Why Do I Still Experience Stomach Pain After Ulcer Treatment?

Even after a gastric ulcer has healed, stomach pain may still persist?

I underwent an upper gastrointestinal endoscopy in early May this year, which revealed a gastric ulcer and tested positive for Helicobacter pylori.
After two months of treatment, I had another endoscopy at the end of July, and the doctor said the ulcer had healed and the Helicobacter pylori was gone.
However, I still experience intermittent stomach pain and a sensation of a foreign body in my esophagus.
Why did the doctor tell me I was cured, yet I still feel uncomfortable? What could be the reason? Should I schedule another appointment with a gastroenterologist for another endoscopy?

nini, 40~49 year old female. Ask Date: 2012/09/11

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello NINI, the visible ulcers have healed.
However, functional disorders and subtle gastroesophageal reflux may still be present and cause symptoms.
Medication adjustments can be made for treatment.
If the condition continues to worsen, further examination may be necessary.
Changhua Hospital cares about your health.
Dr.
Chen Shidian.

Reply Date: 2012/09/11

More Info

Experiencing persistent stomach pain after treatment for a gastric ulcer can be frustrating and concerning. Even after a successful treatment where the ulcer has healed and Helicobacter pylori (H. pylori) has been eradicated, some patients may still experience discomfort. Here are several reasons why this might occur, along with recommendations for further action.

Possible Reasons for Continued Discomfort
1. Functional Dyspepsia: After the healing of an ulcer, some patients may develop functional dyspepsia, a condition characterized by chronic or recurrent pain in the upper abdomen without any identifiable cause. Symptoms can include bloating, nausea, and a feeling of fullness. This condition can occur even when the ulcer itself has healed.

2. Gastric Acid Secretion: Even after the ulcer has healed, the stomach may still produce excess acid, leading to irritation of the gastric lining or esophagus. This can result in symptoms similar to those experienced during the ulcer phase, such as pain or discomfort.

3. Gastroesophageal Reflux Disease (GERD): If you are experiencing a sensation of a foreign body in the esophagus, it could be related to GERD, where stomach acid flows back into the esophagus, causing irritation and discomfort. This can occur even after ulcer treatment.

4. Post-Inflammatory Changes: The stomach lining may still be sensitive or inflamed after an ulcer has healed. This post-inflammatory state can lead to ongoing discomfort as the stomach lining gradually returns to normal.

5. Dietary Factors: Certain foods and beverages can exacerbate stomach discomfort. Spicy foods, caffeine, alcohol, and acidic foods may irritate the stomach lining and lead to pain.

6. Psychological Factors: Anxiety and stress can significantly impact gastrointestinal health. If you are feeling anxious about your health, it may contribute to the perception of pain or discomfort in the stomach.

Recommendations for Further Action
1. Follow-Up with a Gastroenterologist: Given your ongoing symptoms, it would be prudent to schedule a follow-up appointment with a gastroenterologist. They may recommend further diagnostic tests, such as another endoscopy, to assess the condition of your stomach and esophagus.

2. Medication Review: Discuss your current medications with your doctor. Sometimes, adjusting the dosage or changing medications can help alleviate symptoms. For instance, if you are on proton pump inhibitors (PPIs), your doctor may consider adjusting the dose or switching to a different class of medication.

3. Dietary Modifications: Keeping a food diary can help identify any dietary triggers that may be contributing to your symptoms. Consider adopting a bland diet that avoids irritants and gradually reintroducing foods to see if any specific items exacerbate your discomfort.

4. Stress Management: Since psychological factors can influence gastrointestinal symptoms, incorporating stress management techniques such as mindfulness, yoga, or counseling may be beneficial.

5. Symptom Monitoring: Keep track of your symptoms, noting when they occur and their severity. This information can be valuable for your healthcare provider in determining the best course of action.

In conclusion, while it is concerning to experience ongoing stomach pain after ulcer treatment, there are various potential explanations and avenues for management. It is essential to communicate openly with your healthcare provider about your symptoms and concerns to ensure appropriate follow-up and treatment.

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