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Treatments and drugs
By Mayo Clinic staffNonulcer stomach pain that is long lasting and isn't controlled by lifestyle changes may require treatment. What treatment you receive depends on your signs and symptoms. Treatment may combine medications with behavior therapy.
Medications
Medications that may help in managing the signs and symptoms of nonulcer stomach pain include:
- Over-the-counter antacids. Antacids (Maalox, Mylanta, others) in liquid or tablet form are a common treatment for indigestion. Antacids neutralize stomach acid and can provide fast pain relief.
- Over-the-counter gas remedies. Drugs that contain the ingredient simethicone may provide some relief by reducing gas. Examples of gas-relieving remedies include Mylanta and Gas-X.
- Medications to reduce acid production. Called H-2-receptor blockers, these medications are available over-the-counter and include cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR) and ranitidine (Zantac 75). Stronger versions of these medications are available in prescription form.
- Medications that block acid 'pumps.' Proton pump inhibitors shut down the acid "pumps" within acid-secreting stomach cells. Proton pump inhibitors reduce acid by blocking the action of these tiny pumps. Over-the-counter proton pump inhibitors include lansoprazole (Prevacid 24 HR) and omeprazole (Prilosec OTC). Stronger, prescription proton pump inhibitors also are available.
- Medication to strengthen the esophageal sphincter. Prokinetic agents help your stomach empty more rapidly and may help tighten the valve between your stomach and esophagus, reducing the likelihood of upper abdominal discomfort. Doctors may prescribe the medication metoclopramide (Reglan), but this drug may have significant side effects.
- Medications that control muscle spasms. Antispasmodic medications may help relieve stomach pain that's caused by spasms in the intestinal muscles. These medications include dicyclomine (Bentyl) and hyoscyamine (Levsin).
- Low-dose antidepressants. Tricyclic antidepressants and drugs known as selective serotonin reuptake inhibitors (SSRIs), taken in low doses, may help inhibit the activity of neurons that control intestinal pain. Your doctor may suggest antidepressants such as nortriptyline (Pamelor) and desipramine (Norpramin). SSRIs such as sertraline (Zoloft) or escitalopram (Lexapro) also may be helpful.
- Antibiotics. If tests indicate that a common ulcer-causing bacterium called H. pylori is present in your stomach, your doctor may recommend antibiotics. Antibiotics may also be used if tests reveal you have too much bacteria in your intestines.
Behavior therapy
Working with a counselor or therapist may help relieve signs and symptoms that aren't helped by medications. A counselor or therapist can teach you relaxation techniques that may help you cope with your signs and symptoms. You may also learn ways to reduce stress in your life in order to prevent nonulcer stomach pain from recurring.
- Vu H. Dyspepsia, nonulcerative. In: Ferri FF. Ferri's Clinical Advisor 2010. Philadelphia, Pa.: Mosby; 2009. http://www.mdconsult.com/das/book/body/163180634-3/0/2088/0.html. Accessed Oct. 1, 2009.
- McQuad KR. Dyspepsia. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2006. http://www.mdconsult.com/das/book/body/163180634-3/0/1389/0.html. Accessed Oct. 1, 2009.
- Indigestion. National Institute for Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/indigestion/index.htm. Accessed Oct. 1, 2009.
- Geeraerts B, et al. Functional dyspepsia: Past, present and future. Journal of Gastroenterology. 2008;43:251.
- Quigley EMM, et al. Dyspepsia. Current Opinion in Gastroenterology. 2008;24:692.
- Barbara Woodward Lips Patient Education Center. Non-ulcer dyspepsia. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 1999.
- Peppermint. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Oct. 2, 2009.
- Caraway. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Oct. 2, 2009.
- Rohren CH (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 8, 2009
