PPI Treatment for Stomach Ulcers: Duration and Probiotics - Gastroenterology and Hepatology

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Proton pump inhibitors (PPIs) for gastric ulcers?


Hello, doctor! I had a gastroscopy today, and the physician mentioned that I have a bleeding gastric ulcer and some inflammation.
They prescribed me a month’s supply of a proton pump inhibitor (PPI).
My question is, will taking just this one medication be sufficient for recovery? Why do I need to take it for such a long duration? Can I take probiotic capsules after finishing the PPI medication? Thank you for your help!

Jason, 20~29 year old female. Ask Date: 2021/02/27

Dr. Cai Anshun reply Gastroenterology and Hepatology


Hello: 1.
For gastric ulcers, health insurance coverage is for 4 months; however, the duration of medication should be determined by the physician based on clinical symptoms.
2.
Probiotics can be taken.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2021/02/27

More Info


Proton Pump Inhibitors (PPIs) are a class of medications commonly prescribed for the treatment of conditions related to excessive stomach acid, such as gastric ulcers and gastroesophageal reflux disease (GERD). Your question regarding the duration of PPI treatment and the use of probiotics after completing the medication is quite relevant, especially given your recent diagnosis of a bleeding gastric ulcer and inflammation.


Understanding PPI Treatment Duration
PPIs work by inhibiting the proton pumps in the stomach lining, which are responsible for producing gastric acid. This reduction in acid helps to heal ulcers and reduces symptoms associated with acid reflux. The duration of PPI therapy can vary based on the severity of the condition being treated. In your case, a one-month course of PPIs is typical for managing a bleeding ulcer. However, the duration may be extended based on follow-up evaluations and the healing progress of your ulcer.

The rationale behind a longer treatment duration is to ensure that the ulcer has adequate time to heal completely. Gastric ulcers can take several weeks to heal, and continuing PPI therapy helps maintain a less acidic environment, which is conducive to healing. Additionally, if the ulcer is associated with Helicobacter pylori infection, your doctor may prescribe antibiotics alongside PPIs to eradicate the bacteria, which is crucial for healing.


Use of Probiotics After PPI Therapy
Regarding your question about taking probiotics after completing your PPI course, it is generally considered safe to do so. Probiotics are beneficial bacteria that can help restore the natural balance of gut flora, which may be disrupted due to antibiotic use or changes in diet. While PPIs do not directly affect the efficacy of probiotics, they can alter the stomach's acidity, which may influence the survival of certain probiotic strains.
However, once you complete your PPI treatment, your stomach acid levels will gradually return to normal, allowing probiotics to function effectively. Many healthcare providers recommend probiotics to support gut health, especially after antibiotic therapy, as they can help mitigate some gastrointestinal side effects such as diarrhea and bloating.


Additional Considerations
1. Dietary Modifications: While on PPI therapy, it is advisable to follow a bland diet that avoids spicy, acidic, or irritating foods. This can help reduce discomfort and promote healing.

2. Monitoring Symptoms: Keep track of any symptoms you experience during and after PPI treatment. If you notice persistent discomfort, it is essential to follow up with your healthcare provider for further evaluation.

3. Potential Side Effects: Long-term use of PPIs has been associated with certain risks, including nutrient malabsorption (such as magnesium and vitamin B12), increased risk of gastrointestinal infections, and potential bone health issues. Discuss these risks with your doctor, especially if you anticipate needing prolonged therapy.

4. Follow-Up Care: After completing your PPI course, a follow-up endoscopy may be recommended to assess the healing of your ulcer and ensure that no further treatment is necessary.

In conclusion, while a one-month course of PPIs is often sufficient for treating gastric ulcers, the duration may be adjusted based on individual healing progress. Probiotics can be beneficial after completing PPI therapy to help restore gut flora. Always consult with your healthcare provider for personalized advice and to address any concerns you may have regarding your treatment plan.

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