Why am I having GI bleeding even after my ulcer therapy?

Question

Hello doctor,

I was diagnosed with peptic ulcers because I was having blood (fresh) in my stool. I am on medication but the medication is not effective because my blood has not stopped for even one day. It keeps coming every time I go to pass stool and at times my stool has blood in it too. My stomach feels stretchy most of the times and I feel cramps too often. A few days back, I have started facing left side pain as well. I do not really know what is the reason for the blood not stopping and my pains. Just to add, I do not have constipation issues because I am having Ispaghol every night before sleeping.

The medication I am taking are Sucralfate enema (once daily), Transamin 500 mg (twice daily), Mebever 200 mg (twice daily), Motilium 10 mg (twice daily), Caflam (twice daily), Ciproxin 500 mg (twice daily), and Ispaghol (before sleeping).

Answer 1

Hello,

Welcome to icliniq.com.

Well, the peptic ulcer disease often presents with upper abdominal pain. It does not present with per rectal bleeding unless someone has a brisk and huge amount of bleeding ulcers in the stomach or small bowel. And the color of stools often appears dark, tarry black, if the source of bleeding is within the stomach or small bowel.

I understand you have fresh red color bleeding in stools, which comes every day you pass stools. Plus cramps and pain over the left lower side of the abdomen suggest a few possibilities.

1. Infections with the parasites such as E. Histolytica.

2. Diverticulosis with diverticular bleeding.

3. Ulcerative colitis is an autoimmune inflammatory disease causing ulcers in the rectum and large bowel (colon).

I want you to stop Caflam (Diclofenac) since this is a painkiller and can cause ulcers within the stomach, small bowel, and large bowel. It can also precipitate your peptic ulcer disease.

I recommend you use tablet Flagyl 400 mg thrice daily for five days, plus capsule Cefspan (Cefixime) 400 mg once daily for five days. I ask you to get the following tests and get back to me once they are done. I would further guide you on what to do next.

You should also stop Mebever, Motilium, and Ciproxin, as they would not be useful in your case. The rest of your medication can be continued. Plus take capsule Esomeprazole 40 mg half an hour before breakfast daily. This is for your peptic ulcer disease.

I hope this helps.