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Is These Symptoms Gastric And Duodenal Ulcers?
Question: Hello, 9 days ago I woke up with waves of nausea and the sweats which I had for about 3 hours. It went away and I felt kind of hungry. I just figured I must have the flu. The next day it was a little better but then the following day (7 days ago) it was back again. I have had waves of nausea everyday since then. The waves of nausea come and go throughout the day. It seems when the nausea gets really bad then all of a sudden I start getting hungry and I am able to eat. The nausea seems to be the worst in the morning about an hour or two after I get up before I have anything to eat. I do find that when I eat the nausea does not completely go away but it does decrease. It seems to feel worse on an empty stomach. I have had no vomiting, fever or diarrhea. I have not changed my diet recently. I have had normal bowel movements and no blood in my stool. Basically, my only symptom is waves of nausea. Although I am on Marvelon and I got my period 4 days ago, I took a pregnancy test just in case, but it was negative.
3 days ago I went to the clinic. The doctor checked my abdomen and asked questions. She said it could be viral or gastritis (or gastroenteritis -I forget which term she used) or excess stomach acid. She said it sounds like my stomach lining is irritated. She says when my stomach is empty it produces more acid and when I eat, the food coats the stomach which makes the nausea go away. She recommended I take Zantac. She said I may have 2 pills a day at the most. I have taken one a day and do not feel it has helped at all. If it is stomach acid, what can be causing an increase in it?
Today we left for a family vacation for the week. There is no clinic here so today I went to the hospital. The doctor felt my abdomen and asked lots of questions. They checked my blood pressure and blood sugar which were fine. She said she doesn't know what is causing the nausea, but she said nothing was setting off red flags for her. She said to see my doctor when I return (in 9 days) or come back to emerge if I get worse (such as develop fever, begin vomiting, unable to pass gas or a bowel movement, pain, etc). She said that I can take up to 300mg of Zantac per day meaning 2 pills a day/twice a day.
I am so concerned that I have had this for 9 days. In the past I have had many stomach viruses that have felt similar in nature where I will have nausea, no vomiting or diarrhea and I am able to eat. They usually last 8-10 days, even 14 days. Once it lasted a month. I feel similar this time but a little different. So I am not sure if this is viral. I am so worried about what can be causing this.
I am wondering if I should follow the ER doctor's advice to take a larger dose of Zantac per day? It seems like a large dose that she suggested (300mg/day). Also, do you think it will be alright for me to wait 9 days to see my family doctor? He is also on vacation so I cannot see him for 9 days. I would be able to go to my clinic in 7 days and see a different doctor if needed. I am nervous to be waiting that long.
Thank you
3 days ago I went to the clinic. The doctor checked my abdomen and asked questions. She said it could be viral or gastritis (or gastroenteritis -I forget which term she used) or excess stomach acid. She said it sounds like my stomach lining is irritated. She says when my stomach is empty it produces more acid and when I eat, the food coats the stomach which makes the nausea go away. She recommended I take Zantac. She said I may have 2 pills a day at the most. I have taken one a day and do not feel it has helped at all. If it is stomach acid, what can be causing an increase in it?
Today we left for a family vacation for the week. There is no clinic here so today I went to the hospital. The doctor felt my abdomen and asked lots of questions. They checked my blood pressure and blood sugar which were fine. She said she doesn't know what is causing the nausea, but she said nothing was setting off red flags for her. She said to see my doctor when I return (in 9 days) or come back to emerge if I get worse (such as develop fever, begin vomiting, unable to pass gas or a bowel movement, pain, etc). She said that I can take up to 300mg of Zantac per day meaning 2 pills a day/twice a day.
I am so concerned that I have had this for 9 days. In the past I have had many stomach viruses that have felt similar in nature where I will have nausea, no vomiting or diarrhea and I am able to eat. They usually last 8-10 days, even 14 days. Once it lasted a month. I feel similar this time but a little different. So I am not sure if this is viral. I am so worried about what can be causing this.
I am wondering if I should follow the ER doctor's advice to take a larger dose of Zantac per day? It seems like a large dose that she suggested (300mg/day). Also, do you think it will be alright for me to wait 9 days to see my family doctor? He is also on vacation so I cannot see him for 9 days. I would be able to go to my clinic in 7 days and see a different doctor if needed. I am nervous to be waiting that long.
Thank you
Brief Answer:
Can be a possible ulcer in duodenum.
Detailed Answer:
Hello,
Have gone through your detailed history,
Gastric and duodenal ulcers are two kinds of peptic ulcers.A peptic ulcer is a sore that’s on the inside of the stomach lining a gastric ulcer or the upper part of the small intestine a duodenal ulcer.
The characterstic feature of pain of duodenal ulcer is that patient feel nauseating when empty stomach usually at mid nigh or early morning and nausea is relieved on taking food.
Test recommended are-
Gastroscopy is the test that can confirm a duodenal ulcer. In this test a doctor or nurse looks inside your stomach and the first part of your small intestine (duodenum).
A test to detect the H. pylori germ (bacterium) is usually done if you have a duodenal ulcer.
Till then take Omeprazole 40 mg twice daily along with an antacid.
Ranitidine is a week H2 blocker and won't help you much.
Follow up with reports.
Hope i was helpful.
Thanks!
Can be a possible ulcer in duodenum.
Detailed Answer:
Hello,
Have gone through your detailed history,
Gastric and duodenal ulcers are two kinds of peptic ulcers.A peptic ulcer is a sore that’s on the inside of the stomach lining a gastric ulcer or the upper part of the small intestine a duodenal ulcer.
The characterstic feature of pain of duodenal ulcer is that patient feel nauseating when empty stomach usually at mid nigh or early morning and nausea is relieved on taking food.
Test recommended are-
Gastroscopy is the test that can confirm a duodenal ulcer. In this test a doctor or nurse looks inside your stomach and the first part of your small intestine (duodenum).
A test to detect the H. pylori germ (bacterium) is usually done if you have a duodenal ulcer.
Till then take Omeprazole 40 mg twice daily along with an antacid.
Ranitidine is a week H2 blocker and won't help you much.
Follow up with reports.
Hope i was helpful.
Thanks!
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Hello Dr. XXXXXXX
Thank you for your response. Could this still be a duodenal ulcer if I have no pain? I have always heard that ulcers are painful. My only symptom is nausea.
To me this sounds like a dangerous thing to have. The earliest I can go to my clinic will be 6 days from now. I am nervous to wait that long. The emergency room where I am vacationing only wants me to come if I am doing worse. Is 6 days too long to be waiting? I will have had this for 16 days by then. Plus they will have to send me for testing, etc which will take time.
Can Zantac or the medication you recommended cause any heart problems? I have PVCs and don't know if they would be affected.
Would Prevacid be effective?
Also are ulcers worsened with anxiety or is that a myth?
Thank you. I am just so worried about this.
Thank you for your response. Could this still be a duodenal ulcer if I have no pain? I have always heard that ulcers are painful. My only symptom is nausea.
To me this sounds like a dangerous thing to have. The earliest I can go to my clinic will be 6 days from now. I am nervous to wait that long. The emergency room where I am vacationing only wants me to come if I am doing worse. Is 6 days too long to be waiting? I will have had this for 16 days by then. Plus they will have to send me for testing, etc which will take time.
Can Zantac or the medication you recommended cause any heart problems? I have PVCs and don't know if they would be affected.
Would Prevacid be effective?
Also are ulcers worsened with anxiety or is that a myth?
Thank you. I am just so worried about this.
Brief Answer:
follow up.
Detailed Answer:
Hello again my dear patient,
Yes classical presentation is with pain but is not there in every patient can present with only nausea vomiting etc also.The golden rule of medical science is that there is no rule.
No 6 days is not long infact you can even wait for weeks.Its a chronic problem.
Anxiety is the main causr of VPC's.Gastritis can stimulate nervous system and may cause VPC's.So may be they are chances that both are related.
No omeprazole or any antacid would not cause VPc's you can take it.
Anxiety can not only worsen ulcers but may also even cause them.
Thanks.
follow up.
Detailed Answer:
Hello again my dear patient,
Yes classical presentation is with pain but is not there in every patient can present with only nausea vomiting etc also.The golden rule of medical science is that there is no rule.
No 6 days is not long infact you can even wait for weeks.Its a chronic problem.
Anxiety is the main causr of VPC's.Gastritis can stimulate nervous system and may cause VPC's.So may be they are chances that both are related.
No omeprazole or any antacid would not cause VPc's you can take it.
Anxiety can not only worsen ulcers but may also even cause them.
Thanks.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Hi Dr. XXXXXXX
Thank you for answering my questions. I REALLY appreciate it! I am so sorry I have so many questions. I have more to ask you and I apologize in advance for this being a long reply with a lot of questions. As you can tell I am a very anxious person. I worry a lot about health conditions so things like this scare me. I am finding tonight that since I am getting really worried about this, my nausea has been worse. I can normally sleep ok and it doesn't bother me, but tonight it is really bothering me.
I know I should not do this, but I googled about ulcers and saw that they can cause blockages and even holes in the intestine which would be a big emergency. That scared me really bad. We have a family friend that died from a hole in her intestine because she went septic. Doctor believed it was likely a weak spot she may have had her whole life and caused problems. Anyway, as an anxious person you can imagine that this is all causing me a lot of worry. I have two young kids so I worry about being healthy and being here for them.
My mom had an ulcer in her duodenum probably when she was about my age (41). She is a very anxious person too.
This might sound silly but can an ulcer just start causing trouble out of nowhere like this? You're fine one day and then ill the next. I guess I am concerned that if this is an ulcer and it is all of a sudden making me feel so sick, is there something wrong with it?
At the end of July, I had 4 days where I was getting waves of nausea, pains in my upper abdomen that would come and go and the sweats. I had an abdominal X-ray checking for constipation. My doctor just assumed I had a virus or it was constipation. It went away. A week later this all started. Could it be related to this? When I had the abdominal X-ray, would the ulcer show up on X-ray? Nothing was said to me about that. Also, do ulcers take long to develop? I had a colonoscopy 3.5 years ago which was fine. I also had an abdominal ultrasound a year ago which was fine. Back in November I had another ultrasound to check for a hernia (which I have) in my upper abdomen but everything was fine.
Could I also use gravol for the nausea? I am having a hard time handling feeling sick like this all the time.
If the nausea gets worse, but still no vomiting, should I go back to the ER or just wait to see my doctor?
If this is not an ulcer, do you know what else it could be? Again, anything I need to visit ER for? The ER doctor told me to come back if I have fever, vomiting, diarrhea, blood in stool, unable to pass gas or stool, vomiting blood, etc. Is there anything else I would have to go for?
Are there any foods I should avoid?
Thank you again so very much! I really appreciate all of your help. I am sorry again for all of the questions!
Thank you for answering my questions. I REALLY appreciate it! I am so sorry I have so many questions. I have more to ask you and I apologize in advance for this being a long reply with a lot of questions. As you can tell I am a very anxious person. I worry a lot about health conditions so things like this scare me. I am finding tonight that since I am getting really worried about this, my nausea has been worse. I can normally sleep ok and it doesn't bother me, but tonight it is really bothering me.
I know I should not do this, but I googled about ulcers and saw that they can cause blockages and even holes in the intestine which would be a big emergency. That scared me really bad. We have a family friend that died from a hole in her intestine because she went septic. Doctor believed it was likely a weak spot she may have had her whole life and caused problems. Anyway, as an anxious person you can imagine that this is all causing me a lot of worry. I have two young kids so I worry about being healthy and being here for them.
My mom had an ulcer in her duodenum probably when she was about my age (41). She is a very anxious person too.
This might sound silly but can an ulcer just start causing trouble out of nowhere like this? You're fine one day and then ill the next. I guess I am concerned that if this is an ulcer and it is all of a sudden making me feel so sick, is there something wrong with it?
At the end of July, I had 4 days where I was getting waves of nausea, pains in my upper abdomen that would come and go and the sweats. I had an abdominal X-ray checking for constipation. My doctor just assumed I had a virus or it was constipation. It went away. A week later this all started. Could it be related to this? When I had the abdominal X-ray, would the ulcer show up on X-ray? Nothing was said to me about that. Also, do ulcers take long to develop? I had a colonoscopy 3.5 years ago which was fine. I also had an abdominal ultrasound a year ago which was fine. Back in November I had another ultrasound to check for a hernia (which I have) in my upper abdomen but everything was fine.
Could I also use gravol for the nausea? I am having a hard time handling feeling sick like this all the time.
If the nausea gets worse, but still no vomiting, should I go back to the ER or just wait to see my doctor?
If this is not an ulcer, do you know what else it could be? Again, anything I need to visit ER for? The ER doctor told me to come back if I have fever, vomiting, diarrhea, blood in stool, unable to pass gas or stool, vomiting blood, etc. Is there anything else I would have to go for?
Are there any foods I should avoid?
Thank you again so very much! I really appreciate all of your help. I am sorry again for all of the questions!
Brief Answer:
Follow up suggestions.
Detailed Answer:
Hello again my dear patient and am sorry for a bit delayed reply,
Firstly i would like to say that please feel free to ask your queries.I am really happy if i can help you.
1) I worry a lot about health conditions so things like this scare me. I am finding tonight that since I am getting really worried about this, my nausea has been worse. I can normally sleep ok and it doesn't bother me, but tonight it is really bothering me.-Anxiety stimulates the autonomous nerves in our body and can increase symptoms of gastritis.Gastritis may be responsible for nausea and may even cause ulcers in duodenum or gut.
2)I know I should not do this, but I googled about ulcers and saw that they can cause blockages and even holes in the intestine which would be a big emergency. That scared me really bad.-This do happen but in very XXXXXXX and usually neglected cases of GERD and acid peptic disorder.Patients who does not recieve proper treatment for years may present with perforation and bleeding.
3)Plain x ray would neither show a viral infection nor constipation.
4)Ulcers can be seen only by endoscopy.
5)Usually they take from months to years to develop.
6)Was it a hiatel hernia?it is the most common cause of acid peptic disorder. Please attach the report
7)Yes you can use gravol for nausea for time being.
8)You have to go for an endoscopy and stool test to answer that what it could be.
9))Sucralfate is used to treat and prevent l ulcers.Sucralfate works by forming a coating' over the ulcer. This protects the ulcer from the acid of the stomach, allowing it to heal. Sucralfate is best taken with water on an empty stomach 1 hour before meals and at bedtime. It should be taken daily by you and would help in healing ulcers.
General precautions are-
Follow a bland diet (low acid levels, low in fat, not spicy)
Eat frequent, small meals.
Lose weight.
Avoid the use of alcohol, tobacco, and caffeine.
Do not eat food less than 2 hours before bedtime.
Raise the head of the bed before sleeping.
Avoid clearing of the throat.
Hope i was helpful.
Please feel free to follow up.
Regards!
Follow up suggestions.
Detailed Answer:
Hello again my dear patient and am sorry for a bit delayed reply,
Firstly i would like to say that please feel free to ask your queries.I am really happy if i can help you.
1) I worry a lot about health conditions so things like this scare me. I am finding tonight that since I am getting really worried about this, my nausea has been worse. I can normally sleep ok and it doesn't bother me, but tonight it is really bothering me.-Anxiety stimulates the autonomous nerves in our body and can increase symptoms of gastritis.Gastritis may be responsible for nausea and may even cause ulcers in duodenum or gut.
2)I know I should not do this, but I googled about ulcers and saw that they can cause blockages and even holes in the intestine which would be a big emergency. That scared me really bad.-This do happen but in very XXXXXXX and usually neglected cases of GERD and acid peptic disorder.Patients who does not recieve proper treatment for years may present with perforation and bleeding.
3)Plain x ray would neither show a viral infection nor constipation.
4)Ulcers can be seen only by endoscopy.
5)Usually they take from months to years to develop.
6)Was it a hiatel hernia?it is the most common cause of acid peptic disorder. Please attach the report
7)Yes you can use gravol for nausea for time being.
8)You have to go for an endoscopy and stool test to answer that what it could be.
9))Sucralfate is used to treat and prevent l ulcers.Sucralfate works by forming a coating' over the ulcer. This protects the ulcer from the acid of the stomach, allowing it to heal. Sucralfate is best taken with water on an empty stomach 1 hour before meals and at bedtime. It should be taken daily by you and would help in healing ulcers.
General precautions are-
Follow a bland diet (low acid levels, low in fat, not spicy)
Eat frequent, small meals.
Lose weight.
Avoid the use of alcohol, tobacco, and caffeine.
Do not eat food less than 2 hours before bedtime.
Raise the head of the bed before sleeping.
Avoid clearing of the throat.
Hope i was helpful.
Please feel free to follow up.
Regards!
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hi Dr. XXXXXXX
Thank you again for answering my questions and being so kind. You are really helping me to understand all of this. I have more questions again!
I am glad to hear that ulcers causing blockages and holes are rarer cases or cases that have been untreated for a long time. When you Google about ulcers it tells you all of the things that can go wrong but they never mention that those things happen in rarer cases. They make it sound like it happens a lot, and easily, which ended up scaring me. I feel a little better now. Worrying about it has been causing me a lot of stress and ruining my vacation. I will make sure I see my doctor next week so we can get this diagnosed and treated as soon as possible.
So if this is an ulcer and has been taking months or years to develop, the fact that it is causing me a problem now, does that mean it is getting worse? Or just that it needs to be treated within the next few weeks?
I just need to clarify, do ulcers increase the acid in your stomach and that is what causes the nausea? If an ulcer was bleeding, would you know? Is that when larger symptoms would start to happen such as blood in the stool?
If you end up eating something acidic or fatty, does that cause the ulcer to become worse or does it just increase the acid in your stomach which can cause the nausea? The area we are vacationing in unfortunately doesn't have the healthiest food selection. If I end up eating something I shouldn't, will it make the ulcer or the acid worse?
I know you said this is a chronic condition which is why I can wait a week to see a doctor. Just wondering if ulcers can be cured then or will I always have it?
The antacid you recommended (omeprazole), does it require a prescription? I took 150mg of Zantac in the morning and evening yesterday (I had only taken 75mg total the two days before). The nausea did not go away completely but it was not as bad yesterday as it has been. Maybe the Zantac helped a little more than it was when I only took 75mg.
I am not sure what type of hernia I have and unfortunately I wasn't given a report. I have an umbilical hernia and the other hernia is higher up above my belly button. I have been told it is quite small (3mm) but I do have a bump in the area that I can sometimes feel, especially if I am
bloated. I will have to ask my doctor if it could be a problem.
Thank you again for your answers.
Thank you again for answering my questions and being so kind. You are really helping me to understand all of this. I have more questions again!
I am glad to hear that ulcers causing blockages and holes are rarer cases or cases that have been untreated for a long time. When you Google about ulcers it tells you all of the things that can go wrong but they never mention that those things happen in rarer cases. They make it sound like it happens a lot, and easily, which ended up scaring me. I feel a little better now. Worrying about it has been causing me a lot of stress and ruining my vacation. I will make sure I see my doctor next week so we can get this diagnosed and treated as soon as possible.
So if this is an ulcer and has been taking months or years to develop, the fact that it is causing me a problem now, does that mean it is getting worse? Or just that it needs to be treated within the next few weeks?
I just need to clarify, do ulcers increase the acid in your stomach and that is what causes the nausea? If an ulcer was bleeding, would you know? Is that when larger symptoms would start to happen such as blood in the stool?
If you end up eating something acidic or fatty, does that cause the ulcer to become worse or does it just increase the acid in your stomach which can cause the nausea? The area we are vacationing in unfortunately doesn't have the healthiest food selection. If I end up eating something I shouldn't, will it make the ulcer or the acid worse?
I know you said this is a chronic condition which is why I can wait a week to see a doctor. Just wondering if ulcers can be cured then or will I always have it?
The antacid you recommended (omeprazole), does it require a prescription? I took 150mg of Zantac in the morning and evening yesterday (I had only taken 75mg total the two days before). The nausea did not go away completely but it was not as bad yesterday as it has been. Maybe the Zantac helped a little more than it was when I only took 75mg.
I am not sure what type of hernia I have and unfortunately I wasn't given a report. I have an umbilical hernia and the other hernia is higher up above my belly button. I have been told it is quite small (3mm) but I do have a bump in the area that I can sometimes feel, especially if I am
bloated. I will have to ask my doctor if it could be a problem.
Thank you again for your answers.
Brief Answer:
Follow up suggestions.
Detailed Answer:
Hello my dear patient,
Would like to tell you that most of the patients who posts answers are either cases which are not properly handled or have complications.For e.g if you are cured in three days why would you waste your time on googling etc.Therefore most of the experiences written by patients are negative on net.
Therefore proper tests are necessary.Once we have the diagnosis with us we can treat the patient.
See firstly only after endoscopy we can say that you even have a ulcer or not.Initially these symptoms starts with gastritis in which there is erosion and inflammation of layer of stomach.This if left untreated would in long runs lead to wounds termed as ulcers.So hope you can understand its a slow process.
Ulcers are open wounds(in lay mans version) and whenever acid in gastric area touches them it would irritate the nerves passing through it hence would provoke nausea and other symptoms(different patients have different presentation).
Yes a bleeding ulcer would result in charcoal black tarry stools and vomitus would contain red blood.
Any heavy food would cause increased acid production to help in digestion hence would increase symptoms in general fats are the heaviest while carbs are easiest to digest.
Take lots of yoghurt,Chilled milk,Vegetarian non spicy food.
No spices alcohol butter cream smoking etc.
Ulcers will be cured by using prokinetic's antacids and sucralfate in combination.
Omeprazole is over the counter.Take 40 mg twice daily with Zofran 4mg thrice daily(for nausea) over the counter.
Ranitidine is a H2 blocker and much weaker then PPI's like omeprazole.
Yes if it is hiatel hernia it could be a cause of symptoms.
Start medicines and follow up after 4 doses.
Could reach me directly at this link http://doctor.healthcaremagic.com/doctors/dr-ramesh-kumar/72660
Hope i was helpful,
Please feel free to ask any query you have it would be a pleasure to help you.
Wish you happy vacations.
Regards!
Follow up suggestions.
Detailed Answer:
Hello my dear patient,
Would like to tell you that most of the patients who posts answers are either cases which are not properly handled or have complications.For e.g if you are cured in three days why would you waste your time on googling etc.Therefore most of the experiences written by patients are negative on net.
Therefore proper tests are necessary.Once we have the diagnosis with us we can treat the patient.
See firstly only after endoscopy we can say that you even have a ulcer or not.Initially these symptoms starts with gastritis in which there is erosion and inflammation of layer of stomach.This if left untreated would in long runs lead to wounds termed as ulcers.So hope you can understand its a slow process.
Ulcers are open wounds(in lay mans version) and whenever acid in gastric area touches them it would irritate the nerves passing through it hence would provoke nausea and other symptoms(different patients have different presentation).
Yes a bleeding ulcer would result in charcoal black tarry stools and vomitus would contain red blood.
Any heavy food would cause increased acid production to help in digestion hence would increase symptoms in general fats are the heaviest while carbs are easiest to digest.
Take lots of yoghurt,Chilled milk,Vegetarian non spicy food.
No spices alcohol butter cream smoking etc.
Ulcers will be cured by using prokinetic's antacids and sucralfate in combination.
Omeprazole is over the counter.Take 40 mg twice daily with Zofran 4mg thrice daily(for nausea) over the counter.
Ranitidine is a H2 blocker and much weaker then PPI's like omeprazole.
Yes if it is hiatel hernia it could be a cause of symptoms.
Start medicines and follow up after 4 doses.
Could reach me directly at this link http://doctor.healthcaremagic.com/doctors/dr-ramesh-kumar/72660
Hope i was helpful,
Please feel free to ask any query you have it would be a pleasure to help you.
Wish you happy vacations.
Regards!
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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