Managing Gastrointestinal Issues: Concerns About Short-Term Medication Use

Gastrointestinal issues

Hello Doctor, I previously inquired about my throat and esophageal discomfort, but I still feel uneasy.
I also don’t have enough time to visit a large hospital, so today I paid out of pocket for an endoscopy.
I had a complete health check-up in June, including an endoscopy, and the results were: 1.
Mild gastritis 2.
Mild esophagitis 3.
Mild ulcer in the duodenum 4.
Gastroesophageal reflux without detection of Helicobacter pylori.
The doctor originally prescribed an 8-week course of medication, but since the medication is also out of pocket and quite expensive, totaling over 17,000 NTD, I only took a 1-week supply.
The medications are as follows: Cimetidine 200 mg, Lansoprazole 30 mg, Melatonin 3 mg, Active Pyridoxal, and Vitamin C.

I would like to ask the doctor if I really need to take these medications for 8 weeks.
Will taking only one week be ineffective? I also won’t have time to schedule another appointment at a large hospital, as I will be traveling abroad in two days and won’t return to Taiwan until March.
During this period, could my condition worsen or even lead to cancer? Thank you for your assistance.
With only one week of medication, how should I proceed? I appreciate your response!

mmyy, 30~39 year old female. Ask Date: 2015/12/07

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, ulcerative gastritis and gastroesophageal reflux disease (GERD) are both related to excessive gastric acid.
Taking medication for just one week is insufficient.
A proton pump inhibitor (PPI), such as Lansoprazole (which is included in your medication), should be used for 6 to 8 weeks.
However, it is possible to use only one type of PPI (other medications may not be necessary) to obtain a report from an endoscopy.
The National Health Insurance can prescribe PPIs for severe cases of GERD, and a longer duration of the condition may be associated with esophageal cancer.
Sincerely, Dr.
Chi-Feng Chen, Attending Physician, Gastroenterology Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2015/12/07

More Info

Managing gastrointestinal issues can be quite challenging, especially when it comes to medication adherence and understanding the implications of short-term use. Based on your recent experiences and the medications prescribed, let's break down your concerns and provide some clarity.

Understanding Your Medications
1. Cimetidine (200 mg): This medication is an H2 blocker that reduces stomach acid production. It is often used to treat conditions like gastroesophageal reflux disease (GERD) and peptic ulcers. While it can be effective, it may take some time to see the full benefits, typically requiring consistent use over several weeks.

2. Lansoprazole (30 mg): This is a proton pump inhibitor (PPI) that also reduces stomach acid but works differently than H2 blockers. PPIs are generally more effective for severe acid-related conditions and can provide relief from symptoms of acid reflux and promote healing of ulcers. Similar to Cimetidine, it is often recommended for a longer duration to achieve optimal results.

3. Melatonin (3 mg): While primarily known for its role in regulating sleep, melatonin has been studied for its potential benefits in gastrointestinal health, particularly in reducing symptoms of GERD and improving gut motility.

4. Active Pyridoxal and Vitamin C: These are supplements that can support overall health. Vitamin C is an antioxidant that can help with immune function, while pyridoxal (a form of vitamin B6) plays a role in various bodily functions, including metabolism.

Duration of Treatment
Your concern about whether one week of medication is sufficient is valid. Generally, for conditions like gastritis, GERD, or peptic ulcers, a longer duration of treatment (often 4-8 weeks) is recommended to ensure that the acid production is adequately suppressed and that healing can occur. Stopping treatment prematurely may lead to a recurrence of symptoms or insufficient healing of the gastrointestinal lining.

Risks of Short-Term Use
While taking the medications for just one week may provide some symptomatic relief, it is unlikely to fully address the underlying issues, especially if you have been diagnosed with mild inflammation and ulcers. The risk of complications, including the potential for worsening symptoms or the development of more serious conditions, increases if the underlying issues are not adequately treated.

Recommendations for Your Situation
1. Adhere to the Prescribed Regimen: If possible, try to take the medications as prescribed for the full duration. If cost is a concern, discuss this with your healthcare provider. They may be able to provide alternatives or suggest generic versions that are more affordable.

2. Monitor Symptoms: Keep track of your symptoms. If you notice worsening pain, increased reflux, or any alarming symptoms (like significant weight loss, difficulty swallowing, or blood in your stool), seek medical attention promptly, even if it means visiting a local clinic or emergency room.

3. Diet and Lifestyle Adjustments: In addition to medication, consider making dietary changes that can help manage your symptoms. Avoiding spicy foods, caffeine, alcohol, and large meals can reduce acid production and reflux. Eating smaller, more frequent meals may also help.

4. Follow-Up Care: Once you return to Taiwan, schedule a follow-up appointment with a gastroenterologist. They can reassess your condition and determine if further treatment or diagnostic testing is necessary.

5. Stay Informed: Educate yourself about your condition. Understanding your diagnosis can empower you to make informed decisions about your health and treatment options.

Conclusion
In summary, while one week of medication may provide some relief, it is generally advisable to follow the full treatment course as prescribed to ensure proper healing and management of your gastrointestinal issues. If financial constraints are a barrier, communicate this with your healthcare provider for potential solutions. Your health is paramount, and addressing these concerns proactively can help prevent complications in the future.

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