Duodenal Ulcers: Symptoms, Treatment, and Liver Health

Q: Duodenal Ulcers: Symptoms, Treatment, and Liver Health

Hello： 1. The primary treatment for ulcers is proton pump inhibitors. 2. Some abdominal discomfort may stem from functional issues, such as rapid or slow peristalsis. Sometimes it can be challenging to identify the cause directly from imaging studies. 3. I

Duodenal ulcer

I apologize for the inconvenience, but I would like to ask a few questions.
Recently, after eating, I started experiencing pain in the upper left abdomen.
It was diagnosed as a duodenal ulcer.
I was discharged from the hospital a week ago, and the doctor prescribed Pantoloc, one tablet every morning before meals.
I have read that other patients often take more than one type of medication.
My first question is: is taking only Pantoloc sufficient? I have noticed a significant improvement in my eating, and the pain has subsided; however, I still have a discomfort in a specific area in the upper left abdomen, just below the left rib cage.
It is not a widespread pain, just localized, and it hurts when pressed.
I mentioned this to my attending physician, but they said that area has already been examined (X-ray, CT scan, MRI) and showed no issues.
How can it be possible to have pain if there are no problems?
My second question is: what could be the cause of this pain? Could it be related to the ulcer?
Additionally, I want to provide some context: I went to the hospital due to left abdominal pain, and blood tests revealed that my liver enzymes were over 100, leading to hospitalization.
I also have gallbladder polyps and sludge, and I was hospitalized twice.
The first time, they did not identify the ulcer issue; I was discharged because my liver enzymes decreased.
However, two days after discharge, after eating, the pain returned, and my liver enzymes were again over 100, leading to a second hospitalization.
It was during this second stay that the duodenal ulcer was diagnosed.
On the day of my discharge, although my liver enzymes were significantly lower than during my hospitalization, they were still over 200, which is elevated.
The doctor suspects that the frequent use of painkillers and gout medication may have caused drug-induced hepatitis.
I am currently unsure if my liver enzymes have decreased, as I am scheduled for another blood test on the 20th.

My third question is: do liver enzymes decrease rapidly, or do they tend to decrease gradually?

A-Hsuan, 20~29 year old female. Ask Date: 2017/03/07

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: 1.
The primary treatment for ulcers is proton pump inhibitors.
2.
Some abdominal discomfort may stem from functional issues, such as rapid or slow peristalsis.
Sometimes it can be challenging to identify the cause directly from imaging studies.
3.
If there is no persistent damage to the hepatocytes, liver enzyme levels will decrease rapidly.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2017/03/07

More Info

Understanding duodenal ulcers and their implications on overall health, including liver function, is crucial for effective management and recovery. Duodenal ulcers are open sores that develop on the lining of the duodenum, the first part of the small intestine. They can cause various symptoms, including abdominal pain, bloating, and discomfort, particularly after eating.
In your case, you mentioned experiencing pain in the upper left abdomen, specifically under the rib cage, which persists despite treatment with Pantoloc (a proton pump inhibitor). While Pantoloc is effective in reducing stomach acid and promoting healing of ulcers, it is essential to understand that some patients may require additional medications, such as antibiotics if H. pylori infection is present, or other acid-reducing agents, depending on the severity and specifics of their condition.
The discomfort you are experiencing could be multifactorial. It may not necessarily be related to the ulcer itself, especially if imaging studies (like X-rays, CT scans, and MRIs) have ruled out significant issues in that area. Sometimes, pain can arise from functional gastrointestinal disorders, which may not show up on imaging but can still cause significant discomfort. Additionally, the pain could be related to the liver or gallbladder, especially considering your history of elevated liver enzymes and gallbladder polyps.
Regarding your liver health, elevated liver enzymes can be concerning and may indicate liver inflammation or damage. The fact that your liver enzymes were elevated during your hospital stays suggests that there may have been an underlying issue, possibly exacerbated by the use of pain medications, which can lead to drug-induced liver injury. It is essential to follow up with your healthcare provider regarding your liver function tests. Generally, liver enzymes can decrease relatively quickly if the underlying cause is addressed and if there is no ongoing damage. However, the rate of decline can vary based on individual health factors and the extent of liver injury.

As for your dietary concerns, it is advisable to follow a bland diet that avoids spicy, acidic, or irritating foods, especially while recovering from ulcers. Dairy products can be tolerated by some individuals, but it is best to monitor your body's response to them. If you find that certain foods exacerbate your symptoms, it may be wise to avoid them.
In summary, while Pantoloc is a good start for treating your duodenal ulcer, it is essential to communicate openly with your healthcare provider about your ongoing symptoms and concerns. They may consider adjusting your treatment plan or conducting further evaluations to ensure that all potential issues, including those related to your liver, are adequately addressed. Regular follow-ups and monitoring of your liver function tests will be crucial in managing your overall health.

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