Coming Off The Ulcer Drugs

[Gaccha]

Sheryl & friends ,

1 year and 3 months after i developed a stomach ulcer, after 2 false starts, it seems to have cured.

I am still taking the Miracid. Can i now slowly wean myself off it ( it has famously awful side-effects) or do i keep taking it for say another month?

To what extent is my stomach recovered (or what can be inferred) from the pain ceasing? Can i, after ending the medicine, start to drink my beloved red wine? Or is my stomach in a lifetime vulnerable state ( the ulcer is NSAID type).

Thank you in advance.

[Sheryl]

Ideally one would have a repeat endoscopy to assess whether the ulcer and accompanying gastric inflammation have fully resolved.

Are you taking the Miracod once or twice daily? And how much time has passed since all pain disappeared?

And do you still have to take NSAIDs?

[Gaccha]

I never had an endoscopy to start with. The local clinic doctor just stuck me on the miracid.

I take the miracid once daily. For the initial 3 months i needed twice daily.

I went off it for 3 months as i felt it was making no difference . And the symptoms remained the same level of low discomfort. I then went back on it to try to knock this ulcer on the head. And 2 months later it seems to have worked. I have had no pain for 3 weeks.

I have drunk not a drop of alcohol for these last 11 months after the first false start ended after i drank a glass of vodka.

I have not needed the NSAIDS but i might sometimes in the future.

Another question, if i was to need the NSAIDS should i preemptively take the miracid.

Thank you and thank you in advance.

[Sheryl]

Since you did not have an endoscopy, you do not know that you had an ulcer. May have been just gastritis (which if untreated can lead to ulcer), in fact probably was.

You should have either been tested for heliobacter pylori or presumptively treated for it. Sounds like neither was done.

Need to understand that all that the Miracid does is reduce the acidity of the stomach and thereby reducing pain. To some extent it the reduced acidity can promote healing but if you have heliobacter infection the inflammation will likely recur once you stop (and may not have fully resolved in the first place).

My advice:

1. Get tested for heliobacter and treated for it if positive (10-14 days treatment with 3 drugs as this bacteria is very hard to eradicate). In addition to underlying many cases of gastritis and peptic ulcer, heliobacter is a major risk factor for cancer of the stomach.

2. If you do not want to do #1, self treat for heliobacter (provided no contraindications to the meds) , see http://www.ncbi.nlm.nih.gov/pubmed/20010919 for a regimen that has been proven effective in Thailand (can substitute Miracid for the lansoprazole).

3. After completion of treatment for heliobacter, take the Miracid daily for another month and then if completely pain free can try discontinuing it. IF you were tested and heliobacter ruled out, then can try discontinuing it now, but I would not do this without ruling out heliobacter.

And yes, given your history, I would take Miracid prophylactically if it becomes necessary to use NSAIDs in future, unless the use is extremely infrequent.