Medications for Stomach Ulcers: Side Effects and Management

Medications for Peptic Ulcer Disease

Hello, Doctor.
After my gastroscopy, the doctor mentioned that I have some abrasions (likely referring to a duodenal ulcer) and mild inflammation in my stomach.
The doctor prescribed Ulcerin (20 mg), magnesium oxide tablets (250 mg), and Gascol (40 mg), and I have been taking these medications for nearly 20 days.
My questions are as follows:
1.
Initially, when I started taking the medication, I experienced frequent diarrhea, followed by a feeling of needing to go again but often being unable to, accompanied by some cramping pain in my abdomen.
I often woke up at 5 AM with abdominal pain (and also some borborygmi), after which I would go to the bathroom.
Since the side effects of the three medications mention diarrhea (and also constipation and abdominal pain), I wonder if the diarrhea, constipation, and abdominal pain are related to the medication? However, in the past week, I have not had diarrhea, mainly having soft stools (the magnesium oxide acts as an antacid and stool softener), but I still experience some constipation.
Could this mean I am becoming more accustomed to the medication, thus reducing the side effects? Is this phenomenon normal? Do I need to undergo further colonoscopy?
2.
Do Ulcerin and magnesium oxide tablets (antacid and stool softener) have different effects? Don't they both have antacid properties? Wouldn't that be redundant? I am concerned about the burden of taking too many medications; can I skip the magnesium oxide tablets and Gascol? If I do not have bloating, can I skip Gascol?
3.
I generally take my medications on time, but after about 7 to 10 days, I experience a recurrence of symptoms for about 2 days (symptoms include stomach discomfort, acid reflux, nausea, loss of appetite, and fatigue).
What could be the reason for this? How long should I take medication for the ulcer to heal? Will I be able to fully recover in the future?
4.
How effective is Ulcerin? Although I am not experiencing diarrhea now, I feel more nauseous and have a poorer appetite compared to before.
Should the doctor adjust the three medications prescribed? Taking magnesium oxide tablets and Gascol three times a day, is it good for the body in the long term? Will it not be too burdensome, especially since magnesium oxide contains magnesium? Thank you, Doctor, for your answers; I appreciate it.

A-Wen, 40~49 year old female. Ask Date: 2020/03/30

Dr. Chen Shidian reply Gastroenterology and Hepatology

Please discuss medication adjustments with the original gastroenterologist, and pay attention to dietary changes.
A fecal occult blood test may also be added.

Reply Date: 2020/03/30

More Info

When dealing with stomach ulcers, particularly duodenal ulcers, it's essential to understand the medications prescribed, their side effects, and how to manage symptoms effectively. Based on your situation, you are currently taking a combination of medications, including "瘍寧" (likely a proton pump inhibitor), magnesium oxide tablets, and "加斯克兒" (which may be an antacid or similar medication).

1. Side Effects and Symptoms
It's common for medications used to treat ulcers to cause gastrointestinal side effects, including diarrhea, constipation, and abdominal pain. The initial symptoms you experienced, such as frequent diarrhea and abdominal cramping, could indeed be linked to the medications. Proton pump inhibitors (PPIs) like "瘍寧" can alter gut motility, leading to changes in bowel habits. Magnesium oxide can act as a laxative, which might explain the diarrhea, while also potentially causing constipation if not balanced with adequate hydration and dietary fiber.

As you have noted a reduction in diarrhea recently, it may indicate that your body is adjusting to the medications. However, persistent symptoms such as abdominal pain and changes in bowel habits warrant further investigation. If symptoms continue or worsen, a colonoscopy may be necessary to rule out other gastrointestinal issues.

2. Medication Functions
Regarding the medications, while both "瘍寧" and magnesium oxide have acid-reducing properties, they work differently. "瘍寧" (as a PPI) significantly reduces gastric acid production, providing a longer-lasting effect, while magnesium oxide acts more as an antacid and can help with immediate relief of acid-related discomfort. It is not uncommon for patients to be prescribed both, as they can complement each other in managing symptoms. However, if you are not experiencing symptoms like bloating or discomfort, you might discuss with your doctor the possibility of reducing or eliminating one of the medications to avoid unnecessary polypharmacy.

3. Duration of Treatment and Recurrence
The duration of treatment for ulcers can vary significantly based on the severity of the ulcer and individual response to therapy. Generally, treatment with PPIs is recommended for at least 4 to 8 weeks for healing to occur. If you experience a recurrence of symptoms after a period of improvement, it could be due to several factors, including stress, diet, or even the presence of H. pylori infection, which may require additional treatment.

4. Long-term Use of Medications
Long-term use of PPIs and magnesium oxide is generally considered safe, but it can have potential side effects. For instance, long-term PPI use has been associated with an increased risk of certain gastrointestinal infections, nutrient malabsorption (like magnesium and vitamin B12), and potential kidney issues. Magnesium oxide, while beneficial for acid control and bowel regularity, should be monitored for magnesium levels, especially if taken over an extended period.

Conclusion
In summary, while your current medication regimen is aimed at managing your duodenal ulcer and associated symptoms, it's crucial to maintain open communication with your healthcare provider. Regular follow-ups can help adjust your treatment plan based on your symptoms and any side effects you may experience. Additionally, lifestyle modifications, such as stress management, dietary changes, and avoiding NSAIDs, can significantly aid in ulcer management and recovery. If you have concerns about your medications or symptoms, do not hesitate to reach out to your healthcare provider for personalized advice and adjustments to your treatment plan.

Similar Q&A

Understanding Duodenal Ulcers: Medication Insights and Precautions

The mother became a working woman over six years ago, and due to changes in diet and lifestyle, she developed a duodenal ulcer. Although she sought medical treatment at that time and the ulcer stabilized due to her adaptation, she has recently experienced some symptoms again, inc...

Dr. Lin Shunliang reply Pharmacology
Mrs. Tingyu: Hello, the medication your mother is taking belongs to the class of proton pump inhibitors, which are the strongest agents for suppressing gastric acid secretion. It is recommended to take this medication on an empty stomach because it is more stable in an acidic env...

Managing Gastrointestinal Side Effects of Medications: A Guide

Hello, doctor. I would like to ask if I have a history of gastric ulcers and am prone to stomach pain from taking the wrong medications. Due to my condition, I need to take Metformin (Glucophage) three times a day. I am concerned if this will harm my stomach. Additionally, if I e...

Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: 1. Metformin is an antidiabetic medication that is less likely to cause gastric ulcers. 2. You may consider discontinuing the medication or asking your physician to change it. Changhua Hospital cares about your health. Dr. Tsai An-Shun.

Do Certain Medications Like Tenormin and Zandipin Cause Stomach Ulcers?

The use of Tenormin (atenolol), Zandipin (zopiclone), and Manadine (amantadine) is not commonly associated with the development of gastric ulcers. However, individual responses to medications can vary, and it is important to consult a healthcare professional for personalized advi...

Dr. Hou Fangmin reply Pharmacology
Hello: (1) Atenolol (brand name Tenormin): This medication is a selective beta-1 adrenergic receptor blocker, used for the treatment of hypertension and tachycardia. No reports have been found indicating that it causes gastric ulcers. (2) Lercanidipine (brand name Zanidip): This ...

Effectiveness and Side Effects of Omeprazole for Stomach Ulcers

Dear Dr. Liang: How effective is "omezol" (omeprazole) for the treatment of gastric ulcers? Are there any side effects? Can it be taken for general gastric issues? Thank you.

Dr. Liang Jiade reply Gastroenterology and Hepatology
Hello, omeprazole is a proton pump inhibitor that primarily suppresses gastric acid production. It is used for the treatment of gastric ulcers and gastroesophageal reflux disease (GERD). The effectiveness depends on the severity of the ulcer, associated pathogenic factors, and wh...