Re: BLEEDING DUODENAL ULCER

Posted By PATTY on August 12, 1998 at 15:18:19:

In Reply to: Re: BLEEDING DUODENAL ULCER posted by HFHSM.D.-rf on August 12, 1998 at 14:00:05:






: : I had an Endoscopy done Thurs. The Dr could not get the scope into the small intestine past my ulcer. I was having terrible pain until I went on a liquid diet last week. My blood count is still falling
: : and is 8. Do you think It will have to be removed? I saw a Surgeon last thurs and he had an xray done. It showed it is not totally blocked. I have been on Prilosec since the first of June with no improvment. thanks
_______
: Dear Patty,
: Most ulcers will stop bleeding without surgical treatment although there are always some patients who require surgery.  The clinical presentation of bleeding can be either black bowel movements or vomiting of blood.  The blood can be red (indicating active bleeding) or brown, resembling coffee grounds(indicating recent previous bleed).  If black stool is the presentation, remember that the stool will be black for several days after the bleeding has stopped.  Your blood counts can drift downward after bleeding has stopped, reflecting re-equilibration of fluids.  A continuous downward trend, however, would suggest ongoing bleeding.
We know that almost all duodenal ulcers are the result of H. pylori infection.  Ask your doctor whether he checked you for this infection and if treatment is planned.  The literature is clear that eradication of the H. pylori infection will substantially reduce the risk of further ulcers.
This information is presented for educational purposes only.  Always consult your personal physician for specific medical questions.
HFHSM.D.-rf
: *keywords: ulcer, H. pylori, gastrointestinal bleed
: 0.3
I have been tested several times and the H pylori has been negative. The
problem is the ulcer is closing off the intestines. My blood count was down to 5 and I had 4 units of blood in June. I was back in the hospital the end of June with chest pains and the count got up to 12, After 2 weeks and going back to work it dropped to 9 and is now 8. How long should it take for the prilosec to promote healing and for my blood to climb on it's own?
__
Dear Patty,
The persistence of bleeding over several months is unusual as most ulcers should have healed. One can make a strong case for surgery (assuming that there  are no obvious untreated risk factors for ulcers) and no medical conditions that increase the risk of surgery.  Additionally, if you have gastric outlet obstruction, surgery is even more necessary.
We would be happy to see you in the Division of Gastroenterology at Henry Ford Hospital if you would like a second opinion regarding the management of your problem.  You can arrange an appointment with Dr. Fogel, one of our experts in the treatment of gastrointestinal disease, by calling [phone]
This information is presented for educational purposes only.  Always consult your personal physician for specific medical questions.
HFHSM.D.-rf
*keywords: ulcer
0.2
I saw the surgeon this morning and they will take out the bottom of my stomach and reattach the intestines next Wednesday. He will also cut the nerves that send the acid to my stomach. It will be nice to have food again
even if it will be in many small meals.
Thanks for all the helpfull info.