Multiple Stomach Ulcers and Ongoing Symptoms: A Patient's Concern - Gastroenterology and Hepatology

More Info

---

Dear Mr. Lin,
I understand that you are experiencing significant discomfort due to multiple stomach ulcers and the associated symptoms, including persistent pain, excessive gas, and difficulty sleeping. It’s important to address your concerns comprehensively.

Based on your description, you have been diagnosed with multiple gastric ulcers and have tested positive for Helicobacter pylori (H. pylori), a common bacterial infection that can exacerbate ulcer formation and lead to gastritis. The treatment regimen you are currently on, which includes a proton pump inhibitor (PPI) like Pantoprazole (耐適恩), along with antibiotics such as Fuzuin (Amoxicillin) and Klaricid (Clarithromycin), is standard for eradicating H. pylori and promoting healing of the ulcers.

However, it is concerning that you are still experiencing significant symptoms after 21 days of treatment. Here are several points to consider:
1. Expectations of Treatment: While many patients begin to feel relief within a few days of starting treatment, others may take longer, especially if the ulcers are severe or if there are other underlying issues. It is not uncommon for some patients to experience ongoing symptoms during the initial phase of treatment, particularly if the ulcers are extensive or if there is significant inflammation.

2. Potential Complications: The symptoms you describe, such as a burning sensation in your stomach, could indicate that the ulcers are still active or that there is significant gastritis. If the pain is worsening or if you experience new symptoms such as vomiting blood, black stools, or severe abdominal pain, it is critical to seek immediate medical attention, as these could be signs of complications like bleeding or perforation.

3. Gas and Bloating: The excessive gas and bloating you are experiencing can be attributed to several factors, including dietary choices, the effects of the medications, or even the underlying condition itself. PPIs can sometimes lead to changes in gut flora, which may contribute to bloating. It may be beneficial to keep a food diary to identify any potential triggers and discuss these with your healthcare provider.

4. Right Lower Abdominal Pain: The pain in your right lower abdomen could be related to several issues, including referred pain from the stomach or even conditions unrelated to your ulcers, such as appendicitis or other gastrointestinal disorders. It is essential to have this evaluated, especially if the pain persists or worsens.

5. Follow-Up Care: Given that your symptoms have not improved, I strongly recommend a follow-up appointment with your gastroenterologist. They may consider additional diagnostic tests, such as an upper endoscopy, to assess the healing of the ulcers and to rule out any complications. They might also adjust your treatment plan based on your current symptoms and response to therapy.

6. Lifestyle Modifications: In addition to medication, certain lifestyle changes can help alleviate symptoms. Eating smaller, more frequent meals, avoiding spicy and acidic foods, and reducing stress through relaxation techniques may provide some relief. Staying hydrated and avoiding NSAIDs (non-steroidal anti-inflammatory drugs) is also crucial, as they can exacerbate gastric irritation.

In summary, while some discomfort can be expected during the treatment of gastric ulcers, persistent or worsening symptoms warrant further evaluation. Please reach out to your healthcare provider to discuss your ongoing symptoms and to ensure that you receive the appropriate care and support. Your health and comfort are paramount, and there are options available to help you manage your condition effectively.

Take care, and I hope you find relief soon.

Best regards.