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Thirteen years ago, Dr. Barry Marshall first reported that most stomach and intestinal ulcers are caused by a bacteria called helicobacter, but, it's only recently that doctors are learning the best way to cure stomach ulcers.

The major disagreements about the treatment for belching and burning in the stomach are whether all patients need to have a tube put down their mouths into their stomachs or they can just be checked with a simple x ray taken after swallowing barium; whether a blood test or a biopsy is more valuable in diagnosing helicobacter infection; how long to treat helicobacter with antibiotics; and what to do if helicobacter is not eradicated by the first treatment with antibiotics.

All people infected with helicobacter have a positive blood test for that germ, but not all patients with helicobacter will have a positive biopsy for helicobacter. If the doctor biopsies the wrong spot, the test will be negative. Therefore, all patients with ulcer symptoms should have a helicobacter blood test. Another advantage is that the blood test titer will drop three months after a patient is cured with antibiotics. Because 12 years ago, Dr. Marshall recommended treating ulcers with antibiotics for 2 weeks, almost all doctors treat their ulcer patients for 2 weeks. In the last year, many papers have shown that one week treatment with the metronidazole, amoxacillin and omeperazole is as effective as 2 weeks and has far fewer side effects.

Patients who are not cured with first regimen of the metronidazole antibiotic usually are infected with a helicobacter that is resistant to metronidazole and need a second antibiotic regimen that includes clarithromycin and tetracycline.

June 10th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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