Managing Nausea and Vomiting in Post-Operative Ulcer Patients: A Guide

Q: Managing Nausea and Vomiting in Post-Operative Ulcer Patients: A Guide

Hello： 1. <br>If a gastroscopy has been performed and a diagnosis of peptic ulcer has been confirmed, generally, medication treatment should provide relief. <br>If there is still no improvement, it may be necessary to investigate other causes, such as issues with bowel movements,

For patients with gastric ulcers who experience recurrent nausea and vomiting after discharge from the hospital, it is important to follow these management strategies: 1. Dietary Modifications: Encourage a bland diet that is easy to digest. Avoid spicy, acidic, or fatty foods that may irritate the stomach lining. Small, frequent meals can help reduce gastric irritation. 2. Medication Adherence: Ensure that the patient is taking prescribed medications as directed. This may include proton pump inhibitors (PPIs) or H2 receptor antagonists to reduce stomach acid, as well as any other medications for symptom relief. 3. Hydration: Encourage adequate fluid intake to prevent dehydration, especially if vomiting occurs. Clear fluids or electrolyte solutions may

Hello, doctor.
I happened to come across this website and wanted to try asking about my family member.
Of course, while inquiring, I will still take my family member to the hospital to consult the attending physician.
I have a family member in their fifties with a history of diabetes and hypertension who has recently developed a gastric ulcer.
They have been hospitalized three times this month alone.
After each discharge, their condition has not shown any signs of improvement: despite taking antiemetic medication, they continue to experience recurrent nausea and vomiting, and even with the gastric medications prescribed by the hospital, the stomach pain persists.

I would like to ask if this is a necessary part of the recovery process for gastric ulcers? In other words, do gastric ulcer patients have to endure vomiting and stomach pain until they are fully recovered?
My second question is, even though my family member is experiencing these difficulties and has a poor appetite, should I still encourage them to consume some easily digestible liquid foods or diabetic and renal-specific nutritional supplements, at least to ensure there is something in their stomach?
My third question is, if my family member continues to experience nausea and vomiting after taking medication and consuming these liquid foods, what else can I do to alleviate their suffering? Should I take them back to the hospital for IV fluids and antiemetic injections?
Thank you for reading this letter.
I have searched extensively online, excluding farm articles, and found that the medically authored articles on gastric ulcers are very standardized and do not provide the answers I need.
It is already late at night, and my family member has gone to bed, so I wanted to clarify these questions on this platform first.
Thank you for your attention!

Niming, 20~29 year old female. Ask Date: 2020/09/04

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: 1.
If a gastroscopy has been performed and a diagnosis of peptic ulcer has been confirmed, generally, medication treatment should provide relief.
If there is still no improvement, it may be necessary to investigate other causes, such as issues with bowel movements, liver, gallbladder, or pancreatic problems, or even systemic issues (poor blood sugar control, worsening kidney function, dementia, etc.).
2.
It is important to encourage patients to eat, as not eating can lead to malnutrition, decreased immunity, or hypoglycemia.
3.
A physician may need to evaluate what the underlying issue is.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2020/09/04

More Info

Managing nausea and vomiting in post-operative ulcer patients can be quite challenging, especially when the patient has underlying conditions such as diabetes and hypertension. Your concerns are valid, and it’s important to address them comprehensively. Here’s a detailed guide based on your questions.

Understanding Nausea and Vomiting in Ulcer Patients
1. Is nausea and vomiting a part of the recovery process?
Nausea and vomiting can indeed be common symptoms in patients recovering from gastric ulcers, especially after surgery. These symptoms may arise due to several factors, including the healing process of the stomach lining, the effects of anesthesia, and the medications prescribed. However, persistent nausea and vomiting are not necessarily a normal part of recovery and should be addressed. If your family member is experiencing these symptoms despite taking anti-nausea medications, it may indicate that the current treatment plan needs to be reassessed by the healthcare provider.

2. Should I encourage fluid intake despite nausea?
Yes, it is crucial to ensure that your family member stays hydrated, even if they are experiencing nausea. Encouraging the intake of clear liquids or easily digestible foods can help. Options such as broth, electrolyte solutions, or specialized nutritional drinks designed for patients with diabetes and kidney issues can be beneficial. However, it’s essential to introduce these fluids slowly and in small amounts to avoid overwhelming the stomach, which could trigger further nausea.

3. What can be done if nausea persists despite medication and fluid intake?
If your family member continues to experience nausea and vomiting after taking medications and consuming fluids, it may be necessary to return to the hospital for further evaluation. Intravenous (IV) fluids and anti-nausea injections can provide immediate relief and help stabilize their condition. Additionally, the healthcare team may consider adjusting the current medication regimen or exploring alternative treatments to manage the symptoms more effectively.

Additional Considerations
- Medication Review: Ensure that the medications prescribed for the ulcer and nausea are appropriate for your family member’s overall health status, particularly considering their diabetes and hypertension. Some medications can exacerbate nausea or interact negatively with other treatments.

- Dietary Adjustments: While it’s important to provide nutrition, focus on small, frequent meals rather than large portions. Foods that are bland and low in fat, such as rice, applesauce, and toast, can be easier on the stomach.

- Monitoring Symptoms: Keep a detailed log of your family member’s symptoms, including when nausea and vomiting occur, their severity, and any triggers. This information can be invaluable for healthcare providers in tailoring treatment.

- Follow-Up Care: Regular follow-up appointments with the healthcare provider are essential to monitor the healing process of the ulcer and adjust treatment as necessary. If symptoms persist, a referral to a gastroenterologist may be warranted for specialized care.

Conclusion
In summary, while nausea and vomiting can be part of the recovery process for gastric ulcer patients, persistent symptoms warrant further investigation and management. Encouraging fluid intake, monitoring symptoms, and maintaining open communication with healthcare providers are key steps in ensuring your family member receives the appropriate care. Always prioritize safety and seek immediate medical attention if symptoms worsen or new concerns arise. Thank you for reaching out, and I hope your family member finds relief soon.

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