Chronic Stomach Issues: A Guide for Concerned Partners

Hello, doctor... I would like to ask why my husband's stomach condition is so difficult to treat?

Hello Doctor,
I apologize for bothering you with my concerns.
We are a lesbian couple who have been together for four years, currently both working in the Hsinchu Science Park, and we are living together.
I would like to ask you about my partner's health condition, as I am genuinely worried about him.
I am 25 years old, and he is 23, with a height of 168 cm and a previous weight of 85 kg, appearing quite robust.
He rarely drinks alcohol but does smoke, previously about a pack and a half a day.
His company is very profitable but has high demands on its employees.
Since the autumn and winter of 2021, he has experienced multiple episodes of gastric and duodenal ulcer bleeding (including vomiting blood and passing black stools), as well as a history of gastroesophageal reflux disease.
I am particularly fearful during seasonal transitions and winter, as he tends to feel very unwell during these times, often experiencing complications.
Over the past two years, he has undergone at least a dozen endoscopies, with new issues arising each time.
He has taken various antibiotics to eradicate Helicobacter pylori, and we have visited numerous hospitals, trying both Western and traditional Chinese medicine, but his condition has not significantly improved, which has been very distressing for us.
Currently, we are in a seasonal transition period.
Around the end of September, his already poor gastric condition worsened, leading to several weeks of passing black stools and feeling weak and fatigued.
I feared he might be experiencing gastric bleeding again, but due to our busy schedules, I couldn't accompany him to see a doctor, and he was too afraid to undergo another endoscopy.
He initially took leftover medication from his previous gastric bleeding treatment (I can't recall the name, but I think it started with "omer..."), but I felt his condition did not improve.
As I feared, on October 6, while working overtime, he vomited blood and fainted in the parking lot, prompting the security guard to call an ambulance to Hsinchu Mackay Memorial Hospital.
I was terrified and rushed to the hospital.
When I saw him in the emergency room, he was lying on the bed with a nasogastric tube, and the contents being drained were dark and bloody.
The doctor informed me that his gastric bleeding was severe, but after emergency treatment, it stabilized temporarily.
He had lost a significant amount of blood, and they asked if he would consent to a blood transfusion.
According to his later account, he had been feeling increased gastric discomfort due to the cooler weather, but due to work demands, he thought he could wait until things were less busy to see a doctor.
While working overtime, he suddenly felt intense gastric pain and decided to go home to rest instead of calling me for a ride, thinking it was already too late.
As he reached the parking lot and was about to open his car door, he suddenly experienced severe gastric pain, vomited a large amount of blood, and lost consciousness.
The security guard told me he initially thought my partner was dead due to the blood on the ground, suspecting a crime scene.
He was hospitalized for two weeks, during which the doctor managed to stop the bleeding and found large, deep ulcers in his stomach, along with significant duodenal ulcers.
Fortunately, the biopsy results showed no malignancy, but Helicobacter pylori was present.
An abdominal ultrasound revealed no abnormalities in organs other than the stomach, but he was diagnosed with iron deficiency anemia.
After the endoscopy and treatment for bleeding, the vomiting of blood ceased, and the passing of black stools gradually stopped about a week later.
The doctor continued to prescribe ulcer medications and antibiotics, and this was about a month ago.
However, in the past two weeks, as the weather has turned colder, I am extremely worried about his health.
His stomach still feels very uncomfortable, often making strange noises, and whenever it does, he experiences severe pain that prevents him from standing upright.
His appetite is poor, and he complains of stomach pain when fasting.
Even after eating, he still complains of stomach pain, sometimes experiencing sharp, penetrating pain that makes him break into a cold sweat.
He often burps, and the gas has a sour odor.
Additionally, he experiences significant abdominal distension and pain even when fasting; his upper abdomen visibly protrudes and feels hard, resembling a beer belly.
I attempted to massage his abdomen gently, but he cried out in pain, leaving me feeling helpless.
Every day, I see him frowning, pressing on his abdomen, and complaining of pain, struggling to sleep, and speaking weakly.
After being together for four years, I know he has a high pain tolerance, so when he says he is in pain, it is genuinely severe...
It breaks my heart!
Recently, his company started a new project, and last weekend (November 20-21), he worked overtime for two days.
I took the opportunity to visit Kaohsiung (where we are both from) since he seemed stable.
However, when I returned to Hsinchu at 1:30 AM on November 22, I found he was still at work.
I urged him to come home to rest, and he mentioned he was just a bit more tired than usual, but then he passed black stools again.
I was very concerned and took him to the emergency room, where he underwent an endoscopy in the morning.
Unfortunately, the ulcers in his stomach had started bleeding again, and the amount of bleeding was significant, although thankfully, this time the situation was much better than before.
I feel utterly helpless and unsure of what to do.
I have been diligent in ensuring he takes his medication and eats regularly; I have prohibited him from smoking, coffee, tea, and spicy foods; I remind him to keep warm and bought him a heating pad for his stomach; I urge him to leave work early to rest and accompany him to follow-up appointments.
However, I do not see significant improvement in his condition, and since his last hospitalization for gastric bleeding, he has lost nearly 15 kg (from 85 kg to about 70 kg now).
Every night, I see him curled up in bed, frowning in pain, and it truly pains me!
I have heard that gastric diseases are easily treatable, but I don't understand why we are facing such difficulties.
Therefore, I would like to ask you:
1.
Can gastric and duodenal ulcers be completely cured without recurrence? Do they leave scars after healing? I have heard that ulcers near the pylorus can cause blockages, which worries me.
2.
At only 23 years old, is his health condition considered very poor? Is there a possibility that the endoscopy missed something serious? Can young people in their twenties develop gastric cancer?
3.
Before we moved to Hsinchu, he did experience stomach pain, but it was not this severe.
Does this indicate that he may not be suited to live in Hsinchu (as it is significantly colder than Kaohsiung in winter)?
4.
Should he consider temporarily resigning to focus on his health (I previously suggested this, but he does not want to quit his job)?
5.
Why do his gastric ulcers recur so easily? Could it be related to his constitution?
6.
Despite completing a full course of antibiotics, why does Helicobacter pylori still persist upon retesting?
7.
I have heard from colleagues that aloe vera, ginseng, and reishi mushrooms are beneficial for gastric ulcer patients.
Can I purchase these for him?
8.
In caring for a patient with gastric bleeding, is there anything I am not doing adequately? Are there better treatment methods available?
9.
Should we consider surgical treatment?
10.
I am unclear about how to handle a situation where he suddenly vomits blood at home.
Should I let him finish vomiting, or is there another way to manage it?
I sincerely apologize for writing so much about his condition, but I am genuinely worried and feel helpless.
I hope you can provide guidance on how to help him recover.
Thank you very much!

mintern, 20~29 year old female. Ask Date: 2004/11/25

Dr. Su Baojia reply Gastroenterology and Hepatology

1.
Gastric ulcers and duodenal ulcers can be completely cured and may not recur.
However, if they remain untreated, they can eventually lead to obstruction in the duodenum.

2.
Whether a gastric ulcer can transform into gastric cancer can only be confirmed through pathological examination of tissue samples.

3.
Lifestyle, diet, and stress from the work environment can affect patients with gastric ulcers.

4.
Whether to temporarily resign from work to focus on recovery is best discussed with your gastroenterologist.

5.
Gastric ulcers are prone to recurrence, which may be related to the treatment process or the effectiveness of the medication, indicating that they have not been completely cured.

6.
There may be a relationship between antibiotic resistance of Helicobacter pylori and the failure to completely eradicate the bacteria.

7.
There is currently no significant medical evidence to support this.

8.
Care for patients with gastric bleeding should include avoiding smoking, alcohol, spicy foods, and glutinous rice.
It is advisable to provide a gentle diet.

9.
The decision on whether surgical intervention is necessary should be discussed with your gastroenterologist for a final determination.

10.
If you experience vomiting blood at home, it is crucial to seek medical treatment as soon as possible.

Reply Date: 2004/11/25

More Info

I understand your deep concern for your partner's health, especially given the severity of his condition with recurrent gastric and duodenal ulcers, as well as the complications that have arisen from them. It's clear that both of you have been through a lot, and it's commendable that you are seeking to understand and help him navigate this challenging situation.

1. Can gastric and duodenal ulcers be cured permanently?
While many patients can achieve healing of their ulcers, the potential for recurrence is significant, especially if underlying factors such as Helicobacter pylori infection, stress, smoking, or dietary habits are not adequately addressed. Healing does not always mean that the risk of future ulcers is eliminated. Scarring can occur, particularly if ulcers are deep or recurrent, which may lead to complications such as gastric outlet obstruction. Regular follow-ups and monitoring are crucial to manage and mitigate these risks.

2. Is his condition serious for someone so young?
At 23, experiencing such severe gastrointestinal issues is indeed concerning. While gastric cancer is relatively rare in young individuals, it is not impossible, especially with a history of chronic ulcers and H. pylori infection. Continuous monitoring through endoscopy and appropriate imaging is essential to rule out any serious underlying conditions.

3. Is the environment affecting his health?
Environmental factors, including stress levels and climate, can influence gastrointestinal health. If he is experiencing increased discomfort in a new environment, it may be worth considering whether the work stress or climate in Hsinchu is exacerbating his symptoms. Stress management techniques and a supportive work-life balance are vital.

4. Should he consider taking a break from work?
If his condition is significantly impacting his quality of life and ability to function, it may be beneficial for him to take a temporary leave from work to focus on recovery. Stress can exacerbate gastrointestinal issues, and a break might provide him with the opportunity to heal.

5. Why do his ulcers keep recurring?
Recurrence can be attributed to several factors, including persistent H. pylori infection, lifestyle choices (such as smoking and diet), and stress. It’s essential to ensure that the eradication therapy for H. pylori is effective and that he is following up with his healthcare provider to monitor for any recurrence.

6. Why is H. pylori still present after treatment?
Sometimes, the eradication therapy may not be fully effective due to antibiotic resistance or inadequate treatment duration. It’s crucial to confirm eradication with a breath, stool, or endoscopic biopsy test after treatment.

7. Are herbal remedies like aloe vera, ginseng, and reishi mushrooms helpful?
While some herbal remedies may offer benefits for digestive health, they should not replace conventional treatment. Always consult with a healthcare provider before introducing new supplements, as they can interact with medications or exacerbate symptoms.

8. Am I doing enough in caring for him?
You are doing a commendable job by being attentive to his needs and encouraging him to follow medical advice. However, ensure that he is also engaging in stress-reducing activities and maintaining a balanced diet. Regular follow-ups with his healthcare provider are essential.

9. Should surgical intervention be considered?
Surgery is typically a last resort for ulcers, usually reserved for complications like perforation, severe bleeding, or obstruction. A thorough evaluation by a gastroenterologist is necessary to determine if surgery is appropriate.

10. What should I do if he vomits blood at home?
If he vomits blood, it is crucial to seek immediate medical attention. Do not let him vomit more; instead, keep him calm and comfortable while you call for help. It’s important to avoid any food or drink until he has been evaluated by a healthcare professional.

In summary, your partner's situation requires careful management and a multidisciplinary approach, including gastroenterology, dietary support, and possibly psychological support to address stress. Encourage him to maintain open communication with his healthcare providers and to follow their recommendations closely. Your support is invaluable during this challenging time, and together, you can work towards improving his health and well-being.

Similar Q&A

Navigating Relationships and Digestive Issues: Finding Your Path

Hello Dr. Zheng, Since childhood, I have had a sensitive constitution and poor gastrointestinal health even before my condition developed. My grandfather passed away from stomach cancer, and my father has issues with gastric ulcers. For example, eating eggs causes me to have gas...

Dr. Zheng Jingming reply Psychiatry
Hello: Regarding your concerns about gas issues, it is generally advisable to first consult an internist. Only if there are no medical problems should psychological issues be considered. You mentioned that you have seen many doctors; I recommend visiting a medical center to consu...

Struggling with Digestive Issues: Seeking Solutions for Chronic Thinness

Hello Doctor, I have a troubling issue. For a long time, I have been very thin and my complexion is poor. I can hardly digest even a small amount of food. After examination, I was diagnosed with gastritis, but taking gastric medication does not provide relief. I really don’t kn...

Dr. Lin Mingxing reply Family Medicine
Response: As a 28-year-old woman who is quite thin and feels that your complexion is not very good, it indicates that you are not satisfied with your current physiological condition. It may be beneficial to first consider your "psychological" state, including your daily...

Effective Strategies to Alleviate Chronic Stomach Pain and Nausea

If you frequently experience stomach pain and have a long-term lack of appetite accompanied by vomiting after eating while living abroad, what steps can you take to improve your gastric issues?

Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: (1) It is recommended to eat at regular intervals and in appropriate portions, avoiding overeating, smoking, drinking alcohol, and chewing betel nut. (2) It is advised to stop consuming caffeinated beverages (such as tea and coffee) or carbonated drinks (soda). (3) It is r...

Chronic Stomach Pain in a 32-Year-Old: Seeking Medical Guidance

Hello Dr. Chen, my brother is 32 years old. He has a smoking habit and an unhealthy diet (he enjoys fried foods and late-night snacks). For the past two years, he has been experiencing "stomach pain (severe enough to keep him awake at night), often radiating to his back,&quo...

Dr. Chen Jiaming reply Surgery
Based solely on your description, it seems that you often experience pain while "sleeping." If the pain symptoms resemble gastroesophageal reflux (such as chest discomfort, nausea, and burning sensations), you might consider trying antacids or acid reducers to see if th...