Long-Term Stomach Ulcers: Symptoms and Treatment Options

I have had a gastric ulcer for over five years?

Hello, Doctor:
1.
I have had a gastric ulcer for over five years.
Every day, after eating a full meal including fruits, when I sit or lie down to watch TV or use the computer, I experience a feeling of tightness and discomfort in my chest, along with palpitations.
It’s really uncomfortable, and I find myself constantly patting my chest and needing to stand up and walk around, which doesn’t help at all.
I use a massager on my chest, and after about ten minutes, I feel a bit better.
However, doing this every day is not a solution; I need to seek treatment.
I went to the hospital to see a cardiologist: 1.
They performed an X-ray, and the doctor said my heart is enlarged, but I don’t understand what that means.
2.
An electrocardiogram (ECG).
3.
A stress test.
The doctor said there are no issues with my heart.
Could the problem be related to gastroesophageal reflux disease (GERD)?
2.
Sometimes, I suddenly experience pain in my back and break out in a cold sweat, which is very uncomfortable.
I am certain that my gastric ulcer is acting up because on that day, I vomited foam due to stomach acid.
I immediately went to the pharmacy to buy medication for my gastric ulcer, but I still don’t know what’s going on! Which department should I consult?

A Jin, 50~59 year old female. Ask Date: 2020/07/11

Dr. Chen Shidian reply Gastroenterology and Hepatology

You can first schedule an appointment with a gastroenterologist to assess the severity of the reflux.
Depending on the treatment response, you may consider consulting other specialties if necessary.

Reply Date: 2020/07/11

More Info

Understanding long-term stomach ulcers, particularly gastric and duodenal ulcers, involves recognizing the symptoms, potential complications, and treatment options available. Your experience with persistent discomfort, especially after meals, is not uncommon among individuals suffering from these conditions.

1. Symptoms and Diagnosis: The symptoms you describe, such as chest discomfort, heart palpitations, and back pain, can indeed be associated with gastric ulcers or gastroesophageal reflux disease (GERD). The sensation of pressure or discomfort in the chest, especially after eating, can be indicative of acid reflux, where stomach acid flows back into the esophagus, causing irritation. The fact that you have experienced heart palpitations and cold sweats raises the need for careful evaluation, as these symptoms can sometimes overlap with cardiac issues. However, since your cardiac evaluations have returned normal, it is reasonable to consider that your symptoms may be primarily gastrointestinal in nature.

2. Potential Complications: Long-standing gastric ulcers can lead to several complications, including bleeding, perforation, and gastric outlet obstruction. The presence of intestinal metaplasia, as noted in your biopsy results, is a condition where the stomach lining changes to resemble the intestinal lining, which can be a precursor to gastric cancer. While not all cases of intestinal metaplasia progress to cancer, it is a condition that warrants monitoring and lifestyle modifications to reduce risk factors.

3. Treatment Options: The management of gastric ulcers typically involves a combination of medication and lifestyle changes. Proton pump inhibitors (PPIs) like omeprazole or ranitidine are commonly prescribed to reduce stomach acid production, allowing the ulcer to heal. If you find that your symptoms persist despite medication, it may be necessary to reassess your treatment plan. This could involve adjusting the dosage, switching medications, or exploring additional therapies such as antibiotics if Helicobacter pylori infection is present.

4. Lifestyle Modifications: Dietary changes can significantly impact ulcer symptoms. It is advisable to avoid foods that can irritate the stomach lining, such as spicy foods, caffeine, alcohol, and acidic foods. Eating smaller, more frequent meals rather than large meals can also help manage symptoms. Additionally, maintaining a healthy weight, managing stress, and avoiding smoking are crucial components of ulcer management.

5. When to Seek Further Help: Given your ongoing symptoms and the complexity of your case, it may be beneficial to consult a gastroenterologist for a comprehensive evaluation. They can perform further diagnostic tests, such as an endoscopy, to assess the state of your ulcers and the overall health of your gastrointestinal tract. If your symptoms are severe or if you experience new symptoms such as significant weight loss, persistent vomiting, or blood in your stool, it is essential to seek immediate medical attention.

In conclusion, while your symptoms may be related to your long-standing gastric ulcer, it is crucial to continue working with healthcare professionals to manage your condition effectively. Regular follow-ups, appropriate medication, and lifestyle adjustments can help alleviate your symptoms and improve your quality of life.

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