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What causes gastritis and severe back pain in an elderly person?

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Posted on Wed, 9 Dec 2015
Question: I am 63 year old Male and taking Irovel 150 (morning) and Asomex AT (evening) since 2003. Six months after taking the medicine it was observed that my BP was lower than normal. So, the Dr. asked me to take half the dose. Thus, I have been taking the same half dose for over 11 years now. My BP is normal and I do not have any heart problem nor do I have diabetes. I have however developed Gastritis since 2012. My endoscopy reveals some erosion and it is diagnosed as Erosive Gastritis. H Pylori test was negative. I was prescribed Sompraz 40 twice daily for two months. The discomfort subsided. But after few days I started feeling it again. From then on I have been prescribed various medicines like Esompraz D, Nexium (while in USA) etc. Later on I developed back pain. It was found that I was almost in to Osteoporosis; my T Score was above 2.5. I was prescribed different injections and medicines for cure of my Back pain. There is some improvement but I still have It. The pain is on the Right-upper of my back. At present I still have Back pain and Gastritis ( feel burning sensation inside stomach after midnight). My BP is under control. Is prolonged use of the BP medicine the cause of my Gistritis and Osteoporosis? If so, what should I do?
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Answered by Dr. Suresh Heijebu (2 hours later)
Brief Answer:
Side effects are drug related

Detailed Answer:
Hello, Sir.

I can certainly understand your concerns.

I apologize for the delayed response owing to my work schedule.

I have worked through your query in detail.

The erosive gastritis in your case is largely related to side effects of Irbesartan and hydrochlorthiazide- Irovel.

Both these drugs are known to cause dyspepsia and epigastric discomfort on long-term use.

Asomex AT is not associated with such a side effect.

The osteoporosis is largely a side effect of all PPI's drugs like Nexium, Esmaprazole and Sompraz.

These side effects are not significant enough to warrant drug discontinuation.

The only you can probably do is take timely intake of vitamin D ,calcium and avoid precipitating factors for gastritis.

The benefits obtained by anti hypertension drugs is far greater than their side effects profile.

Post your further queries if any.
Thank you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Suresh Heijebu (42 hours later)
Thanks for your observations and advice. I need your advice on substitution of Irbesartan. As I have already told you, I am taking Irovel 150 in the morning and Asomex AT in the evening. Can I stop Irovel 150 and take Asomex AT in the morning and evening as well.
doctor
Answered by Dr. Suresh Heijebu (4 hours later)
Brief Answer:
Substitute Telmisartan for Irovel

Detailed Answer:
Hello, Sir.

I can certainly understand your concerns.

I apologize for the delayed response owing to my work schedule.

It's advisable to avoid hydrochlorthiazide which is responsible for large degree(10%) of epigastric distress and loss of potassium from the body.

Plain Irebisartan is associated with only 1% incidence of epigastric distress and can be tolerated well.

As a suitable substitute for Irebisartan, I recommend Telmisartan 40 mg which can be titrated up to 80 mg based on requirements.
This drug belongs to same class as Irebisartan but is absolutely not associated with Epigastric distress.

Asomex AT can be continued as only prescribed once daily.

Please check with your physician if he shares my view and if can prescribe the medication(s)to you.

Post your further queries if any.
Thank you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Suresh Heijebu

General & Family Physician

Practicing since :2010

Answered : 3661 Questions

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What causes gastritis and severe back pain in an elderly person?

Brief Answer: Side effects are drug related Detailed Answer: Hello, Sir. I can certainly understand your concerns. I apologize for the delayed response owing to my work schedule. I have worked through your query in detail. The erosive gastritis in your case is largely related to side effects of Irbesartan and hydrochlorthiazide- Irovel. Both these drugs are known to cause dyspepsia and epigastric discomfort on long-term use. Asomex AT is not associated with such a side effect. The osteoporosis is largely a side effect of all PPI's drugs like Nexium, Esmaprazole and Sompraz. These side effects are not significant enough to warrant drug discontinuation. The only you can probably do is take timely intake of vitamin D ,calcium and avoid precipitating factors for gastritis. The benefits obtained by anti hypertension drugs is far greater than their side effects profile. Post your further queries if any. Thank you.