet-cells-that-normally-clump-together-to-help-form-clots-less-%E2%80%98sticky%E2%80%99-\">Antiplatelet medications make platelet cells that normally clump together to help form clots less \u2018sticky\u2019. <\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Aspirin (acetylsalicylic acid or ASA)<\/li>\n\n\n\n<li>Clopidogrel (Plavix)<\/li>\n\n\n\n<li>prasugrel (Effient)<\/li>\n\n\n\n<li>ticagrelor (Brilinta)<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"8-anticoagulants-inhibit-clotting-in-other-ways-examples-include\">Anticoagulants inhibit clotting in other ways. Examples include:<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Warfarin (Coumadin)<\/li>\n\n\n\n<li>Newer-generation direct oral anticoagulants (DOACs)<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"9-doacs-include\">DOACs include:<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>apixaban (Eliquis)<\/li>\n\n\n\n<li>dabigatran (Pradaxa)<\/li>\n\n\n\n<li>rivaroxaban (Xarelto)<\/li>\n\n\n\n<li>Edoxaban (Lixiana)<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"data:image\/gif;base64,R0lGODlhAQABAIAAAAAAAP\/\/\/yH5BAEAAAAALAAAAAABAAEAAAIBRAA7\" data-src=\"https:\/\/cdhf.ca\/wp-content\/uploads\/2025\/09\/peptic-doctorpatient-1024x461.webp\" alt=\"Doctor speaking with their patient\" class=\"wp-image-60803 lazyload\"\/><noscript><img decoding=\"async\" src=\"https:\/\/cdhf.ca\/wp-content\/uploads\/2025\/09\/peptic-doctorpatient-1024x461.webp\" alt=\"Doctor speaking with their patient\" class=\"wp-image-60803 lazyload\"\/><\/noscript><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"10-patient-and-caregiver-tips\">Patient and Caregiver Tips<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"11-red-and-yellow-flag-signs-and-symptoms\">Red- and Yellow-Flag Signs and Symptoms<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">If you or your family member has been treated for a bleeding ulcer, be on the lookout for these warning signs and symptoms in the person who is recovering.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"12-reasons-to-get-medical-help-right-away-\">Reasons to get medical help <strong>right away<\/strong>:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Sudden, sharp pain in the abdomen<\/li>\n\n\n\n<li>Vomiting blood or material that looks like coffee grounds<\/li>\n\n\n\n<li>Passing bloody or black stool<\/li>\n\n\n\n<li>Fainting, seeming confused, or feeling sweaty or clammy<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"13-reasons-to-contact-your-health-care-provider-promptly-\">Reasons to contact your health care provider <strong>promptly:<\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Light-headedness or dizziness<\/li>\n\n\n\n<li>Persistent pain or discomfort in the upper part of the stomach<\/li>\n\n\n\n<li>Loss of appetite<\/li>\n\n\n\n<li>Vomiting<\/li>\n\n\n\n<li>Unintentional weight loss<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Someone who has had a bleeding ulcer in the past should<strong> not take<\/strong> any of the over-the-counter pain and fever medications listed below <strong>without consulting their doctor or pharmacist first. <\/strong><strong><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">(Similarly, if another care provider, like a doctor at a walk-in clinic, or a dentist, writes you a prescription for pain medication, make sure you tell them you\u2019ve had a bleeding ulcer.)<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Aspirin (acetylsalicylic acid or ASA)<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Non-steroidal anti-inflammatories (NSAIDs)<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Advil (ibuprofen)<\/li>\n\n\n\n<li>Aleve (naproxen)<\/li>\n\n\n\n<li>Ibuprofen<\/li>\n\n\n\n<li>Motrin (ibuprofen)<\/li>\n\n\n\n<li>Naproxen<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Remember to check the ingredient labels of cold and flu products for any of the above, too.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Your doctor or pharmacist may suggest a different medication, or prescribe a stomach-protecting medication (proton pump inhibitor or PPI) to take along with the NSAID.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"14-tips-for-patients-and-caregivers\">Tips for Patients and Caregivers<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Keep a medication list:<\/strong> Write down all prescriptions, over-the-counter drugs, and supplements. Share this list at every healthcare visit.<\/li>\n\n\n\n<li><strong>Meal support:<\/strong> Encourage small, balanced meals and avoid foods or drinks that irritate the stomach (such as alcohol, caffeine, and very spicy foods).<\/li>\n\n\n\n<li><strong>Hydration and rest:<\/strong> Make sure the recovering person drinks enough fluids and gets adequate rest, both of which support healing.<\/li>\n\n\n\n<li><strong>Monitor closely:<\/strong> Caregivers should keep track of any changes in symptoms, energy levels, or appetite, and communicate these to healthcare providers.<\/li>\n\n\n\n<li><strong>Emotional reassurance:<\/strong> Recovery from a bleeding ulcer can be stressful. Offering encouragement and helping with daily tasks can reduce anxiety and promote healing.<\/li>\n\n\n\n<li><strong>Follow-up care:<\/strong> Remind and accompany the patient to follow-up appointments, since repeat scopes or bloodwork may be necessary to monitor healing.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"15-summary-and-key-takeaways-\"><strong>Summary and Key Takeaways<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Researchers are trying to close gaps in the treatment and prevention of bleeding peptic ulcers. Questions as yet to be answered include:<\/li>\n\n\n\n<li>Why some people with no known risk factors develop peptic ulcers and bleeding ulcers.<\/li>\n\n\n\n<li>Why current treatment regimens for <em>H pylori <\/em>infection don\u2019t always work, and which drug combinations to use when this happens.<\/li>\n\n\n\n<li>Why symptoms persist for some patients with <em>H pylori-<\/em>related ulcers after treatment successfully cures the infection.<\/li>\n\n\n\n<li>How best to manage patients who need to take blood thinners for other conditions.<\/li>\n\n\n\n<li>How current endoscopic tools and techniques can be further refined<\/li>\n\n\n\n<li>Whether a new class of medications might be more effective than PPIs for healing peptic ulcers and preventing them from recurring.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"16-tips-for-patients-and-caregivers-\"><strong>Tips for Patients and Caregivers<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Learning the potential warning signs of re-bleeding that need immediate attention can give patients and their families greater peace of mind after treatment for a bleeding peptic ulcer.<\/li>\n\n\n\n<li>If you\u2019ve ever had a bleeding peptic ulcer, check with your doctor or pharmacist before taking an NSAID medication like ibuprofen.<\/li>\n\n\n\n<li>There are simple ways you can help support someone while they are recovering after treatment for a bleeding peptic ulcer.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>While today\u2019s treatments can successfully heal most peptic ulcers (stomach ulcers) and lower the risk of recurrence (coming back), they aren\u2019t effective for everyone. Some patients continue to struggle, and in some cases, ulcers appear without any clear underlying cause. To close these gaps, researchers are pushing the science forward. Here are just a few [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":60822,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"cdhf2022_sponsors_meta":[],"footnotes":""},"categories":[60],"tags":[58],"class_list":["post-60797","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-article","tag-tags-peptic-ulcer-h-pylori"],"acf":{"article_writer":[54399]},"featured_image_src":"https:\/\/cdhf.ca\/wp-content\/uploads\/2025\/09\/peptic-ulcer2.webp","author_info":{"display_name":"Kelsey Cheyne","author_link":"https:\/\/cdhf.ca\/en\/author\/kelsey-cheyne\/"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.1.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Peptic Ulcers : Insights and Practical Tips for Patients &amp; Caregivers - Canadian Digestive Health Foundation<\/title>\n<meta name=\"description\" content=\"While today\u2019s treatments can successfully heal most peptic ulcers and lower the risk of recurrence, they aren\u2019t effective for everyone.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/cdhf.ca\/en\/peptic-ulcers-insights-and-tips\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Peptic Ulcers : Insights and Practical Tips for Patients &amp; Caregivers - Canadian Digestive Health Foundation\" \/>\n<meta property=\"og:description\" content=\"While today\u2019s treatments can successfully heal most peptic ulcers and lower the risk of recurrence, they aren\u2019t effective for everyone.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cdhf.ca\/en\/peptic-ulcers-insights-and-tips\/\" \/>\n<meta property=\"og:site_name\" content=\"Canadian Digestive Health Foundation\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/CDHFdn\" \/>\n<meta property=\"article:published_time\" content=\"2025-09-24T16:59:08+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-09-24T17:48:48+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/cdhf.ca\/wp-content\/uploads\/2025\/09\/peptic-ulcer2.webp\" \/>\n\t<meta property=\"og:image:width\" content=\"2000\" \/>\n\t<meta property=\"og:image:height\" content=\"900\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Kelsey Cheyne\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@TheCDHF\" \/>\n<meta name=\"twitter:site\" content=\"@TheCDHF\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Kelsey Cheyne\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"7 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/cdhf.ca\/en\/peptic-ulcers-insights-and-tips\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/cdhf.ca\/en\/peptic-ulcers-insights-and-tips\/\"},\"author\":{\"name\":\"Kelsey Cheyne\",\"@id\":\"https:\/\/cdhf.ca\/en\/#\/schema\/person\/990293ff50f898caf38644b75a0105aa\"},\"headline\":\"Peptic Ulcers : Insights and Practical Tips for Patients &amp; Caregivers\",\"datePublished\":\"2025-09-24T16:59:08+00:00\",\"dateModified\":\"2025-09-24T17:48:48+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/cdhf.ca\/en\/peptic-ulcers-insights-and-tips\/\"},\"wordCount\":1451,\"publisher\":{\"@id\":\"https:\/\/cdhf.ca\/en\/#organization\"},\"image\":{\"@id\":\"https:\/\/cdhf.ca\/en\/peptic-ulcers-insights-and-tips\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/cdhf.ca\/wp-content\/uploads\/2025\/09\/peptic-ulcer2.webp\",\"keywords\":[\"Peptic Ulcer &amp; H. 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