Stomach Ulcers and Acid Reflux: Symptoms and Treatments

Gastric ulcers and gastroesophageal reflux issues?

I started experiencing a sour taste in my mouth last December, and after taking traditional Chinese medicine for four months, it improved.
Since then, I have been very careful with my diet, avoiding sweet, sour, and spicy foods that could trigger gastric acid.
However, I still experience a slight sour or salty sensation in my mouth daily, occasional feelings of gastric acidity or bloating, and brief episodes of mild stomach pain lasting one or two minutes.
Because the symptoms are not severe, I did not seek further treatment from traditional Chinese medicine.
However, this condition persisted, and last month, concerned about gastroesophageal reflux potentially causing esophageal changes, I underwent an endoscopy at a gastroenterology clinic.
The doctor diagnosed me with a gastric ulcer.
I saw numerous pinpoint red spots (similar to small wounds) on the stomach wall in the endoscopy images.
The doctor prescribed me Carafate (Sucralfate).
After taking one tablet every morning on an empty stomach for nearly a month, my condition remains unchanged—neither improved nor worsened.
I returned to the doctor to discuss this.
He mentioned it could be due to my constitution and prescribed three days' worth of medication for bloating and gastric ulcers, along with another month's supply of Carafate.

I have two questions:
1.
Should I ask him to change my medication?
2.
I have heard that non-painful gastric ulcers are generally milder.
Is this true?
I would greatly appreciate the doctor's assistance in clarifying my confusion!

Masha, 50~59 year old female. Ask Date: 2020/07/03

Dr. Chen Shidian reply Gastroenterology and Hepatology

The described condition is mild gastritis and superficial ulcers, which can be effectively treated with gastric medications.
However, your symptoms of acid reflux may not necessarily be related to the stomach.
If routine health checks show no abnormalities, further monitoring may be sufficient.

Reply Date: 2020/07/03

More Info

Understanding stomach ulcers and acid reflux is crucial for managing symptoms and ensuring effective treatment. Based on your description, it appears that you have been experiencing persistent symptoms related to gastric acid and possibly a stomach ulcer, which can be quite distressing.

Symptoms of Stomach Ulcers and Acid Reflux
Stomach ulcers, or peptic ulcers, are sores that develop on the lining of the stomach or the first part of the small intestine (duodenum). Symptoms can vary widely among individuals. Common symptoms include:
- Burning stomach pain: This is often described as a gnawing or burning sensation in the stomach, which may improve or worsen with eating.

- Bloating and belching: Many individuals experience a feeling of fullness or bloating, often accompanied by excessive belching.

- Nausea or vomiting: Some may feel nauseous, and in severe cases, vomiting may occur.

- Acid reflux: This is characterized by a burning sensation in the chest (heartburn) when stomach acid backs up into the esophagus.

- Changes in appetite: Some may experience a reduced appetite or feel full after eating only a small amount.

In your case, the persistent sour or salty taste in your mouth, along with occasional feelings of gastric acid and bloating, suggests that you may be experiencing symptoms of acid reflux or a mild ulcer. The presence of "needle-like red spots" in your stomach lining, as noted in your endoscopy report, indicates inflammation, which is often associated with gastritis or ulcers.

Treatment Options
The treatment for stomach ulcers typically involves medications that reduce stomach acid, promote healing, and address any underlying causes such as Helicobacter pylori infection. The medication you mentioned, Gaviskon (佳樂胃), is an antacid that helps neutralize stomach acid and relieve symptoms. However, if you have been on this medication for a month without improvement, it may be time to discuss alternative options with your physician.

1. Consider Changing Medications: If your symptoms have not improved, it is reasonable to ask your doctor about switching to a different medication. Proton pump inhibitors (PPIs) such as omeprazole or lansoprazole are often more effective for reducing stomach acid and promoting healing of ulcers. These medications work by blocking the proton pumps in the stomach lining, significantly reducing acid production.

2. Understanding the Severity of Your Ulcer: It is a common misconception that the absence of pain indicates a less severe ulcer. While pain is a typical symptom of ulcers, some individuals may not experience significant pain, especially if the ulcer is in a location that does not irritate the surrounding nerves. The presence of inflammation and the appearance of the ulcer during your endoscopy are important indicators of the condition's seriousness, regardless of pain levels.

Lifestyle Modifications
In addition to medication, certain lifestyle changes can help manage symptoms and promote healing:
- Dietary Adjustments: Continue to avoid foods that trigger your symptoms, such as spicy, acidic, or fatty foods. Eating smaller, more frequent meals can also help reduce the burden on your stomach.

- Stress Management: Stress can exacerbate symptoms of ulcers and acid reflux. Techniques such as mindfulness, yoga, or counseling may be beneficial.

- Avoiding Smoking and Alcohol: Both can irritate the stomach lining and worsen symptoms.

Follow-Up Care
Regular follow-up with your healthcare provider is essential to monitor your condition and adjust treatment as necessary. If your symptoms persist or worsen, further investigation may be warranted to rule out other gastrointestinal issues.

In conclusion, while your current treatment may not be yielding the desired results, there are alternative medications and lifestyle changes that can help manage your symptoms effectively. It is important to maintain open communication with your healthcare provider to ensure that you receive the best possible care for your condition.

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