Month: March 2018

While you wouldn’t be able to tell from her clear complexion, Holly Cutler battled with severe cystic acne 20 years ago. She tried medical and topical treatments with no success. Amid the physical difficulties, cystic acne also affected her emotionally.
“The emotional impact of having cystic acne all over my face was devastating,” she says. “You wouldn’t believe the comments people actually made to my face to blame me for the breakouts.” People even called her ugly to her face.
Eventually an esthetician managed to resolve her cystic acne through multiple sessions that involved European-style facials and light-based therapy. But, as is the case for many people who have cystic acne, Holly’s skin was scarred afterward. She says this was a shocking surprise, especially since there were no scar-reversing treatments available at the time. This journey prompted her to look into ways of healing her skin’s scars—and eventually she did just that.

The emotional impact of having cystic acne motivated Holly to become a medical esthetician herself. Now a well-known figure in the field, she founded FACE Skincare~Medical~Wellness in Bingham Farms, Michigan, where she and her staff use approaches that she says are far more advanced than those that cured her cystic acne nearly 20 years ago as they incorporate lasers, injectables, and naturopathy.
Cystic acne affects many people and as with Holly, it can have a huge emotional impact. Fortunately, it can be treated. Here’s what you need to know about your cystic acne treatment options.

What is cystic acne?

“Acne occurs when a pore gets clogged. Typically, a clogged pore will have dirt, dead skin cells, and bacteria inside,” says Janet Prystowsky, MD, a Manhattan-based dermatologist. “When the clogged pore is deep in your skin, then it can develop into a cyst, i.e. a tender bump from inflammation.”
A cystic acne pimple is deeper than a regular whitehead. As a result, it doesn’t have a white bump that can be popped, says Prystowsky. The cyst can feel painful and might be felt under the skin before it shows. The area around the cyst might also appear inflamed and red.
Cystic acne can affect people of all ages, but it’s most likely to affect people in their teens and early twenties, says Toni Stockton, MD, a board-certified dermatologist based in Arizona. “The most common age to develop acne is between 12 and 24 years of age but we still see some patients continue to have to deal with this frustrating condition well into their forties and fifties,” she notes. The acne typically appears on one’s face, back, neck, chest, and upper arms.

“Genetics are probably playing a role in some patients but hormones are a more common cause for cystic acne,” says Stockton. Endocrine conditions like polycystic ovary syndrome, for example, can increase your chances of developing cystic acne.
“The type of sebum (oil) that we that we produce can play a role in whether we get small bumps, whiteheads and blackheads, or cystic lesions,” she adds. “In some patients, their sebum causes only a small reaction in the skin but in others, their bodies make a lot of inflammatory cells that cause a deeper inflammation.”

How can cystic acne be treated?

Unfortunately, cystic acne isn’t something that simply goes away over time—so don’t wait to get help, or the scarring will just get worse, warns Holly. Cystic acne can be painful and inconvenient, but fortunately, it’s treatable. Your best bet is to see a dermatologist as soon as possible so that they can treat your acne before it becomes more severe. According to Stockton and Prystowsky, there are a number of different treatments available for those who suffer from cystic acne.

• • Steroid Injections

    A cortisone shot, or direct injection of cortisone into a cystic pimple, can be a really effective way to reduce its size and impact. There are side effects, though: The area might look sunken in after some time, as the cortisone affects the fatty tissue in the area around the injection site. Additionally, if cortisone shots are administered too often, they can adversely impact the skin’s ability to heal itself.

  • Antibiotics

    Antibiotics like minocycline or tetracycline can help reduce cystic acne by preventing the spread of bacteria, a main cause of acne. “We do try to limit the length of time that we use antibiotics to three to six months if possible due to the development of drug resistance,” says Stockton. “If a patient is not getting better in this period of time then we would move to another treatment option.” Note that these medications aren’t advisable for pregnant women or those who might conceive while on a course of treatment for cystic acne.

• • Topical Treatments

    Your dermatologist might recommend retinoid creams and benzoyl peroxide washes to treat your cystic acne. Retinoid topicals, which include a derivative of vitamin A, work to unclog pores whereas benzoyl peroxide topicals reduce acne by killing the acne-causing bacteria on your skin. Some people might be sensitive to these topicals and have adverse reactions that could include painful, red, itching or peeling skin at the application site.

  • Oral Contraception

    Certain forms of oral contraception can improve skin conditions by balancing the hormones, which in turn will regulate sebum production. Of course, some people experience mental and physical side effects when they’re on birth control, which means this treatment isn’t advisable for everyone.

  • Cryosurgery

    A more invasive therapy used by Stockton and other dermatologists to treat cystic acne is cryosurgery. Cryo means cold and cryosurgery involves applying extremely cold substances, like liquid nitrogen or cold carbon dioxide, to the cysts. Cryosurgery causes ice crystals to form within the damaged skin cells, which eventually tears those cells apart. It also reduces blood flow to the cysts, and it can reduce acne scarring. Note that you may feel a tingling, uncomfortable sensation after treatment.

• Isotretinoin

  Isotretinoin, also known as Accutane or Roaccutane, is a strong and effective treatment for acne. It contains a strong form of vitamin A. While Stockton prescribes it to her patients, she notes that it’s only used as a last resort for cystic acne that resists other forms of treatment. This is because isotretinoin unfortunately has many side-effects, including dry mouth, chapped lips, and nosebleeds. As with antibiotics, isotretinoin is not advisable for pregnant women or those who may become pregnant, as it can be lethal to a fetus.

• Changes in Diet and Lifestyle

  One possible way to reduce cystic acne is to start with the food you consume. Stockton says that dairy and whey protein products can trigger or worsen cystic acne. Prystowsky recommends patients avoid whey, dairy, and sugary foods to see how their skin responds.
  Many people are interested in naturopathic, holistic approaches to treating cystic acne. Doug Cutler, ND, of Cutler Integrative Medicine notes that diet and food sensitivities can be linked to cystic acne. As a naturopathic physician, he treats patients by first running a full food sensitivity panel and a comprehensive stool analysis.
  “Food sensitivities originate in the gut and create chronic inflammation, which can impact every part of the body,” he explains. “80 percent of our immune system is found in the gut, so we want to make sure there is no chronic inflammation, which can imbalance the hormones and lead to cystic acne.”
  From there, he might place the patient on an elimination diet for a few months. This involves removing certain foods from your diet to see whether you have an intolerance for them. The elimination diet can help heal the gut and reduce inflammation.

Cutler also suggests supplements like probiotics and addressing emotional and lifestyle factors. “Internalizing stressors and negative emotions can lead to inflammation and skin issues,” he points out. “It is important to recognize our emotional habits and make lifestyle changes, as well as do mind–body medicine therapies throughout our life.” Cutler’s assertion that stress has been linked to skin conditions and aggravating hormonal imbalances is also supported by ample research and more mainstream MDs.
Of course, many people are drawn to alternative cystic acne treatments because of the side effects associated with mainstream treatments. That said, it’s important to remember that alternative treatments may have side effects, too. Stockton notes that many of the alternative treatments that are suggested for cystic acne haven’t been studied thoroughly. Because of this, certain alternative treatments can be risky unless done under the supervision of a health practitioner. For example, alternative treatments like including supplements and herbs in one’s diet require straightforward conversations with healthcare providers, and it’s imperative to tell your doctor which supplements you’re taking since they can interact with other medications.

“We have to be careful with these types of products because these are not regulated, so some of the products can obtain other materials in them and some of these contain very high levels of supplementation that can even be toxic in the younger population,” Stockton says. “There are a few products that have some support. The best help with navigating alternative treatments is to make a consultation with a medical provider who is knowledgeable with the current use of these products.”
In addition to supplementation and dietary changes, many people are after natural home remedies for cystic acne, but Stockton and Prystowsky both advise that there aren’t any effective home remedies. Seeing your dermatologist should be your first port-of-call, and from there, they can advise you on how to properly care for your skin.

Should you pop the pimples caused by cystic acne?

Definitely not, according to Stockton. “The more you manipulate it, the more likely you are to cause permanent scarring,” she says. “I would suggest leaving the surgical treatment of acne to skincare professionals to avoid unnecessary scarring of the skin.” As tempting as it may be, the depth of cystic acne means the follicle will just burst within the skin, causing further inflammation.

Speaking of scarring, one of the most difficult aspects of cystic acne is dealing with the scars it leaves behind. “The best way to reduce your chances of permanent scarring is to seek care early, before you develop the scars and to avoid picking and squeezing cystic lesions,” says Stockton. “Understand this can be a long process, but most of the time, we can successfully control the condition.”

The Psychological Impact of Cystic Acne

Unfortunately, we live in a society where clear skin is seen as essential to beauty. For many people with cystic acne, this can be heartbreaking as they can be made to feel unattractive and undervalued. As in Holly’s case, people might also be bullied or teased because of their skin condition. Cystic acne can have an effect on your mental wellbeing, too.
One study shows that adolescents with acne—especially teenage girls—are likely to experience negative psychological impacts including anxiety due to their skin conditions. Another study links acne to poorer mental health and lower self-worth. Of course, this stress isn’t good for your soul or your skin, and unfortunately stress is related to more agitated and blemished skin, as well as a range of physical and mental health issues.

There is hope for Cystic Acne Sufferers

Therapy can be a useful way to work through these feelings. Kelley Kitley, LCSW, says that she often has clients who struggle with self-image and body-image issues due to acne. She recommends therapy to anyone who struggles with self-esteem and confidence issues due to acne or any other cause.

“The treatment I often use is cognitive behavioral therapy, which is restructuring automatic negative thoughts and focusing on the positive,” she says. “If they are getting treatment for the acne, we work on recognizing that the acne is temporary.” While it’s important to sort out the physical effects of cystic acne as soon as possible, the same can be said for the emotional effects of acne. It’s best to see a therapist sooner rather than later.
Holly feels that she’s lucky because her cystic acne motivated her to find her true calling. “I will never forget my experience with cystic acne, and would never want to go through it again, but it did provide me with a life changing experience,” she says. “If we use our challenges instead of letting our challenges use us, we can change the world one person at a time. That is my purpose and destiny now, every day.”

We spend about one-third of our lives sleeping—or at least trying to: getting our rooms to the perfect temperature and lighting, nestling under just the right amount of covers, arranging our limbs into the best sleeping position. And yet sleeping—one thing that should be so easy—is a struggle for many.
Of course, sleep is complicated. Sleep quality is a major health issue for Americans. According to 2014 numbers from the Centers for Disease Control and Prevention, 35.2 percent of adults get less than seven hours of sleep per night.
If that sounds like you and you’re looking to make a change, take note: Your bedtime and your sleeping position aren’t the only factors that determine the quality of your sleep. According to the Division of Sleep Medicine at Harvard Medical School, improving your sleep hygiene—the habits that affect your sleep—can make a substantial difference. If you’re on prescription medication, living la vida loca, feeling especially stressed out at work, or are indulging in a few too many coffees a day (especially close to bedtime), look at tweaking those parts of your life where you can.
But if you’ve already zenned out around matters both professional and personal, you eat the healthiest foods at the healthiest of times, and your bedroom is perfectly designed for a peaceful slumber—and you still can’t sleep, it might be time to look at how you’re sleeping. Specifically, you need to figure out the best sleeping positions for you because the way you sleep impacts how good that sleep is—and your overall health.
“The biggest purpose for sleep is to help us recover from the activities of the day physically, mentally, and emotionally,” says Scott Bautch, chiropractor and president of the American Chiropractic Association’s Council on Occupational Health. “The physical part is that if I sleep in a good posture, meaning neutral, my spine is resting, and everything is in the right position…I’m trying to help the body recover by trying to be as neutral as possible, so those ligaments and muscles get a chance to recover from the activities of the day.”  
A poor sleeping position can contribute to all sorts of conditions, from insomnia to back pain. But you can make a few minor changes to the way you lay to figure out the best sleeping position. Don’t be surprised if you see—and feel—major results.

Best Sleeping Positions: The Basics

Sleep specialists typically break down positions into three categories: side, back, and stomach. Within those three categories, there are plenty of variations. For instance, sleeping in the fetal position will actually affect you differently than sleeping with your back straight in what some refer to as the log position.
Sleep specialists typically make a simple recommendation: Do what makes you comfortable. If you’re having issues falling asleep or staying asleep, however, the best sleeping position for you likely involves sleeping on your side. 
That’s especially true if you have trouble breathing in other sleep postures. Harvard’s Division of Sleep Medicine also suggests that side sleeping is the best sleeping position for you if you struggle with troubled breathing at night as it may reduce the risk of obstructive sleep apnea (OSA), an extreme and potentially dangerous type of snoring. The school notes that weight loss and continuous positive airway pressure (CPAP) therapy are more effective methods of ensuring long-term healthy sleeping, but if you only experience breathing issues while sleeping on your back, you might consider being comfortably situated on your side as your new best sleeping position.

Best Sleeping Positions for Insomnia

Around 10 percent of American adults suffer from daytime impairment resulting from insomnia and around 30 percent of American adults deal with regular sleep disruption. It’s clear that sleep is a problem in America, and it seems to be getting worse: According to reporting from The New Yorker, insomnia diagnoses rose from fewer than one million to more than five million between 1993 and 2006. It’s a big deal, considering that sleep deprivation can seriously affect health.
To treat insomnia, you have to identify the cause of the condition. That’s not always easy, though, since everything from diet to television-watching habits can affect how you sleep (or don’t). One factor that researchers generally agree upon is that finding the best sleeping position for you can affect whether or not you’re getting healthy sleep.
Issues like back pain and indigestion can also contribute to insomnia, and if you’re constantly tossing and turning to try to get more comfortable, that won’t help you solve any of those issues. That’s why identifying any other physical issues—and attempting to remedy those through sleeping positions and other measures—is key.

Best Sleeping Positions for Back Pain

Back pain is incredibly prevalent. In 2012, the American Physical Therapy Association reported that nearly two-thirds of Americans experience low back pain. Put another (equally painful) way, on any given night, some 31 million people will suffer from low back pain in the States alone.
Even worse, low back pain and poor sleep work together to make sufferers miserable: One study from The Clinical Journal of Pain found that a bad night’s sleep indeed led to a day of increased back pain. Here’s the kicker: A day of worse pain was also associated with a bad night’s sleep! It’s easy to fall into a downward spiral of pain and fatigue.  
Finding the best sleeping position for back pain that works for you could be a game changer. Here’s what medical science says about finding the best sleeping positions for back pain:

Supine Sleeping (or Log Position)

The best sleeping positions for back pain involve keeping your posture neutral, meaning that the body doesn’t bend or twist out of line. Bautch explains, “If you’re standing up and your ears are over your shoulders, and your shoulders are over your hips, and your hips are over your knees, there’s a neutral posture from front to back and left to right. So we want to reproduce that [in sleep].”
Whatever you do, don’t sleep on your stomach, researchers say. The key to finding a healthy sleeping position that eases pain in your back is to keep the spinal column aligned according to its natural shape, which requires support. Sleeping on your stomach doesn’t offer much support for the spine and may even push it into an unnatural curve.
Sleeping face-down can lead to other health problems as well, Bautch warns. “That’s by far the worst,” he says, referring to stomach-sleeping. “People that sleep on their stomachs have more hand and arm problems than any other population…And because we’re not going to breathe into our pillows, we twist our neck all night long. Often we bring our knee and arm up. We’ll put our hand underneath our head, and that continued irritation, we don’t recover from. As life goes on, we start to have more numbness symptoms in our neck and arm.”
Your spine is a long cord of vertebrae, the smaller interlocking bones. Between each vertebra, there’s a squishy intervertebral disk—the skeleton’s shock absorbers. These disks are mostly made of water. Why is this important? When you’re upright, you put pressure on your intervertebral disks, slowly squeezing out some of the fluid. Sleep is when your disks rehydrate. Therefore, the best sleeping position for back pain is one that evenly distributes your body weight to keep pressure on the spine at a minimum.
If you’re most comfortable sleeping on your back, that’s great (unless you’re pregnant—in which case, read on!). “Sleeping on your back is definitely the best position for all body parts, because we’re less likely to twist or compress the nerves,” says Bautch. “Sleeping on your back is definitely the preferred way.”
Just be sure to get a few extra pillows. Place a small one behind your knees, bending them slightly. (If you want to get technical, bend your knees to 135 degrees—the angle prescribed by ergonomist Bart Haex in his book Back and Bed: Ergonomic Aspects of Sleeping.) Find a pillow that keeps your neck and shoulders in line with your ears and hips, which will keep your spine straight all the way to the base of your skull.

Lateral Sleeping

The lateral sleeping position—lying on your side—can also be a good sleeping position for back pain. Pull your knees a bit upward toward your torso to maintain stability. The right mattress also goes a long way here. You want your hip and shoulder to sink into the mattress just enough to keep your spine straight. Perfect the lateral sleeping position by placing a firm body pillow between your knees.
“If you sleep on your side, think about if you looked down and said, ‘Okay, here’s how wide my knees are when I’m standing normally,’” Bautch says. “I’m a big fan of body pillows. You put them between your knees, from your ankles to your knees, all the way to your arms. You hug them, and you have a tendency to keep your arms and legs in the right place.”
Try to align your hips, shoulders, and ears. If you can’t, adjust your pillows. “From your shoulders, you could draw a line on your spine and it would go all the way to your pelvis,” Bautch says. “And if I drew that line, it would continue right through between your knees and all the way to your ankle. That’s how I’d want to try to sleep.”
Long story short: The best sleeping positions for back pain are supine (on your back) and lateral (on your side). Use pillows to support parts of your body that aren’t sinking into the mattress, and to keep your body stable during sleep. Remember, you won’t be awake to purposely adjust.
And if that back pain gets worse, or doesn’t go away? Talk to your doctor.  

Best Sleeping Positions for Neck Pain

Neck pain and your sleeping position are strongly associated with one another. In fact, poor sleeping positions can not only lead to unhealthy sleep, but to musculoskeletal disorders in the neck and shoulders as well. You want the neck to remain straight, lying in the neutral posture. Unfortunately, that’s not something most contemporary pillows are built for.
“Most pillows are biggest in the middle and smallest at the edge,” says Bautch. “But they really need to be bigger on the edge and smaller in the middle because our head needs to sink down so we stay neutral all the time.”
If you have a conventional pillow, you probably need more neck support to get truly healthy sleep, especially if you sleep on your side. Your pillow alone is unlikely to keep your neck and spine aligned, which means it can exacerbate neck pain rather than providing relief.
Bautch suggests you modify your pillow. “Roll up a towel or something. You need to get an edge. The edge needs to be more supportive than the middle.”
Again, sleeping on your back is the best sleeping position to keep your body in a neutral position. If you can drift off on your back (and don’t snore, especially if you’re sleeping with your boo), you won’t go wrong with that sleeping position. Your neck will thank you.

Best Sleeping Positions for Digestion

Everyone knows they’re not supposed to eat just before bed, but many people do it anyway. Maybe you worked late and got home starving. Maybe dinner was just so satisfying that it put you into a food coma and bedtime became inevitable. No matter what happened, your sleeping position can determine how well your body is able to digest that late-night meal. 
Figuring out your best sleeping position is particularly important if you’re prone to heartburn or acid reflux. The gold standard that doctors recommend for people with gastroesophageal reflux disease (GERD) is to raise the head of the bed with six- to eight-inch tall blocks. Extra pillows just won’t cut it according to “Effect of Bed Head Elevation During Sleep in Symptomatic Patients of Nocturnal Gastroesophageal Reflux”—a study published in the Journal of  Gastroenterology and Hepatology in 2012—because they may only lift the head and shoulders. Besides, you might just roll off the pillows in your sleep.
If you’re just looking for relief from an overfull stomach, though, and you don’t want to break out the wood blocks, try sleeping on your left side, which is considered the best sleeping position for digestion. Just be sure not to lie on your right side. A major study found that reflux was significantly worse in healthy subjects when they lay on their right sides rather than their left.
Researchers fed 10 subjects sausage-and-egg biscuits and coffee, then had half of them lie on their left sides and half on their right. The latter group suffered more acid exposure and more episodes of reflux. The takeaway? Next time you overindulge just before bed, try lying on your left side. Just don’t forget that pillow between your knees.

Best Sleeping Positions for Pregnancy

Expecting mothers develop sleep disorders frequently, which isn’t completely surprising, considering the vast range of hormonal, physical, and emotional changes that accompany pregnancy. Sleeping in the best position is, again, one factor among many. If poor sleep is routinely affecting your quality of life during pregnancy, you’re best off speaking with your OB-GYN.
That said, the American Pregnancy Association says sleeping on your back is one sleeping position you should definitely avoid during pregnancy since it can cause a decrease in both maternal and and fetal circulation. They also advise against sleeping on your stomach, because, well, you’re a little too big for that.
Citing the work of OB-GYN Glade Curtis, the Association says that the best sleeping position for pregnant women is on their left sides, keeping their legs and knees bent. Placing a pillow under the abdomen can improve comfort in the last trimester. If you have hip pain, again, try placing a pillow between your knees. Try to get as much sleep as you can now, mama!

It’s happening again. You finished lunch a little while ago and that painful burning sensation in your stomach is back. You pop a Tums and wait for relief, but you know that it won’t last and your heartburn will probably start up again soon. You start to feel queasy and hope you don’t need to run to the bathroom. Why does this keep happening after every meal?
You might have a stomach ulcer. There are more than half a million new cases of stomach ulcers every year, and around 25 million Americans will get an ulcer at some point during their lives, according to the Centers for Disease Control and Prevention (CDC). This health issue is relatively common, but the good news is that ulcers have a high likelihood of being permanently cured.
So how do you know if your stomach pain is caused by an ulcer? HealthyWay asked Will Bulsiewicz, MD, MSCI, the board-certified practicing gastroenterologist behind the popular gut health Instagram account @theguthealthmd, to bust the common misconceptions about stomach ulcers. (Hint: Spicy food doesn’t cause them!) He also shared expert advice on diagnosing, treating, and preventing the disease. Here’s what you should know about stomach ulcers.

Understanding the Condition

There are many myths and misconceptions that swirl around when people talk about stomach ulcers. So let’s set the record straight, starting with the name.
“The term ‘stomach ulcer’ is something that people use liberally to refer to a peptic ulcer, which occurs in the stomach or in the first part of the small intestine, known as the duodenum,” says Bulsiewicz. “A peptic ulcer is basically a breakdown of the lining in the small intestine or stomach due to a disruption in the natural balance between inflammation and the barrier to inflammation that exists in the body.”
In other words, it’s a sore or hole in the lining of the stomach or the first part of the small intestine. Ouch!
So what causes stomach ulcers? You’ve probably heard that spicy food can burn holes in your stomach lining or that a stressful lifestyle contributes stomach ulcers, but that’s not entirely true.
“It does make for an interesting story, though,” explains Bulsiewicz. “After the Germans bombed England in World War II, they found that the rate of stomach ulcers rose substantially, so that’s where the myth that stress causes stomach ulcers comes from. While there’s some truth to the concept of a stress ulcer (they’re common in patients who are critically ill with organ failure), it’s generally caused by a bacterial infection.”
That’s right—rather than a few months of heightened stress causing stomach issues, the Helicobacter pylori bacterium (commonly known as H. pylori) is actually responsible for around 90 percent of ulcers.
“Many people will carry H. pylori without showing any symptoms. There are theories that exist that we have evolved to have this bacteria and it’s protective, but it also disrupts defense mechanisms in the stomach and therefore causes ulcers in stomach or the first part of the small intestine,” says Bulsiewicz.
As for other causes of stomach ulcers, the main culprit can be found right in your own medicine cabinet: non-steroidal anti-inflammatory drugs (NSAIDs), like aspirin, ibuprofen, and naproxen. (Note: Acetaminophen, or Tylenol, is not an NSAID.)
“Long-term use of NSAIDs can break down the natural defense mechanisms in the stomach and small intestine and cause direct harm, wearing away the lining,” says Bulsiewicz. “I don’t love these medicines, because when someone’s having severe gastrointestinal bleeding, it’s often because they’ve been using too much of these medicines to treat arthritis and things like that.”
Stomach ulcers can also be caused by Zollinger–Ellison syndrome, a rare condition that causes the body to produce too much acid. Zollinger–Ellison syndrome occurs in only about 1 in every 1 million people and is more common among men between the ages of 30 and 50, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Your doctor can run tests to determine if you have Zollinger–Ellison syndrome.

Signs You Might Have a Stomach Ulcer

Everyone suffers from the occasional stomachache—it’s no fun, but it usually passes after a couple hours without cause for alarm. But what if the pain is recurring? Could it be an ulcer? What do stomach ulcers feel like?
“The classic indicator is pain in the upper part of the stomach in your midline, but not quite in the chest. It’s the epigastric area,” says Bulsiewicz.
The doctor goes on to explain that mealtime can influence when you feel the worst.
“If it’s a stomach ulcer, the pain happens right after eating. If the ulcer is in the small intestine, it will hurt two or three hours after a meal,” he added.
However, pain isn’t the only sign of a problem. Other stomach ulcer symptoms include nausea, getting full too quickly (a condition known as “early satiety”), and anemia. Abnormal vomit and stools, such as if they’re bloody or look like coffee grounds, can also be big warning signs.
“If you have severe abdominal pain or any of the other symptoms, you should go see your doctor,” warns Bulsiewicz. “Don’t wait until it worsens to ask what’s going on.”
Delaying treatment for a stomach ulcer could lead to potentially serious complications.
“It might erode all the way through the lining of your stomach or intestine and create a perforation. You’ll develop peritonitis and there’s be a sudden onset of severe abdominal pain. It’s also possible to develop an obstruction, where the ulcer causes a deformation of the tube, or lumen, of the intestine and food can’t get through,” says Bulsiewicz.
If you suspect you might have a stomach ulcer or another gastrointestinal issue, get in touch with your physician as soon as possible. Early treatment can help you avoid painful complications down the road. 

How to Get a Diagnosis

When it comes to any health issue, reading about symptoms on the internet should be used strictly for gathering background information. Only a medical professional can say for sure whether you have a stomach ulcer.
Generally, your doctor will start by checking for an H. pylori infection, which might indicate a stomach ulcer. They can look for the bacteria through a stool, blood, or breath test.
You may also need to undergo an upper endoscopy, one of the best ways to diagnose a stomach ulcer, says Bulsiewicz. You’ll receive anesthesia, then the gastroenterologist will slip an endoscope (a thin, flexible tube with a light, camera, and tools to collect tissue for a biopsy) down your throat to look for sores.
“Once I’ve diagnosed it as an ulcer, I can administer a treatment during the procedure if medically appropriate. The endoscopy is the most direct test. It presents the least likelihood of missing an ulcer and it offers opportunity for treatment,” he says.
While used less frequently, a barium swallow can also help determine whether you have a stomach ulcer. This test involves swallowing a liquid with barium sulfate, which will coat the upper part of your gastrointestinal tract. Then the doctor will take a series of X-rays to watch the contrast and potentially spot an ulcer.
Your doctor will provide a recommendation on the best way to diagnose a stomach ulcer in your body.

Treating the Problem

Once your doctor confirms you have a stomach ulcer, he or she can begin making recommendations for treatment. The good news is that most stomach ulcer treatments are short and will help you feel better fast. Stomach ulcers are relatively common and easily cured with the right medical interventions.
“If you have H. pylori, the classic treatment is called a triple therapy. It’s a combination of two antibiotics—usually amoxicillin and clarithromycin—and a proton-pump inhibitor (or PPI), such as Prevacid, Nexium, and Prilosec, to reduce stomach acid,” says Bulsiewicz. “You’ll start to feel better in a few days unless you have a severe ulcer.”
Some doctors may treat a stomach ulcer with a histamine-2 (H2) receptor antagonist, rather than a PPI, to help your body cut down on acid production. The exact combination of drugs, dosage, and duration of treatment will depend on your medical history and the severity of your stomach ulcer.
As with almost every drug, stomach ulcer treatments such as PPIs do come with the risk of side effects. However, Bulsiewicz says that PPIs are safe and effective for the treatment of stomach ulcers.
“Many of the studies people have seen reported in the news about PPIs and their risks are overblown. In general, we believe these medicines are very safe. While there are risks, taking the medicine for 4 to 8 weeks is going to be completely safe for most people,” he says.
Your doctor may also provide recommendations for treating stomach ulcers with natural remedies in addition to medical preventions. For example, Bulsiewicz says that in addition to a PPI, he’s used fiber and probiotics to treat ulcers. This approach fosters gut health and may help prevent future stomach ulcers.
“Fiber, probiotics, and possibly fermented foods: These are things I believe in. What’s cool is that most things that contain fiber also have prebiotics, the food found in plants that feeds our gut microbiome and helps our body work the way it’s supposed to,” Bulsiewicz says.
Garlic and licorice root may potentially help heal stomach ulcers, but more research is required before they can be relied on as a natural treatment, adds Bulsiewicz.

Soothe with food.

What you put in your body can have a big influence on how you feel when you have a stomach ulcer. Bulsiewicz recommends eating a high-fiber diet (as long as you don’t have an obstruction) and limiting consumption of spicy and acidic foods.
“They can aggravate an ulcer. You should also avoid processed foods, which may impair healing of the ulcer,” he says.
It’s a good idea to lay off alcohol and smoking when you’re treating a stomach ulcer, Bulsiewicz cautions.
So what are the best foods to eat when you have a stomach ulcer? Stick with fresh, low-acid fruits and vegetables and lean meats. They’ll give your body the essential nutrients it needs during a time of healing. You may also consider eating homemade sauerkraut, which contains beneficial bacteria for your gut.

Stomach Ulcers and Pregnancy

During pregnancy, there are always heightened concerns about the impact health woes will have on the mother and the baby.
“Pregnancy may actually be protective when it comes to peptic ulcers, because increased progesterone levels from pregnancy lower stomach acid output and create more protective mucus. Nonetheless, ulcers can still happen and are more likely in those who smoke or who have a prior history of ulcer disease,” says Bulsiewicz, adding that if you think you might have a stomach ulcer while you’re pregnant, your doctor can perform an endoscopy—ideally during the second trimester—to make a diagnosis.
“There are safe medication options that could be used to treat the ulcer, such as the H2 receptor antagonists,” says Bulsiewicz.
Your doctor is the best source of information for diagnosis and treatment of a stomach ulcer during pregnancy.

Preventing Stomach Ulcers

Perhaps you’ve figured out that something else was the cause of your stomach pain (ate one slice too many at a pizza party? We don’t judge!), but now that you’ve read about stomach ulcers, you’re worried about getting one. How can you prevent it from happening to you?
“Be cautious with your use of NSAIDs. That’s what I see as the dominant controllable factor,” says Bulsiewicz.
He also recommends moderating the amount of alcohol you drink, quitting smoking, and eating a clean, healthy diet.
“Maximizing your consumption of fruits and vegetables and really doing your best to not consume processed foods is to everyone’s benefit,” says Bulsiewicz.
If you’re worried about getting a stomach ulcer, talk to your doctor so you can work together to decide the best way to check for an H. pylori infection and prevent gastrointestinal issues.