Struggling with Stomach Medications: Gastrointestinal Issues

Taking stomach medication is not effective?

Taking stomach medication for the same condition is not effective.

qing wen, 40~49 year old female. Ask Date: 2012/04/09

Dr. Li Yongming reply Gastroenterology and Hepatology

According to statistics from the National Health Insurance Administration, over 2 billion antacids (commonly referred to as stomach medications) are claimed in Taiwan each year, with an average of more than 100 antacid tablets used per person annually.
In the OTC (over-the-counter) antacid market, the annual sales in Taiwan reach nearly 400 million NT dollars.

1.
If the antacid you are using is classified as an over-the-counter medication, it indicates sufficient safety for self-purchase without a doctor's prescription.
This is the most commonly used and familiar type of stomach medication among the public.
Excess stomach acid can lead to peptic ulcers, and antacids can neutralize stomach acid, providing a protective effect on cells and enhancing the mucosal resistance of the stomach and intestinal walls.
Most antacids on the market contain active ingredients such as magnesium salts, aluminum salts, sodium salts, or calcium salts (also known as magnesium hydroxide, calcium carbonate, aluminum hydroxide, sodium bicarbonate, magnesium carbonate, etc.).
Some are used alone, while others are combined with these ingredients or additional components, referred to as compounded formulations.
They are available in various forms, including tablets, powders, and suspensions (commonly known as "stomach milk").
It is generally recommended to take them one hour after meals and before bedtime.
2.
H2 receptor antagonists can reduce gastric acid secretion, with a better effect on inhibiting nighttime gastric acid production and less effect on acid secretion between meals, so they are generally recommended to be taken before bedtime.
Based on clinical experience, ulcer symptoms can be relieved in about two weeks, with 85-90% of duodenal ulcers healing after eight weeks and 85-90% of gastric ulcers healing after eight weeks.
Most H2 receptor antagonists are prescription medications, but there are also lower-dose versions available over the counter.
3.
Proton pump inhibitors (PPIs) are a newer class of stomach medications that can block gastric acid secretion, with some medications capable of inhibiting up to 90% of gastric acid secretion within 24 hours.
They are generally recommended to be taken 30 minutes before meals.
Compared to H2 receptor antagonists, PPIs provide quicker pain relief and faster ulcer healing.
Clinical experience indicates that 90% of duodenal ulcers can heal after four weeks, and 90% of gastric ulcers can heal after eight weeks.
PPIs are prescription medications, typically more expensive, and health insurance regulations require confirmation of ulcers through endoscopy before prescribing these medications.
Generally, what you are likely to find on the market are antacids, which have limited effectiveness for gastric/duodenal ulcers or gastroesophageal reflux disease.
It is advisable to consult a gastroenterologist for further examination.

Reply Date: 2012/04/09

More Info

When dealing with gastrointestinal issues, particularly conditions like duodenal ulcers and functional gastrointestinal disorders, it can be quite challenging to find the right treatment strategy. Your experience with medications such as Strocain, Gascon, and SMP, and the subsequent relief from symptoms, indicates that you have been under a treatment plan that has had some success. However, the recent development of feeling constipated and having difficulty with bowel movements suggests that your treatment may need to be reevaluated.

Duodenal ulcers are often associated with Helicobacter pylori infection, and it is essential to address this underlying cause if it is present. Treatment typically involves a combination of proton pump inhibitors (PPIs) to reduce stomach acid, antibiotics to eradicate H. pylori, and sometimes medications to protect the stomach lining. If your ulcer has healed, as indicated by your doctor, it is still crucial to monitor for any recurrence of symptoms or complications.

The medications you mentioned, particularly those for anxiety and depression, can have side effects that may impact gastrointestinal function. For instance, benzodiazepines like Diazepam can lead to constipation in some individuals, which may explain your recent symptoms of feeling like your bowels are not moving properly. It is also worth noting that medications used to treat anxiety and depression do not directly address gastrointestinal symptoms, and relying solely on these medications may not provide the relief you need for your digestive issues.

In terms of managing your symptoms, it is advisable to consider a comprehensive approach that includes dietary modifications, stress management techniques, and possibly a review of your current medication regimen with your healthcare provider. A diet rich in fiber can help alleviate constipation, while smaller, more frequent meals may reduce the burden on your digestive system. Additionally, staying hydrated is essential for maintaining regular bowel movements.

If you are experiencing persistent abdominal pain, bloating, or changes in bowel habits, it is crucial to communicate these symptoms to your healthcare provider. They may recommend further diagnostic tests, such as imaging studies or endoscopy, to rule out other potential issues, including inflammatory bowel disease or malignancies.

In summary, while medications can play a significant role in managing gastrointestinal issues, they are often most effective when combined with lifestyle changes and a thorough understanding of the underlying conditions. If you continue to struggle with your symptoms despite medication, it may be time to seek a second opinion or consult a gastroenterologist who can provide a more tailored treatment plan. Remember, effective communication with your healthcare provider is key to finding the right balance in managing your gastrointestinal health.

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