What is the best way of treating an H pylori ulcer?

If the ulcer is the result of H pylori infection you will be recommended to take an acid-reducing drug together with two antibiotics for seven days. Many doctors now advise this treatment not only for newly diagnosed ulcers but for patients who continue to have symptoms thought to be due to an ulcer which has been diagnosed in the past.

CORE also publishes a leaflet on Helicobacter pylori , containing further information.

What can I eat?

You can eat normally, and do not need to follow a special diet. A healthy diet including a wide variety of foods and plenty of fruit and vegetables is good for your general health. Aim to eat five portions of fruit or vegetables each day and to drink at least two litres (8–10 cups) of fluid every day. Further information on healthy eating is available from the Food Standards Agency (www.food.gov.uk).

What if my ulcer is due to NSAID treatment?

For NSAID ulcers the most effective treatment is to stop the NSAID and take an acid suppressing drug for 4–8 weeks. If the NSAID cannot be stopped these drugs will still be effective, but the ulcer may take longer to heal and you will probably have to take an acid suppressing drug, probably at a lower dose, indefinitely.

Will I need another test to prove the ulcer has healed?

For all gastric ulcers and for duodenal ulcers that have bled or perforated it is routine to repeat the endoscopy to confirm healing. In other patients with duodenal ulcers a further endoscopy is not necessary unless symptoms return.

What about checking that H pylori has been eliminated?

Because eradication treatment is effective in approximately 90% of patients the odds are very much on your side. However, if symptoms persist you may need a further test, which will not necessarily be an endoscopy, but is likely to be a urea breath test, as described previously.

Will the ulcer come back?

H pylori related ulcers very rarely recur after the bacterium has been eradicated and NSAID ulcers will not return unless the drugs are taken again.

Do recurrent symptoms always mean the ulcer has come back?

No – in the great majority of patients if H pylori is treated and NSAIDs are avoided,a return of indigestion is usually due to some other problem, most often reflux disease.

Core also publishes a leaflet on Gastrooesophageal Reflux , containing further information.