Peptic Ulcer Puns

I know the basic definition and pathophysiology of these. But in a clinical setting how to differentiate it from each other just from the presenting complaints and history before doing any tests?

I am 20 f recently diagnosed with gastritis and a stomach ulcer after suffering for months. It all started in mid October, when I had a flare up of tendonitis due from stress. I went to see my doctor who out me on three NSAIDS— ibuprofen, naproxen and diclofenac. I was taking naproxen and ibuprofen independently from each other, but with both I applied the diclofenac to the affected area on my shoulder. I didn’t know that topical nsaids apparently also have an affect on your stomach, so I was never careful about spacing out the application and applied it liberally. Fast forward to a couple days before Halloween… after a night out of eating sushi, the next morning I am doubled over with pain having coffee ground like stool and a burning, gnawing sensation right under the middle section of my rib cage. I thought nothing of it and assumed it was food poisoning and went about my day. The next day I have a tele health appointment with my doctor and she suggests that I have a stomach ulcer and to go to the emergency room for my symptoms. At my first visit to the er, the doctors brushed off my pain and made me pop an omeprazole and two Pepcids. I felt better after so then they sent me home saying I just had an “upset stomach” and it was nothing to worry about. I trusted the doctors (which was my first mistake) and went about my life for a couple more days until I had another flare up. This time I visited a different hospital where they ran a CT scan, couldn’t find anything and sent me home. This went on for the rest of November and the whole time I followed up with my pcp who suggested I follow an elimination diet and see a GI. The issue with the GI though was that I couldn’t get an appointment until December. Fast forwards about 6 more er visits— it is December 5th 2021 and finally a different hospital takes my symptoms seriously. I am admitted for pain management and put on a strict liquid diet until I can get an edg and colonoscopy. I only ended up getting an edg because my stomach couldn’t tolerate the burning stabbing sensation that the colonoscopy prep brought along. The next day in my edg, the doctor sees I have gastritis and biopsies my ulcer to test for bacteria and cells. The nurse told me my diagnosis last night and I was discharged today. I am now seeing my GI tomorrow and following up with the doctor who did my edg in a few days to discuss the results and treatment.

I am relieved to finally find out my diagnosis but my next worry is what is causing

Thanks

Been living in my own personal hell for nearly 2 years now.

Current status - my stomach doesn't work at all, at least 50% is scarred. My duodenum is a mess of scarring - liver, pancreas, spleen, gall bladder - all scarred due to this ulcer disease. Doctors told me I'm in the top 1% of cases they have ever heard of and my life is a mess - and I don't know how I'm still alive. All this started in January 2020, and today, I'm not much better. To ice this cake, I had a surgery in August 2020 that was botched, leaving me with a gastric bypass and a kinked bowel. My teeth and gums are a complete wreck due to starvation and puking.

Here's the short story. Bear in mind, I now know I had gastritis for a couple of years leading up to this, but ignored it. Don't ignore gut issues.

January 2020, I had a major flu or covid or whatever, and that lasted over a month - so I thought. When I get a major flu, constipation is always a result. Being proactive, I cleansed the colon with Pico Salex, blew it all out. That likely saved my life, it exposed the fact that I had a massive ulcer in my duodenum. That's when things turned to utter crap. By mid February, I was puking blood and bowel movements were black. I started passing out. These weren't an "I feel faint" moment - it was waking up on the floor wondering what happened - out before hitting the floor. End of February 2020, I was diagnosed by endoscope with a 4 cm duodenal ulcer, created quite a stir in the ER. You know you're in trouble when the entire nursing staff is huddled in shock over the endoscope pictures. Had 5 different docs demand that I confess to being a hard drug user - it was the only explanation they could think of. I've never used hard drugs, and blood test confirmed. I've never used Ibuprofen or others - it's rare for me to take a tylenol. I do drink, but not alot and I'm a smoker and was a coffee addict. Doctors have no idea what caused this, and it wasn't helicobacter. The ulcer had eaten through a vein or artery in the duodenum, and docs told me another 12 hours, I would have passed out and died on the floor from bleeding. They tried to clamp it, but only managed to stem the flow. The next couple of months consisted of hospital visits for blood and iron transfusions and IV fluids. I spent the better part of 2020 with a hemoglobin numbers in the 70's and below - living like a zombie.

All I heard from doctors was take your pantaloc (PPI blocker). What a joke.

In April, my GI doc called me at 9

Would are good example PES Statements for peptic ulcer disease, and H. Pylori infections? How would you have an intervention, and monitor and evaluation?

My dad is 59 and has every risk factor in the book obesity, HTN, diabetes, the works. Ironically he's terrified of dying. two days ago he started throwing up blood and had abdominal pain. He looked at me said " is this normal" , of course being the educated M-4 that I am I told him yes! It is completely normal for humans to vomit blood and be tachycardic at rest. Needless to say we rushed to the hospital. Upon arrival he was admitted and they started fluids, and then a "doctor" came in. The Doctor said Good afternoon I'm Doctor X. My dad said are you a physician? To which the doctor replied no, I'm a nurse practitioner, but I have the same training. Sirens immediately went off in my head, but I kept my mouth shut and quietly observed. The nurse told my dad she suspects that he has a peptic ulcer causing the pain and started him on pantoprazole and ordered a CBC. Meanwhile i'm waiting for the endoscopy to be ordered and for a GI to come talk to my dad but it never happened. About 6 hours later we got the CBC results and his hemoglobin was 8.5, at this point my dad felt and looked like crap, but no one had come to check on him since the initial visit. I saw a physician on the floor rounding , once he finished rounding he was charting at the nurses station , I politely waited for him to finish charting and as he stood up I said "excuse me, I may be out of line since i'm only a fourth year medical student, but If a patient presents with acute bloody emesis, and epigastric abdominal pain isn't part of the work up an endoscopy to identify the source and direct the management?" The physician replied of course, thats common protocol. At this point i started to explain my dads situation to him and he came to the room spoke to my father and within 2 hours he was getting an EGD. And they found his stomach filled with blood and treated him accordingly. The nurse practitioner came back the next morning and spoke to my dad and was explaining to him why she didn't think it was needed since my dad was only "slightly" tachycardia and looked "fine". At this point my dad was exhausted poor man could barely talk and was on oxygen therapy. He said "It's okay nurse don't worry the doctor was able to help me". I don't know if anyones ever seen a human being go from 0-100, but I witnessed it first hand and it was glorious. Fast forward to today my dad's home, he still feels slow and exhausted but he's alive. I wonder when the endoscopy would have been ordered if I didn't have a

I was wondering if covid caused anyone to have peptic ulcers? I noticed my stool was black & also I am so nauseous & experiencing many other symptoms of an ulcer … It’s a horrible feeling !!! Covid is almost gone after 2 weeks, but I am now suffering from this ulcer + parosmia, which is the worst friggen combo imo. So yea, my question is :: has covid caused you or anyone you know to get ulcers??? 2) why does covid cause ulcers anyways???

I'm not talking about appetite suppression or mere nausea, which we all know is a side effect. I'm talking full-blown gastritis/ulcer. I already have a hiatal hernia and GERD which means that gastritis is a chronic thing for me. I take tons of stomach meds daily to keep it under control but since I started Vyvanse that awful old ulcer pain is flaring up again. The gnawing, have-to-eat-constantly to keep it under control sensation accompanied by stabbing shoulder pains & such. You know it if you've ever had one.

I always take it with tons of food and water so it's not that. The strange thing is, I was already taking another OTC stimulant for years that's seemingly very caustic and was having no problems, so it makes me think Vyvanse must be somewhat like an NSAID or otherwise acidic af to be causing these problems. Does anyone know whether lisdexamfetamine itself is super acidic? Because I don't think it's stimulants themselves that are the problem.

I'm beyond bummed because it took me decades to work up the courage to ask for help from a doctor and he's had to fill out paperwork just to get my insurance to approve this med. Should I ask him to try Adderall or something? I guess I just need someone who knows about the chemical makeup of Vyvanse & how it would affect the stomach lining haha. I can't find anything about Vyvanse & ulcers online.

Thanks for reading this wall of text :)

Long before I found out I have the MTHFR gene (heterozygous for the c677t mutation, and then homozygous for COMT), I had hearburn for like 3 months, all day, every day. I took antacids once or twice, they made me feel gaggy and awful. I went to a gastroenterologist, and she put me on Omeprazole (a proton pump inhibitor) without a second thought. I'm 17 and she gave me no way to come off of it. When I did try to, it felt like I was literally being stabbed in the stomach.

Now, there's two things this could be. A peptic ulcer, or a hiatal hernia. If it's a peptic ulcer caused by h-pylori, then it's just an antibiotic course. If not, then the treatment is antacids or PPIs, neither of which people with MTHFR are supposed to take. However, I feel like it's unlikely to be an ulcer because the pain shouldn't have gotten worse, the PPI should've allowed it to heal, at least to some extent, and plus, I had an h-pylori stool test, which was negative.

The problem with the hiatal hernia is that, apart from surgery, there's no real treatment, other than again, antacids and PPIs, which I can't take. Or, there's lifestyle changes, most of which I already do, and the ones that I don't do (eating garlic, onions and chocolate), I'm not willing to cut out, because I have a really restricted diet due to other health issues.

I don't know where I was going with this, I guess it just turned into a rant. I really want to get off this stupid PPI and get the stupid hiatal hernia fixed without surgery.

Has anyone experienced anything similar?

So I have had stress related digestive issues (pain, mild constipation and bloating, etc.) on and off for a while.

This has been worse the past 2-ish weeks due to some major life stressors, so I have been on a bland diet for about a week, which was helping.

Until….

Friday night, I had a big glass of decaf coffee. I felt “off” that night before bed.

Then when I woke up Saturday, I felt nauseous and had multiple BMs (very unusual for me), plus I noticed my upper middle abdomen was very sensitive to the touch / hurt when I moved too quickly for example sitting up in bed or moving too fast.

The “painful to touch” symptom REALLY scared me. it’s never happened before…

So I went to the ER.

They did an ultrasound and a CT Scan and blood work / urine sample and said all my organs look fine, and diagnosed me with a probably peptic ulcer.

But I’m wondering if this could be gastritis brought on by stress and then hugely triggered by the coffee I had the night before the pain? Anyone have a similar experience?

Also…

Is being very tender (sharp pain when touched) common for things like gastritis and peptic ulcer?

Weirdly It doesn’t hurt at all unless I touch it or move fast.

Appreciate any help. This is all new to me and it’s been a scary experience.

Has anyone with BED been diagnosed with a non H. Pylori or NSAID related peptic (or other) ulcer? Or inflamed stomach?

I recently had an endoscopy and found these things and was wondering if anyone else had these issues.

I’m 22 and I was recently diagnosed with Chronic Gastritis and Peptic Ulcer Disease which my GI doctor believes was caused by stress. Which I also believe he is correct or the terrible diet I had while working at 7/11. You can imagine. I was weighing in at 160 when this started back in Jan 1 and now I’m 135. I’ve been taking Omeprazole 20mg when this first started and now I’m taking Pantoprazole 40mg(I just started today). I wouldn’t say my symptoms are severe like others, but in the beginning it was a lot of burning in my stomach, abdominal pain, and alot of indigestion. Now I feel really good sometimes, but I’ll still get burning every now and then or gas will get stuck and I’ll have to push down on my stomach hard to let it flow out. It hurts too when it gets stuck. Also I’ve noticed recently, I’ve been getting diarrhea in the mornings, like once or twice. It might be from what I’m eating which is why I’m here posting this. What sort of diet did you follow? Like what did you actually eat on a daily basis? How long did it take you to recover? And how are you now? My GI doctor said I will recover but it’ll take months.

Was just reading about how he discovered it, no one believed him and the pharmaceutical industry refused to acknowledge it as they were making so much money of gastric drugs. Even other scientists shunned him. He then proved it to the world by taking samples and infecting himself. He also discovered bismuth and antibiotics killing it. To this day he has been working to try and find a vaccine for it with no such luck.

Has anyone had any experience with either getting or getting rid of stomach ulcers when fasting? Any knowledge out there in this? I did a quick google search but nothing really came up.

We know that vagal stimulation leads to increase acid secretion in stomach directly and indirectly via histamine on parietal cells.

But it's also stated that stressed individuals are prone to peptic ulcers because of increased acid secretion.

But doesn't sympathetic inhibit abdominal viscera movement and secretion. Can someone explain this to me. And also the receptors involved (like alpha 1 Gq signalling etc)

Would are good example PES Statements for peptic ulcer disease, and H. Pylori infections? How would you have an intervention, and monitor and evaluation?