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Suggest treatment for duodenal ulcer

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Posted on Tue, 3 Oct 2017
Question: I was diagnosed in the ER on Tuesday with Duodenal ulcer (gastric). The pain is now overwhelming again and it appears to involve both my kidneys and my lower abdomen and pubis. I am not able to eat very much without nausea and tremendous diarrhea that I've had for about 6 years, almost continually. I am a diabetic and recently put on Januvia because I became allergic to NovoLog and Lantus after 25 years, just had gastric emptying study and I think that started this mess (not that I was great before then but not critical). I am allergic to many drugs, sulfa among them. I have diverticulosis. I can't take this pain and I'm not at all sure this isn't a drug reaction or something more serious. Pain is overwhelming. I am taking Mylanta with Lidocaine "cocktail" for a little pain relief but it is working about 20 minutes and that's it. I think this is Lyme disease which I've had twice for the last 22 years x 2 separate bites. Treated for 4 weeks with antibiotics and now I'm allergic to all oral antibiotics. Sounds like I'm a whacko and right now I just might be but the pain is overwhelming.
i have no addictions. No alcohol or substance or cigarettes. I wanted a gastroenterologist to tell me what is wrong with me. I didn't see an ID doctor on there and I think this is an advanced case of Chronic Lyme. Could it be that? What should I do about it
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Answered by Dr. Matt Wachsman (56 minutes later)
Brief Answer:
Great news, you have the only case

Detailed Answer:
where it is proven you do not have LYME.
Lyme disease is due to an organism that produces a particular type of scarring. It attacks nerves and joints.
It is sensitive to a lot of antibiotics. They work. the organism goes away. But, one cannot say that with 100% certainty most of the time because we cannot directly go into the nerve or joint and do a biopsy and see:
1) no organism
2) none of the damage that the organism does is there
3) that there is another cause that is NOT lyme
4) that the area healed up.
However, in duodenal ulcer, which is NOT a lyme syndrome, biopsies are done. The organism is not going to be there. If there were lyme caused pathology, called granulomas, then that would have been not only noted but be treated. People don't get nerve and joint ulcers. Lyme doesn't do ulcers.

More to the point is the pain. Ok, lidocaine and mYLANta do not stay around nor do they fix an ulcer. The pain relief you would expect from it would be brief. They do not accumulate, they don't even get through the gut. They can be taken every 20 minutes. Acid blockers such as proton pump inhibitors actually get rid of acid and help healing. they are not immediate but they work fairly fast. So, getting them and a locally soothing intervention like antacid, or lidocaine or icy drinks are going to help. the locally acting drugs fast, but the ulcer healers will help in the long run. Karafuto is a bit of both. It is tricky because it really gums things up and can prevent other drugs from being able to be absorbed if taken at the same time.

But it isn't lyme.
really.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 4058 Questions

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Suggest treatment for duodenal ulcer

Brief Answer: Great news, you have the only case Detailed Answer: where it is proven you do not have LYME. Lyme disease is due to an organism that produces a particular type of scarring. It attacks nerves and joints. It is sensitive to a lot of antibiotics. They work. the organism goes away. But, one cannot say that with 100% certainty most of the time because we cannot directly go into the nerve or joint and do a biopsy and see: 1) no organism 2) none of the damage that the organism does is there 3) that there is another cause that is NOT lyme 4) that the area healed up. However, in duodenal ulcer, which is NOT a lyme syndrome, biopsies are done. The organism is not going to be there. If there were lyme caused pathology, called granulomas, then that would have been not only noted but be treated. People don't get nerve and joint ulcers. Lyme doesn't do ulcers. More to the point is the pain. Ok, lidocaine and mYLANta do not stay around nor do they fix an ulcer. The pain relief you would expect from it would be brief. They do not accumulate, they don't even get through the gut. They can be taken every 20 minutes. Acid blockers such as proton pump inhibitors actually get rid of acid and help healing. they are not immediate but they work fairly fast. So, getting them and a locally soothing intervention like antacid, or lidocaine or icy drinks are going to help. the locally acting drugs fast, but the ulcer healers will help in the long run. Karafuto is a bit of both. It is tricky because it really gums things up and can prevent other drugs from being able to be absorbed if taken at the same time. But it isn't lyme. really.