Managing Duodenal Ulcers: Symptoms, Treatment, and Dietary Tips

Duodenal ulcer medication is ineffective, along with other symptoms?

Hello Doctor, I am currently 19 years old.
In February, I suddenly experienced severe stomach burning, and it wasn't until the end of February that I underwent an endoscopy, which revealed a mild duodenal ulcer.
There was no Helicobacter pylori, and I informed the doctor that I tend to get anxious, so I was prescribed Anxiolytics and Omeprazole.
I have been taking them from February to June, but there has been little improvement.
My weight has dropped from 56 kg to 47 kg, and my body fat percentage decreased from 20% to 16.7%.
My visceral fat has gone from 2 to 1, and my bowel movements have decreased in frequency and volume, leading to constipation.
In March, X-rays, ultrasounds, and blood tests all came back normal.
Currently, my symptoms include a warm sensation and discomfort in my stomach after meals, along with a heavy, tight feeling around my navel, as if there is a stone in my abdomen.
It feels so heavy that my abdominal muscles tense up on their own, especially after dinner when the symptoms are more uncomfortable.
Should I consider having another endoscopy, or would you recommend undergoing some health checks, such as an MRI? Additionally, can I consume yogurt and oatmeal porridge (the kind that is cooked until mushy) with a duodenal ulcer? If yogurt is permissible, should I drink it before or after meals?

Lin Yi-hong, 10~19 year old female. Ask Date: 2020/05/30

Dr. Chen Shidian reply Gastroenterology and Hepatology

It is recommended to first consult a psychiatrist to manage anxiety and tension, and to use medications from the gastroenterology department as needed.
A normal diet is acceptable, with the exception of avoiding刺激性食物 (irritating foods), and there should be no significant restrictions.

Reply Date: 2020/05/30

More Info

Managing duodenal ulcers can be challenging, especially when symptoms persist despite treatment. It’s important to understand the symptoms, treatment options, and dietary considerations to effectively manage your condition.

Symptoms of Duodenal Ulcers
Duodenal ulcers are sores that develop on the lining of the duodenum, the first part of the small intestine. Common symptoms include:
- Abdominal Pain: This is often described as a burning sensation, typically occurring a few hours after eating or during the night.

- Nausea and Vomiting: Some patients may experience nausea, which can lead to vomiting.

- Bloating and Gas: Many individuals report feelings of fullness or bloating, especially after meals.

- Changes in Appetite: Some may experience a decrease in appetite due to discomfort.

- Weight Loss: Unintentional weight loss can occur, as seen in your case, due to reduced food intake.

Treatment Options
The treatment for duodenal ulcers typically involves:
1. Proton Pump Inhibitors (PPIs): Medications like Omeprazole reduce stomach acid production, promoting healing.

2. Antibiotics: If H. pylori infection is present, antibiotics may be prescribed.

3. Antacids and H2-Receptor Antagonists: These can help alleviate symptoms by neutralizing stomach acid.

4. Lifestyle Modifications: Stress management, avoiding NSAIDs, and dietary changes are crucial.

Self-Management Strategies
1. Medication Adherence: Continue taking your prescribed medications as directed. If symptoms persist, consult your doctor about adjusting your treatment plan.

2. Dietary Adjustments:
- Avoid Irritants: Steer clear of spicy foods, caffeine, alcohol, and acidic foods that can exacerbate symptoms.

- Incorporate Soothing Foods: Foods like oatmeal and yogurt can be beneficial. Oatmeal, when cooked to a soft consistency, is gentle on the stomach and can help absorb excess acid. Yogurt may help due to its probiotic content, which can aid digestion.

- Meal Timing: Eating smaller, more frequent meals can help manage symptoms. If you choose to consume yogurt, it may be better to have it between meals rather than immediately before or after eating to avoid exacerbating discomfort.

When to Seek Further Evaluation
Given your ongoing symptoms, including significant weight loss and discomfort, it is advisable to follow up with your healthcare provider. A repeat endoscopy may be warranted to assess the healing of the ulcer and rule out any complications, such as strictures or malignancy. Additionally, imaging studies like an MRI can provide further insights into your gastrointestinal health.

Conclusion
Managing a duodenal ulcer requires a comprehensive approach that includes medication, dietary modifications, and regular follow-ups with your healthcare provider. Your symptoms of heaviness and discomfort after meals, along with significant weight loss, warrant further investigation. Incorporating soothing foods like oatmeal and yogurt into your diet can be beneficial, but always consult your doctor before making significant changes to your treatment plan. Remember, effective management of duodenal ulcers is possible with the right strategies and medical guidance.

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