Gastric Ulcer not getting better

[nhagerty74]

I was recently diagnosed with a stomach ulcer via endoscopy.  I’ve been having the symptoms on and off for over a year.  I had been taking low dose aspirin everyday for a few years before this, and stopped taking it over 6 months ago.  I get a burning/gnawing pain in the center of my upper abdomen that is usually better after I eat a large meal.  I get bloating also.  It feels worse if I am upset or stressed and also if I do excersize that causes me to tense my ab muscles.

My primary care physician originally put me on Protonix for one month when I told him my symptoms.  I had some improvement but the symptoms came back after stopping, so I was then put back on Protonix for 3 months.  It did not get rid of the problem, so I had an endoscopy which revealed “erosion in the antrum compatible with gastritis”.  I was told it was a small ulcer and looked like it was already trying to heal.  Biopsies were taken also and everything was normal…no sign of cancer or infection.  Previous to this I had a blood test for h.pylori that was negative also.  I have now been prescribed Dexilant 60mg once a day.  I’ve been on it for 2 weeks so far and am still having the burning/gnawing pain almost daily. I've tried Zantac, Aloe Juice, as well as drinking raw cabbage juice everyday for 3 weeks.  I'm now taking DGL licorice everyday, but nothing seems to be helping.  I'm getting very depressed and I have no idea what to do.  I'm supposed to call my doctor back in a week and let them know how I am, but they made it sound like I should have symptom relief by now if this medicine is working, and I'm on the strongest PPI there is.

[Christopher R Watters, MD]

If younsat and poked a finger into your epigastrium for an hour the pain would probably be aggravated also. Why would you not expect that constant flexing of your rectus abdominus would do the same? As for endometriosis, it can pop up anywhere in the abdomen and cause misery. I would consider it a long shot but I suppose it could land on the stomach and show up as inflammation inside. With the cancer history have you had a CT scan? I think it would also be unlikely given the time that has passed but abdominal imaging would be appropriate. Breast cancer frequently metastasizes to the omentum or liver. But, as I said, this would be unlikely given the early stages and the time that has passed.

[nhagerty]

Also wanted to ask in my previous comment:  I normally lift weights 3 to 4 times a week, and have noticed that tensing up my abs, which happens with almost any weight training excersize, seems to make my ulcer symptoms start up after I've been working out for about 20 minutes. It's usually very mild, but I've stopped working out because I'm scared I'm making things worse.  Will that make an ulcer worse or stop it from healing?

I also have endometriosis and was wondering if there could be any connection between the two?  I get alot of bloating and constipation from the endometriosos, so between that and the ulcer situation I'm miserable :(    

I also had stage 1 breast cancer when I was 31 and stage 0 melanoma when I was 33.  I'm turning 38 this month and have been doing good other than this stomach situation.  The Dr. doesn't think this ulcer is related to either of those, but of course I'm scared.  They said all the biopsies were normal that were taken during the endoscopy.  I had an abdominal ultrasound last year that was normal also.

I know I'm asking alot of questions...my doctors love that about me! lol!  Thanks for talking to me...I hope you're having a nice holiday weekend.

[nhagerty]

I'm scheduled for a HIDA scan next week to find out if I have any problems with my gallbladder.  I'm still having symptoms on and off and still taking Dexilant 60mg (it's been 30 days now).  I'll have a few good days where I think I'm getting better and then a day where it bothers me again (like today).  I'm starting to get scared and depressed and feel like it's ruining my life.  I'm starting to think that this situation is never going to get better.  After the endoscopy the Dr. said this was "very easy to treat".  Apparently he was wrong.  I'm worried they won't find anything that could be causing this and I'll have to live with it and risk ending up with stomach cancer.  Have you seen many cases where there is no explanation for something like this and it won't go away?

[Christopher R Watters, MD]

One can think of erosions as very shallow ulcerations.

[nhagerty]

Does "Erosion in the antrum compatible with gastritis" mean I have an ulcer, or something that can lead to an ulcer?  

[Christopher R Watters, MD]

Please see my prior comment.