The Coffee and Tea Wreck

February 20, 2006 8:30 PM

So I've got what's probably an ulcer. What can I do to make life more bearable?

A few weeks ago, I started developing a massive appetite, then stomach pains, dizziness, and nausea. After a couple of weeks of eating far too much food, I went to the doctor, who prescribed some antacids and some blood tests. The h. pylori test came up negative - but all the rest of the symptoms match up with an ulcer (sez the Doc), and so I'm up for a barium milkshake in a week.

In the meantime, and given that I'm not exactly sure what the problem is, what can I do to minimize the symptoms? My doctor has changed my prescripton to Losec, 20mg a day, but that doesn't quite seem to do the trick. It does help, but I'm still hungry, and my stomach still hurts. I'm trying to stick to mild foods, and eat lots of dairy and Tums; what else can I try? Google turns up all sorts of crackpot-ish, often contradictory sugestions, so MeFites, I turn to you. What'll help a stomach full of acid?

posted by ZaphodB to health & fitness (12 comments total)

I had a sort of pre-ulcer condition a year ago (it still comes and goes) and i basically took a prescription acid reducer for several months, tums on top of that, and ate nothing but bland, bland foods, like you say you're doing.

The doctor also advised that i drink a lot of water with my food to make it easier to digest, especially when eating something dry like bread. I also took a lot of preventative tums (check with your doctor first) after eating instead of waiting until pain started. No soda or anything acidic or caffeine (that was the hardest part!). Oh, and eating regularly helped a bit.

Mostly, it just took several months of medication and bland food to really feel better.
posted by clarahamster at 8:35 PM on February 20, 2006

no coffee, no alcohol. Especially coffee. I developed an ulcer in grad school (h pylorii neg as well). Cutting back on coffee worked the best.
posted by gaspode at 8:49 PM on February 20, 2006

Most ulcers are caused by chronic inflammation due to Helicobacter Pylori so you should see if you can get on an appropriate antibiotic, eg. Penicillin presuming the strain is non-resistant.
posted by unSane at 8:49 PM on February 20, 2006

sorry, missed the h pylori negative
posted by unSane at 8:50 PM on February 20, 2006

I'm not your doctor, but I'd discuss these problems with him or her. It's not uncommon for people to take Losec (prilosec, omeprazole) twice a day, especially if they have peptic ulcer disease. If food helps, it's probably a duodenal ulcer, not a stomach ulcer, or so goes the classic teaching.

I'd also be careful about eating too much dairy and Tums, actually. While milk and Ca products can help improve symptoms, calcium can actually stimulate production of stomach acid, so you might want to try switching to Rolaids. You can also develop something called Milk-alkali syndrome.

Your dizziness is concerning--I hope your doctor has warned you, but if you start vomitting blood, or vomitting what looks like coffee grounds, or having BMs that are black or red, you should probably get to a hospital.

on preview: h pylori screen was negative, unsane.
posted by gramcracker at 8:51 PM on February 20, 2006

Oh, and I had the test where they made me drink the barium milkshake too, and it's not nearly as gross as people said. It was sort of thick and fruity flavored -- not something you'd want to drink recreationally, but not at all unpalatable. A lot of what I read on the internet said it was awful, but it really wasn't. Plus, you get to watch on a screen as your insides work to make you swallow, which is pretty cool! (unless you're squeamish about that sort of thing...)
posted by clarahamster at 8:52 PM on February 20, 2006

The common breath test for H. pylori has a sensitivity of around 90%, so it could've been missed. Some people would go ahead and treat anyway, if further tests are inconclusive.

Recent metanalysis of most of the PPIs shows that they pretty much all work well, with differences between doses of omeprazole and esomeprazole. GI docs often double up PPI doses for acute treatment, but as far as I know, that practice hasn't been accepted as guideline.

Milk-Alkali syndrome is real. I think I mentioned it in a pregnancy thread before, but the cutoff is 2 grams of elemental calcium per day. Calcium carbonate, found in TUMS is 40% elemental calcium.

Whether you have gastritis or an ulcer, your doctor is doing the right thing. It takes a while for the PPI you're taking to work (Losec=omeprazole, same class as Protonix, Aciphex [an unfortunate name], Nexium, Prilosec), and it takes a while for things to start healing up (4-8 weeks is typical treatment course). In the meantime, your idea of sticking to mild foods sounds good. Just realize it'll take time to heal.

If the pain bothers you to the point where you really just want something done, you can ask for your doc to write you for a GI cocktail, which contains an antacid like maalox, donnatal (mix of a bunch of stuff to ease the GI tract), and may also have lidocaine, which numbs things up. I think a study was done showing that there's no difference between using GI cocktails and maalox by itself, but the patients I've written cocktails for say it works (they first received maalox, and when they keep complaining, I then try the cocktail).

Avoid booze, coffee, aspirin, ibuprofen and aleve. Avoid kim chi, tacos and chili dogs. Cool Ranch doritos might be ok, but Black Pepper doritos are a no-no.

Good luck with everything. Hope you feel better soon!
posted by herrdoktor at 9:39 PM on February 20, 2006

Ketchup bothers me when my stomach is acting up in an ulcerish fashion.
posted by adamwolf at 10:36 PM on February 20, 2006

Losec and other PPIs do work but they can hit your stomach hard. The pain and hunger you're feeling now is possibly related to Losec. Rest assured it's doing its job and turning off the acid pumps in your stomach. I found yoghurt (especially before bed) and a good long daily walk the most useful for coping with it. Active Manuka Honey also occasionally helped.
posted by DirtyCreature at 12:54 AM on February 21, 2006

Tums are old fashioned armature crap for chumps. The best antacid is Gaviscon tablets. Chew them up and swallow the resulting foam for fast relief!

HOWEVER: eating antacids right after food can be bad for your tummy. When you eat, the acid is there to digest. Neutralizing that acid results in your stomach trying to grind up stuff that hasn't been properly softened by acid. Not good.

Another thing you may wish to try is salts of bismuth. You'd know it best as Pepto Bismol. When the whole h.pylori thing was discovered (to everyone's surprise), they were saying to use salts of bismuth with antibiotic (tetracycline, IIRC). IANAD!
posted by Goofyy at 6:24 AM on February 21, 2006

Losec and PPIs take days to begin to have an effect on acid. Stomach acid aggravates ulcers but just stopping the acid doesn't necessarily cure the ulcer (it can -- sometimes they will self heal without acid or pepsin which is activated by the acid).

Ranitidine (Zantac) would be a good bridge until the PPI kicks in. Tums is one of the least powerful antacid and the calcium causes some stomach acid rebound. Some people don't like the notion of taking aluminum, but Rolaids is more powerful for the acid neutralization.

And get a definitive H pylori test, just in case it was missed the first time through.
posted by dances_with_sneetches at 8:11 AM on February 21, 2006

Same thing here. As stated, stopped the coffee, booze, and started the zantac. The coffee stoppage was key.

But, man, does new england clam chowder taste like the best thing in the entire world when I feel ulcery and bottomless pit of hunger-y.
posted by birdie birdington at 9:03 AM on February 21, 2006