My fiance has just been diagnosed with an ulcer. He smokes and drinks several cans of Mountain Dew a day. Should he stop doing this?

Robbin

Peptic ulcers -- ulcers caused by acid in the stomach and upper intestine, or duodenum -- are common in developed countries. Studies have shown that the most common causes of ulcers are Helicobacter pylori (a type of bacterium that resides in the stomach) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen. If Helicobacter pylori is found and eradicated by antibiotics, ulcers recur in less than 1 percent of patients. Similarly, in patients who develop ulcers as a consequence of NSAIDs, discontinuing these medications greatly lowers the risk of ulcer recurrence.

In addition to the measures mentioned, doctors also often recommend acid-suppressive medications, such as ranitidine (Zantac) or omeprazole (Prilosec). These medications encourage ulcer healing by preventing acid production in the stomach.

Another step is to make lifestyle changes, such as quitting or cutting back on smoking and alcohol consumption. Although these factors are not thought to directly cause ulcers, they can retard their healing. On the other hand, caffeine -- found in high levels in Mountain Dew -- is not believed to either cause ulcers or slow their healing. However, keep in mind that caffeine in large quantities can lead to dyspepsia -- an uncomfortable stomach condition associated with nausea and bloating. These symptoms are bothersome and can lead to significant anxiety for someone recently diagnosed with an ulcer.

The bottom line: Your fiance should definitely stop smoking to maximize the healing of his ulcer. In addition, reducing his intake of Mountain Dew may help him feel better if he still is having stomach discomfort. Also, depending on the location of his ulcer, he may need to have a repeat endoscopy to document its healing.