Gastric Ulcer: Intense pain after eating, then relief after vomiting

by Kerri
(Orlando, FL)

I'm 29. For the past year, on and off, I have been having intense pain centered directly under my ribs and it spreads to the middle of my back.

It happens shortly after I eat.


The pain is a severe, searing pain. Almost like there is a hot, spikey rock in my stomach and its burning through to my back.

The only thing that relieves the pain is making myself vomit. I don't feel nauseous, I just feel like I SHOULD vomit. It helps and I feel fine afterward. Recently, though, the relief from vomiting is not complete. For the last four days, it's been a constant, dull pain and then the intense pain after I eat.

There is no change in bowel movements and no diarrhea involved. I have stopped drinking and I try to stay away from caffeine and spicey foods.

I haven't noticed any weight loss from it. I'm getting married in less than a month, so there is some stress, but I don't feel overwhelmed or anything. I don't take any medications and I have a healthy past.

I had a baby through c section a year and a half ago. I don't have any food allergies, my only allergy is to ants wasps and bees.

I have not gone to the doctor about it yet, but the pain has become so frequent, I will be making an appointment asap. Any insight until I get that appointment would be greatly appreciated!

Kerri

......................................................

Dear kerri,

This intense pain after eating, then relief after vomiting you described here is almost certainly due to your having a gastric ulcer.

Gastric ulceration is literally the presence of a "raw wound" on the inner wall of your stomach, as depicted in the pictures above.

It is usually caused by an imbalance in stomach acid production and neutralization mechanisms.

Triggers include:

• Smoking
  
• Excessive Alcohol intake
  
• Us eof certain medications including NSAIDS such as Advil, Motrin or Neurofen, Aleve or Naproxen, Diclofenac etc or steroids, cochicine, medicines for blood pressure and more
  
• Colonization and overgrowth of a bug in our stomach called Helicobacter pylori
  
• Sustained stress and more.

Gastric ulcer typically causes mild to severe central upper abdominal pain within 15 to 30 minutes after meals, relieved to some degree by vomiting.

Episodes usually comes in bouts for 10 to 14 days after every month or two.

Kerri, I agree with you. It is best to see your doctor who would ask further questions to help better analyze and understand your pain, examine you and if needed, order a number of tests, including an EGD or stomach endoscopy to confirm the diagnosis.

Gastric ulcer is treatable.

It would require a very detailed and careful documentation of possible triggers in you and avoiding such.

Medications used include:

1. Dexilant - perhaps the best in the market at this moment, though quite expensive and not covered by many third party insurance providers. A dose of 60mg once or twice daily for 8 to 10 weeks in recommended or the use of Nexium - also called Lansoprazole, 30 mg once daily for about 12 weeks. Other similar agent sthat may be prescribed may include Omeprazole or Pantoprazole.
   
2. Sulcrafate 1g Three Times Daily. This is an antacid that helps coat the wall of the stomach. It does not taste well, but could give you very fast relief if you can tolerate the taste.

If the bug, Helicobacter pylori is suspected to be the cause, you may have what we call Urea Breath Test (UBT) or H. pylori fecal antigen stool test to confirm this. Once confirmed, cure is usually achievable with the use of a combination of 3 or 4 drugs over a two weeks period.

Kerri, please do not hesitate to contact us, should you have any further question or concerns on this issue.

Get well.

Dr Omatseye Edema MD MRCGP CCFP MSc DRCOG
Family Physician, Emergency Medicine Practitioner and WebMD
Abdopain.com.

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