Got a pit in your stomach??

In times of high stress, I tend to not eat a lot (I am the opposite of most people who tend to eat when they are stressed out) because when I do eat, I feel like I literally have a burning pit in my stomach.  Originally, I freaked out that I had an ulcer and ad a whole work up, then as it ended up, my HCP just diagnosed me with being super stressed; as soon as the stress ended, so did the symptoms!  But, many people do have symptoms of peptic ulcer disease and they self treat instead of getting a proper work up.  And sometimes peptic ulcer disease is caused by bacteria that is treated with two weeks on an antibiotic, instead of a lifetime of OTC antacids!!

What exactly is a peptic ulcer?
It is basically an open sore on the inside of your esophagus, stomach lining, and/or s mall intestine. These ulcerations can cause pain from contact with stomach acids.  Usually it causes pain, but there can be other symptoms as well.  And, it is usually a bacteria or medication that causes these ulcerations and not stress or diet as it had always been presumed in the past.

What are the symptoms?
-You can have pain and or burning anywhere from underneath the breastbone down to your navel area.
-Pain that is decreased with the use of antacids
-Increased pain with an empty stomach
-Vomiting blood *(immediately seek treatment at the closest Emergency Department)
-Dark blood in bowel movements (Go to see your HCP ASAP)
-Nausea and vomiting that is not related to an illness and random
**if any of these symptoms are continued you should go to see your HCP and if you are worried at any time you should seek help.

Why do you get ulcers?
-It can be caused by an infection with a bacteria called Helicobacter pylori (H. pylori is its more common name).  This bacteria causes irritation to the stomach lining and eventually ulcerations; and it can be transmitted person to person and through food and water.
-Certain medications like OTC pain relievers can cause ulcerations as well.  Aspirin, Ibuprofen, and Naproxen can cause ulcers if not taken with food, or taken with frequency.  Tylenol is one OTC pain medication that does not cause ulcers and is a safe alternative for those diagnosed with ulcers.  Also medications for osteoporosis (i.e. fosamax) can cause ulcers too!

Is there anything I can do to decrease my risk?
Don't smoke, limit drinking, and try to limit your stress (I know, easier said than done.) And, while stress doesn't "cause" ulcers, the medical community still accepts it as a risk factor, so we encourage stress relieving techniques for patients with high stress.

What happens if I have an ulcer that is untreated?
-You can have ulcerations that cause internal bleeding, requiring surgical procedures to treat and stop the bleeding.
-You can have scar tissue build up which can caused slowed digestion and malnutrition problems and excessive vomiting
-You can also get an extensive infection due to the overwhelming bacteria overgrowth

How will I be tested?
-H. pylori can be tested by drawing a blood sample, through a stool sample, or a breath test (you drink a glass of a medication that reacts with the bacteria, so wen you exhale into a bag, it will have high levels of the medication and C02.)
-Endoscopy: you will have to stop eating at midnight the night before, go in to the clinic, and you will get an IV and some medications to make you VERY sleepy so you actually don't remember anything, and a small scope is passed from your mouth into your stomach and small intestine so they can visualize any ulcerations and take samples of tissue if bacteria is still suspected.
-Barium Swallow Study: you will drink some barium then a series of xrays are taken to see if there are any ulcerations present.

Treatment options?
-If it is bacterial, you will be given an antibiotic, such as Flagyl, for two weeks.
-Histamine-2 (H2) blockers decrease the amount of stomach acid produced (such as pepcid/famotidine)
-Proton Pump Inhibitors (PPI's) block acid production and create a healthy environment for healing. An example of PPI's are protonix (pantoprazole), prilosec (omeprazole), and prevacid (lansoprazole).
-Cytoprotective agents coat the lining of the stomach and do cause slower digestive times but create a barrier for acids, making it harder to create new erosions (i.e. carafate) but you do have to be careful with other medications as they might not absorb as well.

And make sure after starting to treatment to follow-up with your HCP to ensure that your treatment is appropriate and how long you will require treatment.  Continue to live a healthy lifestyle with exercise, healthy diet, smoke-free, limit alcohol, and try to keep stress to a minimum.  If you do experience any of these symptoms, while it could be nothing, as it was in my case, or it could be pretty serious and you should talk to your HCP about it so they can be aware and maybe get some preventative treatments in place!

Yours in Good Health
B