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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Upper GI Pain. Barium Test Had Showed Peptic Ulcer. Is That It?

I am a 36 year old female. I have had upper GI pain for 3-4 months. Usually ranging from a butter-like knife to a steak knife-like pain stuck in my stomach. Sometimes it goes away, but usually it is there. The only thing that seems to make it worse is coffee. Tried Dexilant, Nexium , and now 40 mg Prilosec because I cannot afford the other two. Endoscopy this week was normal, and my stomach hurts. So something is wrong. Fyi Six years ago Barium test showed peptic ulcer disease, but the pain went away until about 3 months ago. I also had gastritis at age 20. Could it be stress/depression ? What could cause upper GI pain that is not detectable by endoscopy ?
Tue, 14 Aug 2012
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Gastroenterologist,  's  Response
Hello, sbcec,
If the pain is aggravated by intake of food and if this happens
almost daily and also if you have pain during the night , this
might suggest peptic ulcer. If the ulcer is small and hidden
it is possible that an endoscopist can miss it, especially if she
or he is in a hurry ! I assume the endoscopist did do a biopsy
and look for Helicobacter Pylori presence. You mention coffee
making the pain worse. Caffeine is the culprit and it can increse
acidity. Even de-caffeinated coffee can do this. Calcium that is
in the milk can make you produce more acid. Citrus fruits,
Tomato based products, too much spicy foods can all add to
the damage. Aspirin, Non-steroidal Antiinflammatory drugs like
Ibuprofen,Naproxen can cause problems.Prilosec is a good drug
and has been available the longest among those class of drugs.
I would advice that you take the medication in split dosage
once in the morning about an hour and a half before your morning
meal and then the second dose about an hour before bed time.
I also suggest sonogram of the gallbladder if that is not done.
Wish you well.
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Upper GI Pain. Barium Test Had Showed Peptic Ulcer. Is That It?

Hello, sbcec, If the pain is aggravated by intake of food and if this happens almost daily and also if you have pain during the night , this might suggest peptic ulcer. If the ulcer is small and hidden it is possible that an endoscopist can miss it, especially if she or he is in a hurry ! I assume the endoscopist did do a biopsy and look for Helicobacter Pylori presence. You mention coffee making the pain worse. Caffeine is the culprit and it can increse acidity. Even de-caffeinated coffee can do this. Calcium that is in the milk can make you produce more acid. Citrus fruits, Tomato based products, too much spicy foods can all add to the damage. Aspirin, Non-steroidal Antiinflammatory drugs like Ibuprofen,Naproxen can cause problems.Prilosec is a good drug and has been available the longest among those class of drugs. I would advice that you take the medication in split dosage once in the morning about an hour and a half before your morning meal and then the second dose about an hour before bed time. I also suggest sonogram of the gallbladder if that is not done. Wish you well.