Appetite Loss and Anxiety in Gastric Ulcer Patients - Surgery

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Understanding appetite loss and anxiety in patients with gastric ulcers is a multifaceted issue that intertwines physical health and psychological well-being. Gastric ulcers, which are sores that develop on the lining of the stomach, can lead to a variety of symptoms, including abdominal pain, nausea, and notably, appetite loss. This appetite loss can be exacerbated by anxiety, particularly when patients are concerned about their health or have experienced significant stressors, such as a family member undergoing major surgery.

When a patient is diagnosed with a gastric ulcer, the initial treatment often includes proton pump inhibitors (PPIs) like Omeprazole (耐適恩) and medications to protect the stomach lining. While these medications can help alleviate symptoms and promote healing, they may not immediately restore appetite. It's not uncommon for patients to experience fluctuations in their desire to eat, especially if they are dealing with anxiety or depression related to their health condition.
In your case, you mentioned that your appetite improved initially after starting medication but has since declined again. This could be due to several factors:
1. Physical Symptoms: Even if the ulcer is healing, residual discomfort or anxiety about eating can lead to a reduced appetite. The fear of pain or discomfort after eating can create a psychological barrier to wanting to eat.

2. Anxiety and Stress: The anxiety stemming from your diagnosis and concerns about potential misdiagnosis (such as the fear of gastric cancer) can significantly impact your appetite. Anxiety can lead to a physiological response that suppresses hunger signals, making it difficult to feel motivated to eat.

3. Medication Side Effects: Some medications can also affect appetite. While PPIs are generally well-tolerated, they can sometimes lead to gastrointestinal side effects that may contribute to a feeling of fullness or discomfort.

Regarding your concern about the accuracy of the endoscopy (胃鏡) and whether a repeat procedure is necessary, it's important to understand that while endoscopy is a highly effective diagnostic tool for identifying gastric ulcers and other gastrointestinal issues, no test is infallible. If you have persistent symptoms or new concerns, discussing the possibility of a repeat endoscopy with your healthcare provider may be warranted. They can evaluate your current symptoms, the effectiveness of your treatment, and whether further investigation is needed.

In the meantime, here are some strategies to help manage your appetite and anxiety:
- Small, Frequent Meals: Instead of large meals, try eating smaller portions more frequently throughout the day. This can help reduce the fear of discomfort associated with eating.

- Relaxation Techniques: Incorporate stress-reducing practices such as deep breathing, meditation, or gentle yoga. These can help alleviate anxiety and may improve your appetite.

- Nutrient-Dense Foods: Focus on foods that are high in nutrients but low in volume, such as smoothies, soups, or pureed foods, which can be easier to consume without causing discomfort.

- Consult a Dietitian: A registered dietitian can provide personalized dietary advice and help you create a meal plan that accommodates your current symptoms while ensuring you receive adequate nutrition.

- Mental Health Support: If anxiety continues to be a significant issue, consider seeking support from a mental health professional. Therapy can provide coping strategies and help address the psychological aspects of your condition.

In conclusion, while gastric ulcers can lead to appetite loss, the interplay of physical symptoms and psychological factors like anxiety can complicate recovery. Open communication with your healthcare provider about your symptoms, concerns, and treatment options is crucial for managing both your physical and mental health effectively.