Duodenal Ulcer Recurrence: Symptoms and Treatment Insights

Q: Duodenal Ulcer Recurrence: Symptoms and Treatment Insights

Hello： 1. If there is bleeding, you may pass black stools. 2. If you have any concerns, you can consult a gastroenterologist to see if another endoscopy is necessary. Changhua Hospital cares about your health. Dr. Tsai An-Shun.

Duodenal ulcer recurrence!?

Hello doctor, I previously fainted at home due to a duodenal ulcer, likely because of excessive bleeding.
I was treated with Nexium (Esomeprazole) about two years ago, but I still felt unwell and underwent another endoscopy.
It was discovered that I had a Helicobacter pylori infection, which was why I hadn't improved.
The doctor mentioned that the ulcer was quite deep.
I then took medication to treat the Helicobacter pylori infection for about two to three months.
The doctor said I was better, which was around last year.
However, a few days ago, I suddenly felt dizzy after getting up to use the bathroom, similar to when I fainted from the duodenal ulcer (I also had cold symptoms).
Is it possible that the duodenal ulcer has recurred and is bleeding again? Because of this, I immediately took Nexium again, but will that be sufficient? Can the ulcer really heal completely with medication, or is there a risk that it will reopen due to irritants?

Xiao An, 20~29 year old female. Ask Date: 2017/04/03

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: 1.
If there is bleeding, you may pass black stools.
2.
If you have any concerns, you can consult a gastroenterologist to see if another endoscopy is necessary.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2017/04/03

More Info

Duodenal ulcers, also known as peptic ulcers, are sores that develop on the lining of the duodenum, which is the first part of the small intestine. They can cause significant discomfort and complications, including bleeding, which can lead to fainting or feeling lightheaded, as you experienced. Your history of duodenal ulcers and the treatment for H. pylori (Helicobacter pylori) infection are crucial in understanding your current symptoms.

When you mentioned that you felt faint after using the restroom, it raises concerns about potential complications related to your previous duodenal ulcer. Fainting can occur due to several reasons, including significant blood loss, dehydration, or even a sudden drop in blood pressure. If your ulcer has recurred and is causing bleeding, this could explain the symptoms you experienced. It is essential to monitor any signs of bleeding, such as black or tarry stools, or vomiting blood, as these are indications of a serious condition that requires immediate medical attention.

Regarding your treatment with medications like "耐適恩" (likely referring to a proton pump inhibitor or similar medication), these drugs are designed to reduce stomach acid, promoting healing of the ulcer. While they can be effective in managing symptoms and facilitating healing, they do not address the underlying causes of ulcers, such as H. pylori infection or lifestyle factors (e.g., NSAID use, smoking, excessive alcohol consumption). If the ulcer is deep or if there is ongoing irritation from dietary choices or medications, it is possible for the ulcer to reopen or for new ulcers to form.

The recurrence of symptoms after treatment could indicate that the ulcer has not healed completely or that new factors are contributing to your condition. It is crucial to follow up with your healthcare provider for further evaluation. They may recommend additional diagnostic tests, such as an endoscopy, to assess the state of the ulcer and determine if further treatment is necessary.

In terms of lifestyle modifications, it is advisable to avoid irritants such as spicy foods, caffeine, alcohol, and smoking, as these can exacerbate ulcer symptoms. Additionally, managing stress through relaxation techniques or counseling can also be beneficial, as stress can contribute to ulcer formation and recurrence.

In summary, while medications can help heal duodenal ulcers, they are not a standalone solution. It is vital to address any underlying causes, monitor for complications, and make necessary lifestyle changes. If you experience any alarming symptoms, such as fainting or signs of bleeding, seek medical attention promptly. Regular follow-ups with your healthcare provider will ensure that your condition is managed effectively and that any recurrence of ulcers is addressed in a timely manner.

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