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Gastroenterology (Expert Forum)
Peptic Ulcers despite 2 years of Prevecid
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Peptic Ulcers despite 2 years of Prevecid
by Martha RN, Oct 07, 1999 12:00AM
Help! My 30 year old brother has been experiencing severe nausea, vomiting with intermittent diarrhea for the past 2 years. There is nothiing in particular that seems to trigger the attacks but when they happen he is so nauseated and agitated he can not even be in the same room as food or he will vomit. Two years ago he had a fairly exptensive GI work up with A colonoscopy revealed some polyps (biopsy normal) and some colitis. A gastroscopy revealed a few ulcers and gastritis wilyh mild esophagitis. He was placed on prevecid, levsen and some other medicine for the colitis (it began wiht an A), this allowed him to be able to resume his ADL's with just a few of these attacks a week. The situation took a turn for the worse about a week ago when he woke up with excruciating abd. pain, nausea, vomiting. The Er did a CT scan with contrast which was read as normal and he was sent home with lorbid for the pain. The following morning he woke up with swollen hands and feet, a feeling like his throat was closing and a very strange rash plus he was still nauseated,agitated, vomiting with diarrhea and a tindling feeling in his shoulders and arms.. The rash looked something like a lupus rash except that the centers were not dry and scaley just pale pink with a red border the splotches were irregular and varied in size (they looked sort of like geranium leaves).Benadryl failed to control the rash and the rash only disappeared with Prednisone 40mg qd. A new gastroscopy showed esophagitis, gastritis,duodenitis and several small ulcers in his stomach despite having been on Prevecid 30 mg qd. for the past 2 years and he took it religiously. All standard tests run so far are normal with the exception of mildly elevated LFT's. his pain is in the upper abd (epigastric area) and extends down to the umbilicus. when hosp[italized the MD heard a Bruit in this area that disappeared when the rash went away. He was hospitalized for one week and discharged with no diagnosis. 2 days ago he was readmitted to the hospital with severe nausea intractable vomiting and diarrhea, severe dehydration (he had lost 20 lbs. in 1-2 days 6'4 170- down to 150) and the rash is returning. So far no one has a clue as to what to do for him (gastroenterologist, Internal medicine or infectious medicine MD's) Any ideas as to where to go form here? Could this be caused by toxins or poisons? any help would be greatly appreciated. sorry for the length of this letter.
Doctor's Answer
by HFHSm.D.-Gastro-rf, Oct 25, 1999 12:00AM
Dear Martha RN,
There arer several ways to approach your brother's problems, depending om which symptom is the primary focus. FRom the perspective of ulcer disease, the common causes include aspirin, H. pylori infection, smoking and a gastrin-secreting tumor. Although ulcer disease can be associated with nausea, vomiting and abdominal pain, the skin rash and colitis would not be expected problems. Conditions that involve multiple organs (in this case, gastritis, colitis, skin rash)are often the presentation for a vasculitis. This can be an autoimmune condition (e.g. like lupuis) or secondary to medications.
Given th eseverity of symptoms e.g. weight loss, dehydration, it is important that you continue to seek medical care.
There arer several ways to approach your brother's problems, depending om which symptom is the primary focus. FRom the perspective of ulcer disease, the common causes include aspirin, H. pylori infection, smoking and a gastrin-secreting tumor. Although ulcer disease can be associated with nausea, vomiting and abdominal pain, the skin rash and colitis would not be expected problems. Conditions that involve multiple organs (in this case, gastritis, colitis, skin rash)are often the presentation for a vasculitis. This can be an autoimmune condition (e.g. like lupuis) or secondary to medications.
Given th eseverity of symptoms e.g. weight loss, dehydration, it is important that you continue to seek medical care.
I am so sorry to hear of your brothers gastro problems. Throughout your entire letter, you didn't say whether or not they checked for the h.pylori bacteria. This is the bacteria that causes stomach ulcers, gastritis and God only knows how much other stomach damage it can cause. I've even read that left untreated this bacteria can lead to stomach cancer. I don't mean to frighten you. The good news is that this bacteria is treatable and with the proper antibiotics, all of the symptoms can be releaved....IF this is the problem. Ask your brother's doctors if they checked for the bacteria. I walked around for over a year with very bad stomach pains and upon my insistence for my dr to give me an answer, he finally did a blood test for the h.pylori and it was positive. I was treated with a 2-wk regimen of antibiotics and things have improved but not totally back to normal yet. It's been abour 4 wks thus far and I'm told it takes about 2 months for things to get totally back to normal.
Hope this helps. Feel free to e-mail me cathy_hill@b-f.com
Cathy