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Suggest Treatment For Peptic Ulcer Disease
Question: Hi I am a 37 yo female with two months of sharp localized pain in left upper quadrant under breast and rib cage. I have been to my primary care and gastro and had test for h. Pylori (negative) blood tests for kidney function, liver function, CBC, celiac and these were all negative and normal. I had an abdominal ultrasound which was normal. I refused an upper endoscopy but had a double contrast upper gi series...this was totally normal. I took pantoprazole 40mg for 2 weeks and was afraid of the side effects so I went to a naturopathic doctor and he put me on DGL licorice tid, mastic Chios gum 1g bid, and zinc carnosine bid. I have been doing this 12 days. I am worried I have an ulcer that will perforate. I do not drink alcohol or smoke and I never take NSAIDS. Do you think I have an ulcer? Will my current regimen work or do I really need to be on a PPI?
Brief Answer:
continue PPI
Detailed Answer:
Hello,
Your symptoms could be due to peptic ulcer disease. A double barium study is not very good in picking up small ulcers; you might not have an ulcer it might just be gastric erosions or even non ulcer dyspepsia.
In case you are not ready for an endoscopy the other option would be to take pantoprazole for at least 6 to 8 weeks as more than 90 percent of ulcers heal with proton pump inhibitor drugs.
Hope this helps
Do get back in case you have further queries
Regards
Dr Samir Patil
continue PPI
Detailed Answer:
Hello,
Your symptoms could be due to peptic ulcer disease. A double barium study is not very good in picking up small ulcers; you might not have an ulcer it might just be gastric erosions or even non ulcer dyspepsia.
In case you are not ready for an endoscopy the other option would be to take pantoprazole for at least 6 to 8 weeks as more than 90 percent of ulcers heal with proton pump inhibitor drugs.
Hope this helps
Do get back in case you have further queries
Regards
Dr Samir Patil
Above answer was peer-reviewed by :
Dr. Prasad
So, in your experience, the DGL and mastic and zinc are not enough to heal erosions or ulcers? Will a ppi for 6-8 weeks cause problems...I don't want to end up on a ppi indefinitely. I feel like that happens a lot.
Brief Answer:
PPI is preferred
Detailed Answer:
Hello,
In my practice I don't prescribe zinc for ulcer healing. We have high quality evidence that PPI's are the best drug for the treatment of peptic ulcer and erosions.
A six to eight week course dose is unlikely to cause problems.
It's difficult to predict at this stage if you might need a long term PPI. But without an endoscopy result, 6-8 weeks of PPI is my best suggestion.
Regards
Dr Samir Patil
PPI is preferred
Detailed Answer:
Hello,
In my practice I don't prescribe zinc for ulcer healing. We have high quality evidence that PPI's are the best drug for the treatment of peptic ulcer and erosions.
A six to eight week course dose is unlikely to cause problems.
It's difficult to predict at this stage if you might need a long term PPI. But without an endoscopy result, 6-8 weeks of PPI is my best suggestion.
Regards
Dr Samir Patil
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Above answer was peer-reviewed by :
Dr. Prasad
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