Q. Does peptic ulcer cause severe dull pain in the abdomen?
Hi doctor,
I have a suspected peptic ulcer and will have a live gastroenterology appointment. In the meantime, I started feeling weird yesterday (around 24 hours ago). The pain in my abdomen worsened and woke me up during the night. It is a dull pain, and I feel like my upper abdomen is being strained. I have been taking over-the-counter medicine for acid reflux, but it is not improving like before, and I am afraid the ulcer might be perforated.
How can I know if it is perforated and if I need to go to the ER (emergency room)?
Thank you.
Hi,
Welcome to icliniq.com.
I suggest taking acid suppression medicine like Pantoprazole 30 milligrams half an hour before breakfast and some antacid syrup like Gaviscon 10 milliliters (Sodium alginate 500 mg, Sodium bicarbonate 213 mg, and Calcium carbonate 325 mg) after every meal.
There are two important complications, and one is bleeding. That means bleeding in vomiting or stools. If this is not present, then do not worry.
Thank you.
Hi doctor,
Thank you for your answer.
Do you not think the ulcer is perforated?
Thank you.
Hi,
Welcome back to icliniq.com.
Another complication you mentioned is perforation. It is even worse than bleeding, but in that case, the patient is very sick with severe abdominal pain. The abdomen is as hard as a wooden board, and pain will not resolve with painkillers.
Changes from simple ulcer to perforation are very few.
Thank you.
Hi doctor,
Thank you for your answer.
Do you think this aggravation of the symptoms (before I had heartburn but not constant pain) could mean that I am at risk of perforation, or is this persistent pain normal in a simple ulcer?
Thank you.
Hi,
Welcome back to icliniq.com.
How much will you score your pain intensity out of 10?
1 means negligible pain, and 10 means severe pain, unable to tolerate at all.
Which antacid are you taking?
Mild to moderate pain can occur in patients with gastritis or simple ulcers. Perforation is severe and almost the last complication of an ulcer, so it is very unlikely to have pain for the first time, and your ulcer has already perforated.
Thank you.
Hi doctor,
Thank you for your answer.
Right now, probably about a four or five, it is a dull pain, like it is burning or as if I am very hungry. I am taking Gaviscon double action liquid sachets.
Thank you.
Hi,
Welcome back to icliniq.com.
Pain is not that severe, like perforation. Gaviscon (sodium alginate 500 mg, sodium bicarbonate 213 mg, and calcium carbonate 325 mg) is an excellent antacid, and you can increase the dose. You can add proton pump inhibitors like Pantoprazole or Lansoprazole once daily, half an hour before breakfast.
Try to eat home-cooked soft meals. Avoid re-heated meals or eating out for a few days.
Thank you.
Hi doctor,
Thank you for your answer.
I will do that.
Thank you.
Hi doctor,
I started taking Omeprazole, and it improved the pain massively. I have been taking 40 milligrams of Omeprazole every day for 14 days now. I visited a gastroenterologist, who prescribed it for 60 days for the unidentified abdominal pain. It helped with the pain, but another situation came up.
I went to the emergency room because I started having abdominal cramps and diarrhea 48 hours ago. By the end of yesterday afternoon, it intensified (I went to the bathroom around five times in 1 hour and 30 minutes), and there seemed to be blood in my stool. They told me to come home and take some cramp medicine and that it was probably hemorrhoid. However, my belly keeps hurting, and the blood does not seem to go away. I took a picture now to help the doctor assess the cause.
Should I go back to the ER (emergency room) or do you believe it will go away on its own?
Thank you.
Hi,
Welcome back to icliniq.com.
I have reviewed your case history and attached pictures (attachment removed for patient identity protection).
1) These are two different conditions, do not confuse them, initial upper abdominal pain that resolved with acid suppression medicine was likely gastritis, and I agreed you can take medicine for 30 to 60 days.
2) This time, abdominal cramps, diarrhea, and associated gastrointestinal bleeding seem to be a gut infections like small or large bowel infections commonly known as enterocolitis. You might have a history of eating out or eating unusual meals. This does not relate to acid suppression medicine use or coming from the stomach as such.
3) I do not think that this is hemorrhoidal bleeding. Hemorrhoidal bleeding is fresh red and most often occurs with constipation rather than diarrhea. There should be no abdominal pain in the case of hemorrhoids.
My suggestions,
1) Get your stool DR (detailed report) simple test to see stool infection.
2) Take anti-spasmodic medicine like Mebeverine (Mebeverine hydrochloride 135 mg) or Drotaverine (40 mg of Drotaverine hydrochloride) half an hour before meals twice a day.
3) Start probiotics once daily.
4) If there is an infection in your stool report, you may need a short course of antibiotics.
Thank you.
Hi doctor,
Thank you for your answer.
I shall do that.
Thank you.
Hi,
Welcome back to icliniq.com.
I hope you will be fine soon.
Thank you.
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|Same symptoms doesn’t mean you have the same problem. Consult a doctor now!
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