PAIN IN UPPER MIDABDOMEN: TREATMENT
If you think you have an ulcer, you should see your doctor, who will conduct a complete health history and physical exam, which may include a digital rectal exam to detect any blood in the stool. He will also ask you a series of questions to find out about your diet and any medications you take, especially aspirin or other antiarthritic medications.
If you ate vomiting blood, your doctor will recommend that you head for the emergency room, where a nasogastric tube will be inserted to help confirm the diagnosis of a bleeding ulcer in addition to helping remove the blood clots from the stomach. Intravenous fluids will be administered, and, in the case of extensive blood loss, a transfusion will be done. An endoscopy may also be used to find the source of the bleeding, and a biopsy may be done to check for cancer. If H. pylori bacteria are determined to be the cause of yout ulcer, your doctor will prescribe a course of an antibiotic such as Flagyl or ampicillin that will last several weeks.
To treat your ulcer or gastritis on a long-term basis, the first thing you should do is to eliminate the food, alcohol, cigarette smoking, or medication that is causing it. If stress is also the culprit, your doctor will tell you how to use biofeedback, exercise, and other relaxation techniques to ease your stress and soothe your stomach.
I also suggest using an antacid such as Mylanta or Maalox to ease the pain of the ulcer. Take a tablespoon of the liquid a half hour after eating and before going to sleep. Your doctor may want to prescribe an antiulcer medication such as Tagamet to be taken in 300-milligram doses four times a day and before going to sleep. Other antiulcer medications called H2 antagonists are available; they include Zantac, which should be taken in 150-milligram doses twice a day, and Pepcid, which should be taken in 20-milligram doses twice a day. You’ll probably take these medications at their full dosage for a month and then cut back to once a day as maintenance for several months after that.
There is also a medication called Carafate that is taken in 1-gram doses four times a day in pill or liquid form. This coats the stomach lining and prevents acid from getting through. Carfare is often prescribed for older people who need to take a large amount of antiarthritis medications; taking aspirin or Motrin on a full stomach can also cut down on the ulcer pain.
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