Brief Answer:
Pale stools are generally related to liver and bile problems- please see detailed answer below

Detailed Answer:
Hello,

It is true that some of your symptoms like nausea, bloating, low appetite and pain below the ribs can be caused by the peptic ulcer but the chalky stools don't seem to be related to it. Problems with the liver and gallbladder can cause pale stools and proper examinations should be done for that.

The tests that would be recommended are blood tests like liver function tests (ALT, AST, bilirubin) and tests for the gallbladder to check for blockage like alkaline phosphatase and GGT. An abdominal ultrasound is recommended as well.

These are generally the first step of examinations. Sometimes the doctor might ask for other more rare tests to check the biliary tract like ERCP which is an endoscopic examination that extends to the entrance of the biliary tract in the bowel and tries to visualize if there are problems there.

To conclude:
- only some of the symptoms can be explained with a peptic ulcer, still pantoprazole in the dose you are having should have helped to control these as well
- pale stools are not related to peptic ulcer but problems with the liver or the gallbladder (or pancreas which might affect the bile tract) and you will need proper examinations to find the cause.
- it is important for you to have a visit with your doctor and consider the following tests:
ALT, AST, bilirubine, alkaline phosphatase, GGT and an abdominal ultrasound
- the doctor might consider other more rare tests in a second step like ERCP and also MRI

I hope i have answered to your query. Let me know if i can assist you further.

Kind regards,
Dr. Antoneta Zotaj

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