Dr Stephen John Middleton MA MD FAHE

Consultant Gastroenterologist

Stomach and duodenal ulceration (peptic ulcers)

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These are caused by acid and peptic juices produced by the stomach.  If acid blockers are used and have reduced the acid to a sufficient degree the ulcers heal. 
 
It has relatively recently been discovered that in most cases  the primary trigger for ulceration in the stomach and duodenum is an infection called Helicobacter pylori.  If untreated it can lead to an increased risk of developing cancer.  People with ulcers should be checked to see if they have this infection, this can be done at endoscopy or by a stool test via GP surgery or a urea breath test.  If the infection is present, treatment with two antibiotics and an acid blocker for one week is generally recommended.  After six weeks a test can be done to check the infection has been successfully eradicated.  If the infection is still present, further antibiotics can be given depending upon the individual situation.   If the infection proves to be resistant, it is possible to take small samples at endoscopy so that the laboratory can test to check what antibiotics will be best to treat the infection.
 
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