Managing Esophageal and Stomach Ulcers: Treatment and Dietary Tips

How to treat gastric ulcers and esophageal ulcers, and how to manage diet?

Hello Doctor: My mother has been suffering from esophageal and gastric ulcers for the past month.
Although she has seen a doctor, her symptoms have been fluctuating, and recently they have become more pronounced.
In addition to dizziness, nausea, and vomiting, she often feels a surge of heat rising up, but she cannot vomit.
The doctor performed an endoscopy and prescribed medication, but her symptoms have not improved.
Could you please explain why my mother's symptoms are like this? Also, why has there been no progress after a month of medication? I would greatly appreciate your answers.
Additionally, could you advise on her dietary intake and what she should pay attention to in her daily life?

Li Zi, 60~69 year old female. Ask Date: 2004/08/16

Dr. Su Baojia reply Gastroenterology and Hepatology

Your mother has been diagnosed with gastric ulcers and esophageal ulcers.
Typically, the treatment period for these conditions lasts for several months.
However, since there are various medications available for treatment, if one medication is not effective, it can be switched to another.
Therefore, it is advisable to discuss with the attending physician whether a different medication is necessary.
Generally, individuals with gastric and esophageal ulcers should avoid smoking and alcohol; their diet should be normal and moderate, and they should also refrain from consuming spicy, sour foods and glutinous rice products.

Reply Date: 2004/08/16

More Info

Managing esophageal and stomach ulcers can be a complex process, especially when symptoms persist despite treatment. Your mother’s experience with esophageal and gastric ulcers, characterized by dizziness, nausea, vomiting, and a sensation of heat rising in her chest, indicates that her condition requires careful management and possibly further evaluation.

Understanding the Symptoms
The symptoms your mother is experiencing can be attributed to several factors related to her ulcers. The sensation of heat or burning in the chest is commonly associated with gastroesophageal reflux disease (GERD), which can occur alongside ulcers. The nausea and vomiting may be due to irritation of the stomach lining or esophagus, which can be exacerbated by certain foods or stress. Dizziness could be a result of dehydration, especially if she is experiencing vomiting, or it may be related to medication side effects.

Why Symptoms Persist
Despite being on medication for a month, there are several reasons why your mother’s symptoms may not have improved:
1. Medication Efficacy: Not all medications work for everyone. If the prescribed medication (likely a proton pump inhibitor or an H2 blocker) is not effectively reducing stomach acid, her symptoms may persist. It’s essential to discuss with her physician the possibility of adjusting her medication.

2. Dietary Factors: Certain foods can aggravate ulcer symptoms. If she continues to consume spicy, acidic, or fatty foods, this could hinder healing.
3. Stress: Stress can exacerbate ulcer symptoms and may lead to increased acid production. If your mother is under significant stress, this could be a contributing factor.

4. Underlying Conditions: There may be other underlying conditions that need to be addressed, such as H. pylori infection, which can cause ulcers and may require specific antibiotic treatment.

Treatment Recommendations
1. Medication Review: Consult with her healthcare provider to review her current medications. If she has been on the same medication for a month without improvement, it may be time to consider alternative treatments or dosages.

2. Dietary Modifications:
- Avoid Irritants: Eliminate spicy foods, caffeine, alcohol, and acidic foods (like citrus and tomatoes) from her diet.
- Eat Smaller Meals: Encourage her to eat smaller, more frequent meals rather than large meals to reduce stomach pressure.

- Stay Upright After Eating: Advise her to remain upright for at least 2-3 hours after eating to prevent reflux.

- Hydration: Ensure she stays well-hydrated, especially if she is experiencing vomiting.

3. Lifestyle Changes:
- Stress Management: Encourage practices such as yoga, meditation, or gentle exercise to help manage stress.

- Avoid Smoking and Alcohol: These can irritate the stomach lining and exacerbate symptoms.

4. Follow-Up Care: Regular follow-up appointments are crucial. If symptoms do not improve, further diagnostic tests may be necessary to rule out complications or other conditions.

5. Consider a Gastroenterologist: If her symptoms continue to be severe or unmanageable, a referral to a gastroenterologist may be warranted for specialized care.

Conclusion
Managing esophageal and stomach ulcers requires a comprehensive approach that includes medication, dietary changes, and lifestyle modifications. It’s essential to maintain open communication with her healthcare provider to ensure that her treatment plan is effective and adjusted as needed. Encourage your mother to be proactive about her health and to seek further evaluation if her symptoms do not improve. With the right management, it is possible to alleviate her symptoms and promote healing.

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