Managing Gastric Ulcers: Medication, Symptoms, and Dietary Tips

Q: Managing Gastric Ulcers: Medication, Symptoms, and Dietary Tips

Hello： (1) If you have concerns, it is advisable to return for a follow-up consultation rather than self-medicate. <br>(2) Certain cases of gastroesophageal reflux disease (GERD) can cause discomfort in the chest area; however, this discomfort typically follows the central line,

Medication issues for gastric ulcers?

Hello, I currently weigh about 93 kg and am 177 cm tall.
Let me describe the history of my symptoms.
Five years ago, I had gastroesophageal reflux disease (GERD), which improved after about four months of treatment.
Previously, I had a habit of drinking coffee and tea during the day and consuming beverages and snacks at night.
In early March of this year, shortly after drinking coffee, I experienced occasional sudden sensations in my chest, along with dizziness, acidity in my stomach, and a burning sensation in my chest.
At that time, I didn't think much of it.
About a week later, after having a spicy dinner, I broke out in cold sweats, experienced persistent burping, and felt tightness in my left chest, which led to an emergency visit to Chang Gung Memorial Hospital for a night consultation.
My heart rate was nearly 140 beats per minute, but I hardly felt that my heart was racing.
At that time, I weighed about 103 kg.
After the consultation, the doctor believed it was caused by GERD and not related to the heart, but still arranged for a resting electrocardiogram (ECG).
After the consultation, I felt normal again.
During a follow-up visit, the doctor said the ECG was normal and advised me to see a gastroenterologist.
If I was still concerned, I could see a cardiologist for more detailed examinations.
Since then, I have not consumed coffee, tea, or soft drinks, and I have tried to eat light or vegetarian meals.
However, shortly after, I began to cough persistently, so I consulted an otolaryngologist.
After about a month, my cough improved significantly, and I finally went to see a cardiologist.
During this period, whenever I sat or lay down, I would occasionally feel a sudden sensation in my left chest.
The cardiologist performed another resting ECG and, after the consultation, also believed it was not related to the heart and initially suggested I see a gastroenterologist.
Eventually, I underwent a 24-hour Holter monitor test, which revealed premature ventricular contractions, classified as benign arrhythmia.
The doctor suggested that it might be caused by gastric acid or psychological factors and advised me to undergo an upper endoscopy.
In mid-April, I finally saw a gastroenterologist, underwent an endoscopy, and tested for Helicobacter pylori.
It was found that I had mild gastric ulcers and duodenal ulcers, but no H.
pylori was detected; it was attributed to gastric acid.
While waiting for the H.
pylori test results, the doctor prescribed pantoprazole (40 mg) and Mosapride, and on the first day of taking these medications, all my symptoms disappeared.
However, taking pantoprazole made me feel a bit dizzy and nauseous, with occasional urges to vomit, which would subside after 2-3 hours.
During my follow-up visit last week, I informed the doctor of my condition.
Consequently, the doctor prescribed rabeprazole and Mosapride, and after taking them, I experienced minimal discomfort.
However, about 5-6 hours after going to bed, I felt bloating in my lower chest, and walking around helped alleviate it, but lying back down soon led to a recurrence of the bloating.
Additionally, the occasional sensation in my left chest returned, requiring me to move around to relieve gas before lying back down, which sometimes alleviated the sensation.
Interestingly, during the day, I felt no discomfort, possibly due to increased activity, and even short naps of half an hour to an hour did not cause issues.
I consulted a pharmacist I know, who advised me not to eat fruit after dinner (which I had been doing).
I initially considered buying anti-bloating medication, but the pharmacist suggested that taking probiotic capsules would have a similar effect, recommending I take one after dinner and another before bed.
Following the pharmacist's advice, while I still experience some bloating in my lower chest, it has improved significantly.
However, after waking and moving around, lying back down still occasionally leads to sensations in my left chest.
Previously, during my treatment for GERD, I took rabeprazole without experiencing bloating.
I would like to ask: 1.
Should I request a medication change during my follow-up visit, or would it be sufficient to buy anti-bloating medication? I noticed that one of the side effects of rabeprazole is bloating.
2.
Additionally, I mostly release gas by burping and rarely pass gas.
Could this be the reason for the occasional sensations in my left chest while lying down? 3.
Is it safe to drink unsweetened yogurt if I have gastric ulcers? Thank you!

Xuan Xuan, 30~39 year old female. Ask Date: 2016/05/02

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: (1) If you have concerns, it is advisable to return for a follow-up consultation rather than self-medicate.
(2) Certain cases of gastroesophageal reflux disease (GERD) can cause discomfort in the chest area; however, this discomfort typically follows the central line, which corresponds to the path of the esophagus.
If a cardiologist has already diagnosed that there are no heart issues, it is important to manage the GERD and monitor whether symptoms recur.
If symptoms persist, you may need to consult both a cardiologist and a gastroenterologist.
(3) If you do not experience any discomfort after drinking, it is fine to continue drinking.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2016/05/02

More Info

Managing gastric ulcers effectively requires a comprehensive approach that includes medication, dietary adjustments, and lifestyle changes. Based on your detailed history and current symptoms, here are some insights and recommendations to help you manage your condition.

Understanding Your Symptoms
From your description, it seems you are experiencing a combination of gastric discomfort, bloating, and occasional chest tightness, which can be distressing. The fact that you have a history of gastroesophageal reflux disease (GERD) and have recently been diagnosed with gastric and duodenal ulcers indicates that your gastrointestinal system is sensitive and may react strongly to certain foods and stressors.

1. Medication Side Effects: The medications you are taking, such as proton pump inhibitors (PPIs) like Pantoprazole (百抑潰) and Mosapride, can sometimes lead to side effects like nausea and bloating. If you find that these symptoms persist or worsen, it’s essential to discuss this with your healthcare provider. They may consider adjusting your medication or dosage.

2. Bloating and Gas: The bloating and gas you are experiencing, especially at night, can be attributed to several factors, including the type of food you consume, how you eat, and the medications you are on. It’s not uncommon for individuals with gastric ulcers to experience increased gas production, which can lead to discomfort when lying down. The fact that you feel better when you are active during the day suggests that movement helps alleviate some of the pressure in your abdomen.

Dietary Recommendations
Diet plays a crucial role in managing gastric ulcers. Here are some dietary tips that may help:
- Avoid Irritating Foods: Steer clear of spicy foods, caffeine, alcohol, and acidic foods (like citrus fruits and tomatoes), as these can exacerbate your symptoms. Since you mentioned avoiding coffee and tea, continue to do so, as they can increase stomach acid production.

- Eat Smaller, More Frequent Meals: Instead of three large meals, try eating smaller meals throughout the day. This can help reduce the burden on your stomach and minimize acid production.

- Incorporate Soothing Foods: Foods that are gentle on the stomach, such as bananas, oatmeal, and yogurt (if tolerated), can be beneficial. You asked about consuming sugar-free yogurt; it can be a good option as long as it doesn’t contain irritating additives.

- Stay Hydrated: Drink plenty of water throughout the day, but avoid drinking large amounts during meals to prevent feeling overly full.

- Consider Probiotics: As suggested by the pharmacist, probiotics can help maintain gut health and may assist in reducing bloating. Incorporating probiotic-rich foods like yogurt or taking a probiotic supplement could be beneficial.

Lifestyle Modifications
- Stress Management: Stress can significantly impact gastrointestinal health. Consider incorporating stress-reducing techniques such as mindfulness, yoga, or gentle exercise into your routine.

- Posture During Meals: Maintain an upright posture while eating and for at least an hour afterward. This can help prevent acid reflux and improve digestion.

- Sleep Position: If you experience discomfort while lying down, try elevating the head of your bed or using extra pillows to keep your upper body elevated during sleep.

When to Seek Further Help
1. Persistent Symptoms: If your symptoms do not improve with dietary changes and medication adjustments, or if they worsen, it’s crucial to follow up with your healthcare provider. They may recommend further diagnostic tests or a different treatment approach.

2. Bloating and Gas Remedies: While over-the-counter medications for gas relief can be helpful, it’s best to consult with your doctor before starting any new medication, especially considering your current treatment regimen.

3. Regular Follow-ups: Given your history of ulcers and ongoing symptoms, regular follow-up appointments with your gastroenterologist are essential to monitor your condition and adjust treatment as necessary.

In summary, managing gastric ulcers involves a multifaceted approach that includes careful medication management, dietary modifications, and lifestyle changes. By taking proactive steps and maintaining open communication with your healthcare provider, you can effectively manage your symptoms and improve your quality of life.

Similar Q&A

Best Foods and Remedies for Stomach Ulcers: What to Eat?

Our teacher recently developed a gastric ulcer. Are there any home remedies for gastric ulcers? What supplements would be beneficial?

Dr. Liang Jiade reply Gastroenterology and Hepatology
Patients with gastric ulcers must take their prescribed medications (antacids) on time and avoid irritating foods. Additionally, it is important to check for Helicobacter pylori infection; if present, antibiotic treatment must be included.

Essential Dietary Tips for Managing Stomach Ulcers Effectively

Hello, for daily life with a gastric ulcer, are there any specific dietary considerations? What foods should be avoided, and what can help improve the condition of a gastric ulcer?

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Hello: Avoid smoking and alcohol, limit tea and coffee, reduce刺激 foods, and minimize sweet, sour, and carbonated beverages. As for what foods are better to eat, gentle and easily digestible options are sufficient, but avoid eating porridge frequently. Wishing you good health. Sin...

Diet and Lifestyle Tips for Managing Mild Gastric Ulcers

I was recently diagnosed with a mild gastric ulcer. Even though I am careful to avoid overly acidic, spicy, or sweet foods, I still often experience a bitter taste in my mouth, which feels different from when my stomach was healthy. Therefore, I would like to ask the doctor what ...

Dr. Chen Shidian reply Gastroenterology and Hepatology
Hello, Miss: For ulcer diet, it is recommended to have small, frequent meals, avoid spicy foods, and refrain from sweets, smoking, alcohol, tea, and coffee. There are various gastric medications available, which can be prescribed by a gastroenterologist based on your condition an...

Understanding Stomach Ulcers: Causes, Symptoms, and Dietary Tips

Gastric ulcers are caused by an imbalance between the protective factors of the stomach lining and the aggressive factors that can damage it. Common causes include infection with Helicobacter pylori, prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs), excessive alcoho...

Dr. Chen Zhiping reply Gastroenterology and Hepatology
Hello, the development of gastric ulcers and duodenal ulcers can be attributed to various factors, including excessive gastric acid secretion, Helicobacter pylori infection, medications, significant illnesses or injuries, burns, and emotional stress, all of which may contribute t...