What is the effective treatment for chronic stomach pain after using Naproxen that resists multiple treatments?

Question

Hello doctor,

I have had moderate stomach pain for the last three years. It started after being on Naproxen for one week. I have never taken any other NSAIDs before, and it was taken with a PPI to help protect the stomach. I have taken Lansoprazole, Pantoprazole, and now Dexilant to treat this condition (Dexilant dosage two times a day 30 mg). Unfortunately, no medicine seems to provide any real relief. Eating fatty or acidic foods is especially harmful to my stomach, and the pain generally lasts for days or weeks. My only salvation right now is to drink homemade aloe water (the only thing that provides temporary relief) and eat a diet consisting of grains, lean protein, and vegetables. I have had multiple ultrasounds, a HIDA scan for my gallbladder, a breath test for H. pylori, two gastroscopies or colonoscopies, and various blood tests. The findings are as follows:

1. Bilirubin and iron were mildly elevated on the blood tests (nothing concerning, according to the doctors).

2. Liver or kidney was slightly enlarged on the MRI (nothing concerning according to the doctors).

3. Gastroscopies revealed mild irritation to the stomach lining.

4. Colonoscopy first was clean, and second revealed five polyps that were removed.

I am now waiting for another specialist (estimated 12-month wait time), and my family has recommended a blood test for H. pylori as I was still medicating shortly before the breath test, which could of lead to a false negative. Unfortunately, my stomach is now in too much pain to abstain from medication (acid spike from withdrawal) to take another breath test. I desperately need help from someone highly specialized in this condition.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I went through your symptoms, history, blood work, and results.

At the outset, let me assure you the results are good, and your organ functions are excellent for your age. However, you have a very sensitive stomach leading to inflammation of gastric mucosa called gastritis. This possibly is the cause of abdominal pain. You are right. Sometimes, the endoscopy may not reveal much evidence. However, given the fact that you have had GERD in the past and there is a little bit of relief with proton pump inhibitors, I should agree with you regarding the analysis.

1. Please analyze if any foodstuffs aggravate your condition and avoid it.

2. Please avoid large late-night meals.

3. Please take frequent small meals.

4. Avoid spicy foods and excessive coffee.

5. Avoid soda and lemonade.

6. Avoid being hungry for a long time.

7. You can continue your aloe drink as it is effective and soothes your bowel lining.

8. You could also take curd and yogurt to balance your gut bacteria, as it acts as a natural probiotic.

Thank you.