Is It Possible To Prevent Gastric Ulcers?

Gastroduodenal ulceration is quite common and has a high rate of recurrence, often seen among patients. Therefore, being able to prevent gastric ulcers is an opportunity to be seized.

What are gastric ulcers?

They develop and persist thanks to the acidic activity of the gastric juice.  The disease is associated with two main factors: bacterial infection by Helicobacter pylori  and consumption of non-steroidal anti-inflammatory drugs.

Most people who have a gastric ulcer will develop it asymptomatically or will only develop dyspepsia:

• Pain in the pit of the stomach.
• Burning or acidity.
• Meal intolerance with belching and bloating.
• Nausea and vomiting.

What factors increase the chance of having gastric ulcers?

One of the determining factors is gastric infection by  Helicobacter pylori.  Between 85% and 100% of patients with gastroduodenal ulcers test positive for the presence of the bacteria in the stomach or duodenum.

Likewise, the use of non-steroidal anti-inflammatory drugs such as aspirin, ibuprofen, indomethacin, diclofenac, piroxicam and naproxen, along with other drugs such as cigarettes and alcohol, are risky practices. The problem progressively increases with the number of years of use.

It is also known that there is a familial predisposition to the appearance of ulcers. This genetics is usually accompanied by certain habits that facilitate the onset of the disease, such as the ingestion of foods and beverages that can cause stomach upset. Maintaining a healthy diet with lots of fruits, vegetables and fiber can lower the risk of someone developing gastric ulcers.

The role of stress in ulcer formation is controversial.  There is some evidence that it may contribute to its development, as well as to partial cure and increased recurrence.

How to prevent gastric ulcers?

To prevent gastric ulcers, here are some recommendations you can follow that fit in the context of healthy habits and evidence-based medical treatments:

• Avoid aspirin whenever possible. In particular, its indication should be carefully evaluated in patients with a history of gastric ulceration. Likewise, the smallest possible doses should be used, accompanying them with meals. If an analgesic is needed, acetaminophen is preferred.
• For patients who have a history of ulceration and who should continue to use aspirin or other NSAIDs, concurrent treatment with a proton pump inhibitor (eg, omeprazole) is often recommended while they are being used.
• Eradicate H. pylori infection with  antibiotics.  Several antibiotics have been evaluated and many of them have failed to clear the infection. The selected treatment regimen should consider local bacterial resistance patterns. One of the regimens used is the combination of clarithromycin and amoxicillin for 14 days.

• Avoid smoking and limit the amount of alcohol.
• Change your diet: avoid chocolate, fatty foods, fried foods, coffee, citrus and highly seasoned foods. Although they are known not to be a direct cause of gastric ulcers, they can make things worse, so it is always suggested to decrease your intake.
• Avoid being overweight.

Preventive measures are important to prevent recurrence

Patients who have had gastric ulcers before will benefit from most of the prevention measures already recommended. Particular emphasis should be placed on preventing the use of NSAIDs and ending smoking.

In addition, the eradication of H. pylori should be evaluated by a physician. This is not something the patient can decide on their own. Complementary methods must be applied to verify the existence of the bacteria, as well as its resistance to antibiotics. Once this process is completed, the action protocol will be established.

Healthy habits, stress reduction and dietary measures, although not causal factors, can improve symptoms or prevent dyspepsia from worsening. There are no magic bullets for this prevention, although commitment and persistence in applicable changes is required.