Post-Ulcer Complications: Ongoing Abdominal Pain and Bloating

Q: Post-Ulcer Complications: Ongoing Abdominal Pain and Bloating

Hello Jack： You report persistent abdominal bloating and pain. <br>After undergoing colonoscopy and gastroscopy, you still experience abdominal pain and bloating. <br>You later visited a clinic and received treatment for irritable bowel syndrome, but the results were unsatisfacto

Issues Following Gastric Ulcers

Hello Doctor: In early January 2021, I noticed persistent abdominal bloating and pain, so I went to the hospital for a gastroscopy, which revealed a gastric ulcer and inflammation.
The colon only had benign polyps.
After taking the PPI medication prescribed by the doctor for over four months, I underwent another gastroscopy, and the gastric ulcer had completely healed, with only slight inflammation remaining.
However, I still experience daily abdominal pain and bloating, along with some constipation and flatulence.
I visited a family medicine clinic, and the doctor diagnosed me with irritable bowel syndrome (IBS) and prescribed me three medications: Splotin, EAR, and Trancolon, advising me to take them for 2 to 3 months.
Initially, I felt a bit better, but it wasn't long before I started feeling uncomfortable again.
It has been a year, and I still experience mild pain and bloating daily.
Is there a possibility that this could be cancer? What further examinations should I consider? Thank you.

jack, 20~29 year old female. Ask Date: 2022/01/04

Dr. Zhang Kebin reply Gastroenterology and Hepatology

Hello Jack: You report persistent abdominal bloating and pain.
After undergoing colonoscopy and gastroscopy, you still experience abdominal pain and bloating.
You later visited a clinic and received treatment for irritable bowel syndrome, but the results were unsatisfactory.
You would like to inquire about the possibility of cancer and whether additional tests are necessary.
If you have undergone standard colonoscopy and gastroscopy, theoretically, you do not need to worry excessively about colorectal cancer or gastric cancer.
Your symptoms are consistent with those of irritable bowel syndrome; however, since irritable bowel syndrome is a functional disorder, if treatment is not effective, it is advisable to visit a hospital's gastroenterology department for further evaluation to rule out any organic lesions and to adjust your medication treatment.
Thank you for your inquiry!

Reply Date: 2022/01/04

More Info

Post-ulcer complications can be quite complex, especially when symptoms like ongoing abdominal pain, bloating, and changes in bowel habits persist after the initial treatment of a gastric ulcer. Your experience of having a gastric ulcer diagnosed and treated with proton pump inhibitors (PPIs) is a common approach, and it’s reassuring that follow-up endoscopy showed healing of the ulcer. However, the persistence of symptoms such as abdominal pain, bloating, and constipation raises important considerations.

Firstly, it’s essential to understand that after an ulcer heals, some patients may continue to experience gastrointestinal symptoms due to several factors. One possibility is functional gastrointestinal disorders, such as Irritable Bowel Syndrome (IBS), which can manifest as abdominal pain, bloating, and altered bowel habits. The medications prescribed by your physician, including Splotin, EAR, and Trancolon, are often used to manage symptoms associated with IBS. While these medications may provide some relief, they may not completely resolve the underlying issue, which can lead to frustration and concern.

Another important aspect to consider is the potential for post-inflammatory changes in the gastrointestinal tract. After an ulcer heals, the surrounding tissues may still be sensitive or reactive, leading to discomfort. Additionally, changes in gut motility or sensitivity can occur, contributing to symptoms like bloating and pain.

Regarding your concerns about the possibility of cancer, it’s understandable to feel anxious, especially when symptoms persist. While the likelihood of cancer following a gastric ulcer is relatively low, it is not impossible. Factors such as family history, smoking, and certain dietary habits can increase risk. Given that you have ongoing symptoms, it would be prudent to discuss further evaluation with your healthcare provider. This may include additional imaging studies, such as an abdominal ultrasound or CT scan, or even repeat endoscopy if indicated.

In terms of management, it may be beneficial to explore dietary modifications, stress management techniques, and possibly a referral to a gastroenterologist for specialized care. Keeping a symptom diary can also help identify potential triggers related to food, stress, or lifestyle that may exacerbate your symptoms.

In summary, while ongoing abdominal pain and bloating after ulcer treatment can be concerning, they are not uncommon. It’s crucial to maintain open communication with your healthcare provider, consider further evaluations, and explore comprehensive management strategies that address both physical and psychological aspects of your symptoms. Your health and well-being are paramount, and taking proactive steps can lead to better outcomes.

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