detect ulcers, screen for colorectalcancer, or a number
of other diseases. The test requires collection of three
stool samples that should be taken one day apart. The
samples are returned to the physician’s office or a
laboratory and are examined under a microscope for
signs of blood. Certain foods and medicines affect test
results and should not be eaten or used about two to
three days before beginning the test.
Upper GI series
An upper gastrointestinal (GI) series is an x-ray
examination that helps diagnose problems in the esoph-
agus, stomach, and duodenum. It may be the first test a
physician orders to detect an ulcer. Clearly showing the
inside lining of these organs requires drinking a thick,
white liquid called barium. The barium coats the linking
and as it moves through the digestive system, the radiol-
ogist can follow the milkshake-like liquid on images,
using a machine called a fluoroscope. The resulting
images detect some ulcers, but not all of them. The
procedure takes one to two hours or longer if imaging
the small intestine as well. No food or drink is allowed
after midnight the night before the examination so the
stomach will be empty for the procedure. The barium
can causeconstipationand a white-colored stool for a
few days following the procedure.
Upper GI endoscopy
Upper GI endoscopy uses a thin, flexible, lighted
tube to help see inside the esophagus, stomach, and
duodenum. In some cases, the endoscopy may follow
the upper GI series. In other cases, the physician
may perform the endoscopy first. The physician
sprays the throat with a numbing agent before insert-
ing the tube to help prevent gagging. Pain medication
and sedatives also help patients relax during the pro-
cedures. The camera at the end of the tube transmits
pictures that allow the physician to carefully examine
the lining of the organs. The scope also has a device
that blows a small amount of air, which can open folds
of tissue so the physician can more easily examine the
stomach lining and look for ulcers. No eating or drink-
ing will be allowed for eight to 10 hours before the
procedure.TreatmentThe treatment ofH. pyloriinfection is called ‘‘triple
therapy’’, since a combination approach is used. Two
antibiotics, often clarithromycin and amoxicillin, are
prescribed for about two weeks. In addition, use of
bismuth subsalicylate (a common brand name is
Pepto Bismol) will be used along with the antibiotics.
Follow-up tests should be ordered to be certain that the
H. pylorihas cleared up.
Other medicines help treat ulcers and their symp-
toms. Acid blockers and proton pump inhibitors reduce
the amount of acid made in the stomach. This helps
relieve pain and promotes healing of ulcers. These drugs
are available by prescription or over=the-counter and
are sold as ranitidine (Zantac), famotidine (Pepcid),
cimetidine (Tagamet), and nizatidine (Axid).
If an ulcer has erupted to the point that it has bled,
treatment of anemia may requireironsupplements.
An ulcer that has caused a perforation or obstruction
in the stomach to develop may require surgery. The
surgery will remove the ulcer or the ulcer can be cov-
ered with tissue from another part of the intestine.
Other options may be to tie off the bleeding vessel or
to cut off the nerve supply to the base of the stomach.Nutrition/Dietetic concernsThe old school of though about spicy foods causing
ulcers has been shown to be untrue. But those who have
ulcers may still need to watch what they eat to relieve
symptoms of peptic ulcer disease. The effect of diet on
ulcers varies for everyone, but certain foods and drinks
can worsen pain. Drinking coffee can increase pain,
whether it containscaffeineor is decaffeinated. Tea,
chocolate, chili powder, mustard seed, meat extracts,
black pepper, and nutmeg are other foods and spices
that may cause discomfort for those with ulcers. With
proper use of medications, dietary restrictions should
not be necessary, except to ease symptoms.
People with ulcers should avoid alcoholic bever-
ages. Eating a balanced diet is advised. Avoiding large
meals in one setting may help relieve feelings of bloat-
ing and fullness. It is best to eat small, frequent meals
when having ulcer pain. The American Gastroentero-
logical Association recommends eating food that has
been properly prepared and only drinking water from
clean, safe sources to help prevent ulcers.KEY TERMS
Anemia, anemic—Anemia is the condition in
which the blood’s hemoglobin, which is the part
of the blood rich in iron, decreases.
Antibodies—Proteins in the immune system that
help fight disease.
Peptic—A description that relates to digestion.Ulcers