Should Medication Be Changed After Gastric Polyp Removal?

Is it necessary to change medications after the removal of gastric polyps?

Hello Doctor, my wife has been experiencing stomach pain and bloating.
She has been taking medication from the clinic for 18 days (starting with cimetidine and later switched to ranitidine) without improvement.
On Wednesday, we went to a larger hospital where Dr.
Yang prescribed pain relief and anti-bloating medication.
However, from the time she started the medication until today, she still has stomach pain and bloating.
Today, Friday, after undergoing an endoscopy, Dr.
Hong said her stomach looks good with no inflammation or ulcers, but there was a small polyp that has been removed.
After returning home, my wife continues to experience bloating and stomach pain, along with a new vague pain sensation.
I would like to ask...
in this situation (1.
having had a small polyp removed, is there a wound? 2.
still experiencing stomach pain and bloating), should we consider changing her medication? Dr.
Hong mentioned discussing the possibility of changing medication with Dr.
Yang when we return for the report.
I just realized that the report will take two weeks to come out, so if a medication change is necessary, should we consider returning earlier for a medication adjustment? (Note: the outpatient consultation and endoscopy were performed by different doctors).
Thank you for taking the time to respond.

Li, 40~49 year old female. Ask Date: 2017/09/15

Dr. Chen Qifeng reply Gastroenterology and Hepatology

1.
Endoscopic removal of polyps rarely has complications.
2.
If symptoms do not improve, abdominal ultrasound and other examinations may be considered.

Reply Date: 2017/09/15

More Info

After the removal of a gastric polyp, it is common for patients to experience lingering symptoms such as abdominal pain and bloating. In your wife's case, despite the polyp being removed and no signs of inflammation or ulcers being present, her ongoing symptoms raise important considerations regarding her medication regimen.

1. Surgical Considerations: When a polyp is removed via endoscopy, there is typically minimal trauma to the surrounding tissue, and any resultant "wound" is usually minor. However, the removal process can lead to temporary irritation or inflammation in the stomach lining, which might contribute to ongoing discomfort. This is a normal part of the healing process, and symptoms may persist for a short period post-procedure.

2. Medication Review: Given that your wife has been experiencing persistent symptoms despite taking medications like cimetidine and ranitidine, it may be prudent to reassess her medication. Both of these medications are H2 receptor antagonists that reduce stomach acid production, but they may not be sufficient for all patients, especially if the underlying cause of her symptoms is not solely related to acid production.
If her symptoms of bloating and pain continue, it may be beneficial to consider other classes of medications. Proton pump inhibitors (PPIs) like omeprazole or esomeprazole are often more effective for managing gastric acid-related symptoms and might provide better relief. However, switching medications should be done under the guidance of her healthcare provider.

3. Timing for Medication Change: Since the report from the endoscopy will take about two weeks, it is essential to monitor her symptoms closely during this time. If her symptoms worsen or do not improve, it would be reasonable to contact her healthcare provider sooner rather than waiting for the report. Early intervention can sometimes prevent further complications or discomfort.

4. Follow-Up Consultation: It is crucial to have a follow-up appointment with the physician who performed the endoscopy to discuss the findings and any necessary changes to her treatment plan. This appointment will allow for a comprehensive review of her symptoms in the context of the endoscopy results, and the physician can make informed decisions about whether a medication change is warranted.

5. Lifestyle and Dietary Adjustments: In addition to medication, consider discussing dietary modifications and lifestyle changes that may alleviate her symptoms. Certain foods can exacerbate bloating and discomfort, and identifying these can be beneficial. Encouraging smaller, more frequent meals and avoiding known irritants (such as spicy foods, caffeine, and alcohol) may also help.

In summary, while the removal of a gastric polyp typically does not necessitate an immediate change in medication, persistent symptoms warrant a thorough evaluation. It is advisable to maintain open communication with her healthcare providers, monitor her symptoms, and consider a medication review if her discomfort continues.

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