Stomach ulcer - given too many drugs?

[RickG16]

I have what the doctor thinks could be a stomach ulcer. At first, the doctor gave me just meracid to decrease acid production.

 

Symptoms persisted after 10 days, so now he has given me 2 different types of antibiotics, more meracid, a digestive tablet for after meals, another anti acid tablet for bed time, and a liquid antacid for after meals!

 

I'm glad he's trying to solve the problem, but could this be too much? And do Thai doctors have form for prescribing more medcine in an effort to make more money for the in house pharmacy?

 

Cheers

[RichCor]

Is It an Ulcer or GERD?

Common digestive health problems are easily confused. Find out how doctors can tell the difference.

EverydayHealth  |  By Madeline R. Vann, MPH;  Medically Reviewed by Pat F. Bass III, MD, MPH

 

The existence of Ulcer's are exacerbated by higher levels of stomach acid. 

Since ulcer's can have many causes, including bacterium known as Helicobacter pylori (H. pylori) or taking non-steroidal anti-inflammatory drugs (NSAIDs), it's always best to be under a doctor's care when seeking treatment.

 

I'd suggest you look into trying to lower the levels of bad bacteria in the stomach and increase the good bacteria that benefit the healing of the body.  So, take the antibiotics, followed up a few hours later with Yogurt or other Probiotics.  Lay off the beer and spicy food while doing the treatment. Hopefully you'll only need to live with it for a few weeks, and not the rest of your life (as in the old days). 

[carlyai]

Why don't you go in and get a camera into the stomach, take a sample of the tissues while they're in there?

Then you should know exactly what you have and what treatment.

There seems to be (maybe) some correlation about taking quick ez and other stomach medication and finally developing pancreatic cancer.

 

 

Sent from my SM-J700F using Tapatalk

 

 

 

 

[perthperson]

The treatment/medication you describe is intended to eliminate H.Pylori ( an organism known to be the cause of gastric ulceration.) 

 

Most of your medication can be bought without prescription and at a lower cost from the local pharmacy.. there is no need to buy from the "in house" pharmacy. 

 

If you are unhappy with the doctors treatment you could obtain a second opinion from a gastroenterologist. 

 

 

[sinbin]

2 hours ago, perthperson said:

The treatment/medication you describe is intended to eliminate H.Pylori ( an organism known to be the cause of gastric ulceration.) 

Perthperson is correct that H Pylori is the cause of stomach ulcers. A 2 week course of antibiotics prescribed by a Gastroenterologist should clear you up. Make sure you have a stool test, post medicine, to confirm H Pylori eradication. Good luck.

 

RichCor is wrong, IMO, in saying  ulcer's can have many causes. H Pylori is proven to be the cause of stomach ulcers.

 

 

Quote

 

H. pylori infections can lead to peptic ulcers, but the infection or the ulcer itself can lead to more serious complications. These include:

• internal bleeding, which can happen when a peptic ulcer breaks through your blood vessel
• obstruction, which can happen when an ulcer blocks the food from leaving your stomach
• perforation, which can happen when an ulcer breaks through your stomach wall
• peritonitis, which is an infection of the peritoneum, or the lining of the abdominal cavity

Studies show that infected people also have an increased risk of stomach cancer. While the infection is a major cause of stomach cancer, most people infected with H. pylori never develop stomach cancer.

 

Edited June 30, 2017 by sinbin

[Sheryl]

As other poster mentioned you are being treated for h. pylori which is the usual cause of both gastritis and gastric ulcers. Thsi requires triple therapy with 3 drugs: 2 antibiotics and a PPI. So that is the 2 antibiotics and meracid you are getting.

 

The "digestive tablet" is likely Motilum, debatable how much it helps if at all. You can omit this if you like.

 

The antacids are intended to help alleviate discomofrt while the eradication of the [resumed underlying cause is in progress. They do nto have to be taken if you are nothaving any pain/heartburn i.e. you can take those only if needed.

 

But DO not stop the 2 antibiotics and the meracid. Take those as prescribed for the full time.

 

Thai doctors do tend to overprescribe and they do this even in government hospitals where it not only does not make money, it costs the hospital.

 

It is a cultural thing - Thais equate good quality care with getting multiple drugs and will feel slighted if given only one or two.

[RickG16]

I think it sounds like this is a normal amount of drugs then! Just never been given this many different meds for anything before.

 

Doctor said we will do 2 weeks on the antibiotics, and if still not better, then go for the camera in stomach. 

[perthperson]

1 minute ago, RickG16 said:

I think it sounds like this is a normal amount of drugs then! Just never been given this many different meds for anything before.

 

Doctor said we will do 2 weeks on the antibiotics, and if still not better, then go for the camera in stomach. 

That sounds like a very reasonable plan ! 

 

[carlyai]

That sounds like a very reasonable plan ! 
 

I had the very same problem. Dr. said camera, if anything found biopsy then treatment. something was found and a biopsy taken.
It was an ulcer/reflux problem that would not respond to antibiotics.
No antibiotics and problem fixed with other medicine.
In Australia they knock you out for this, but (I was invited into the operating theatre to watch part of the procedure), in Thailand, they don't knock you out. My sister in law went in on the morning, did the scan and biopsy, then back home. She said afterwards, no problems. They give a local spray in the throat.
I'm no Dr. but it seems an easy procedure to have before treatment.



Sent from my SM-J700F using Tapatalk

[perthperson]

1 minute ago, carlyai said:

I'm no Dr. but it seems an easy procedure to have before treatment.

 

The procedure (gastroscopy) can be expensive and carries risk (as do all invasive procedures) 

 

It is entirely reasonable to treat 'classic' gastric ulcer symptoms empirically. 

[RickG16]

On 01/07/2017 at 6:09 AM, carlyai said:

I had the very same problem. Dr. said camera, if anything found biopsy then treatment. something was found and a biopsy taken.
It was an ulcer/reflux problem that would not respond to antibiotics.
No antibiotics and problem fixed with other medicine.
In Australia they knock you out for this, but (I was invited into the operating theatre to watch part of the procedure), in Thailand, they don't knock you out. My sister in law went in on the morning, did the scan and biopsy, then back home. She said afterwards, no problems. They give a local spray in the throat.
I'm no Dr. but it seems an easy procedure to have before treatment.



Sent from my SM-J700F using Tapatalk
 

Cheers, I'm halfway through the antibiotics and no improvement.  If it turns out the bacteria isn't the cause, what was the name of the other treatment you said works?/ 

 

And how much is it for the camera check in Thailand? 

[RickG16]

On 01/07/2017 at 6:20 AM, perthperson said:

 

The procedure (gastroscopy) can be expensive and carries risk (as do all invasive procedures) 

 

It is entirely reasonable to treat 'classic' gastric ulcer symptoms empirically. 

Understand the gastrocopy can be expensive, but if the ulcer won't respond to the antibiotics, which other empirical treatmemts do you know you of?  Change of diet? (I am already sticking to an 'ultra sensitive diet')

 

Thanks for your replies 

[RickG16]

Update... I'm about halfway through the antibiotics, but can still feel the same twinges (gnawing \ stinging ab pain, sporadically).

 

I very stupidly had one (only one) glass of wine and smoked a couple of cigarettes in a weak moment on Saturday night. Is this likely to mess up the antibiotics? I started last Tuesday.

Edited July 5, 2017 by RickG16

[perthperson]

5 minutes ago, RickG16 said:

Understand the gastrocopy can be expensive, but if the ulcer won't respond to the antibiotics, which other empirical treatmemts do you know you of?  Change of diet? (I am already sticking to an 'ultra sensitive diet')

 

Thanks for your replies 

If your current treatment proves ineffective I would expect you to be subject to a more intense diagnostic process which will probably include a gastroscopy.  Further treatment depends on a definitive diagnosis and I am therefore unwilling to speculate. 

If you eat a normal healthy varied diet there is no real need to change unless a food item clearly exaggerates the condition. Avoiding chillies  would be wise ! 

[carlyai]

My sister in law had one, as I said. Local anaesthetic spray in the throat. She said afterwards, no problems, no pain. I think it was about B 8000 for everything. This was at the private hospital in Roiet.

Sent from my SM-J700F using Tapatalk

[carlyai]

Update... I'm about halfway through the antibiotics, but can still feel the same twinges (gnawing \ stinging ab pain, sporadically).
 
I very stupidly had one (only one) glass of wine and smoked a couple of cigarettes in a weak moment on Saturday night. Is this likely to mess up the antibiotics? I started last Tuesday.

Won't mess up the antibiotics (someone could correct me on this), but smoking and wine is no good for your stomach at the moment.

Sent from my SM-J700F using Tapatalk

[Sheryl]

The medication works by eradicating the bacteria that causes the inflamtion of the stomach lining. The inflammation (and ulcer if one is present) itself takes some time to resolve, it is not the case that you'll feel better immediately. It also sometimes takes more than one full course of treatment to eradicate the bacteria. Inflammation takes time to resolve and ulcerstion even longer. Usually an acid suppressing drug (PPI) will be prescribed for an extended period after the 10-14 day treatment with combined antibiotics.

 

Of course in your case the bacteria is presumed present but you have not actually been tested.

 

It would make sense to proceed to gastroscopy (or, at a minimum, test for presence of the bacteria, which can be done noninvasively) if you do not improve, but that is usually determined after full course of treatment has been completed and at least a week or two passed thereafter.

 

You have not described your symptoms in much detail. If you are having heartburn like discomfort this could be due to reflux (GERD) which is a different problem. One can of course have both GERD and gastritis/ulcer disease at the same time but they are different things with different causes and treatment. Gnawing pain on the other hand is more suggestive of ulcer.

 

 

 

 

[Sheryl]

P.S. forgot to mention:

 

1. Gastroscopy under sedation in private hospital in Bangkok these days runs 20-24 k.

 

2. If you are Asian more reason to do gastroscopy sooner rather than first try presumptive treatment -- this is because stomach cancer is more common in Asian populations. It is comparatively rare in westerners.

 

 

[sinbin]

14 hours ago, Sheryl said:

1. Gastroscopy under sedation in private hospital in Bangkok these days runs 20-24 k.

About half price if done at Suranaree  University of Technology , Korat. The Gastroenterologist speaks excellent English. Good luck. 

[Sheryl]

And even less than that at most government hospitals. But be warned not all give sedation. Some just spray a topical anesthetic into the throat

 

 

 

[RickG16]

For the record I'm not Asian... I have 5 days left of a 14 day antibiotic course, after that I have an appointment booked in with the doc. He says he will do some non invasive tests to see if any bacteria is present, and then maybe advise gastroscopy.

 

My problem now is that my stomach is feeling worse than before I started the antibiotics. It also hurts in more areas than it did before I started the treatment. With only 5 days to go, should I just ride it out? Or stop the antibiotics?

 

Obviously it would help to know what the cause is, so I am looking forward to the tests afterwards - but either way, the doctor assured me that the antibiotics can't do any harm, even if bacteria isn't the cause.

 

All replies welcome.....

[RichCor]

48 minutes ago, RickG16 said:

I have 5 days left of a 14 day antibiotic course [...]

My problem now is that my stomach is feeling worse than before I started the antibiotics. It also hurts in more areas than it did before I started the treatment. With only 5 days to go, should I just ride it out? Or stop the antibiotics?

If you are feeling worse, symptoms changing, then you should immediately return to your doctor or health facility for consultation.

 

You never want to stop antibiotics (unless it's causing an allergic reaction). Antibiotics shouldn't make things feel worse (pain wise), but it's always possible you're having a bad reaction. 

[perthperson]

1 hour ago, RickG16 said:

With only 5 days to go, should I just ride it out? Or stop the antibiotics?

 

 

That is a decision for you. In my opinion you would be very unwise to stop talking the antibiotics.

 

You say the pain is worse and more widespread. If this is the case you should be seeking early (urgent?) medical advice not altering your currently prescribed medication.

[sinbin]

1 hour ago, RickG16 said:

With only 5 days to go, should I just ride it out?

I had the antibiotics course to treat the H Pylori bacteria and I can state for certainty that the side effect are not pleasant. I had difficulty in finishing the course, but I did and never looked back. Stick with it. No pain, no gain. Good luck.

 

The most frequently reported side effects of triple therapy H pylori treatment are:

• Nausea
• Vomiting
• Metal taste in mouth
• Glossitis (painful, inflamed tongue)
• Abdominal pain and cramps
• Diarrhoea
• Urticaria (hives)

Other side effects include:

• Fatigue
• Depression
• Heartburn and acid reflux
• Sleep disruption
• Alterations in mood
• Joint and muscle pain
• Headaches
• Painful and tender liver / right shoulder blade area

Edited July 7, 2017 by sinbin

[RickG16]

1 minute ago, sinbin said:

I had the antibiotics course to treat the H Pylori bacteria and I can state for certainty that the side effect are not pleasant. I had difficulty in finishing the course, but I did and never looked back. Stick with it. No pain, no gain. Good luck.

Thanks... which kind of side effects did you feel?

[sinbin]

For me it was the metalic taste in my mouth. Horrible. Constant diarrhea. My poo was black and really smelly and a consistently dry mouth as far as I remember.

Edited July 7, 2017 by sinbin

[RickG16]

1 minute ago, sinbin said:

For me it was the metalic taste in my mouth. Horrible. Constant diarrhea. My poo was black and really smelly and consistently dry mouth as far as I remember.

Yeah I can concur on the taste - it's like I've been smoking, even though I haven't. But the most noticeable is ab pain / cramps - which for something which is meant to be curing my stomach, can be disconcerting! 

[lemonjelly]

Keep off the acidic and oily food for a good while ..... apparently raw potato juice is very effective in the treatment of ulcers too.... (obviously keep taking the antibiotics though)


Sent from my iPhone using Thaivisa Connect

[sinbin]

1 hour ago, RickG16 said:

something which is meant to be curing my stomach, can be disconcerting!

With me my problem wasn't my stomach. My problem was that I had a persistent cough/wheezing, similar to Asthma. Although H Pylori, gut bacteria, was the cause. It's difficult to explain the link..

Edited July 7, 2017 by sinbin

[RickG16]

50 minutes ago, lemonjelly said:

Keep off the acidic and oily food for a good while ..... apparently raw potato juice is very effective in the treatment of ulcers too.... (obviously keep taking the antibiotics though)


Sent from my iPhone using Thaivisa Connect

My typical diet is since this stomach pain is - 

 

breakfast - porridge oats with soy milk and sliced apple

lunch - pasta with vegetables and tuna (not cooked in oil)

dinner - sometimes some red meat or something naughty, but quite often grilled fish / chicken, salad, brown rice

 

I've had one glass of wine, no coffee, and have even been trying to cut back on tea (this has been hard!). Have also eliminated spicy food from my diet!

 

I had a bout of hepatitis before this stomach problem (now cleared and liver normal), so have pretty much been on a disciplined diet with little alcohol for over 3 months - it makes the (suspected) ulcer all the more annoying!