can pain mangement help my stomach pain??

[rocketship]

I have peptic ulcer disease and have bouts of pain that cause me to miss work and make me only want to eat ice cream and crackers for days.  The only time I get relief from it is if I take some vicodin I have left over from a surgery.  I can't take NSAIDs, they just make the problem worse.  I would like to be referred to a pain management specialist.  Does this sound like a problem they could help me with?  If so, how do you get referred to a pain management doctor?  My gastroenterologist just thinks taking a proton pump inhibitor should help me but it doesn't so he looks at me like I'm crazy.

[nuggetone]

I have had 5 ulcers at once.  3 in stomach and 2 on esphogus.  I know your pain.  However after taking nexium, prilosec and mepergan for 1 mth.  I was relieved of most pain.  I was hospitalized for 5 days.  So if this continues maybe you need more tests or another DR.  Ulcers will heal and if yours doesnt something isnt right.  Dont take any asprin cause it is toooooo hard on stomach.  Eat right.  Dont eat spicey things to set off the pain. Bake your meat instead of frying.  I really dont think a pain clinic will help due to this is a condition that a normal Dr. can relieve.   Also I got down to 90 lbs due to not being able to eat.  My normal weight is 120.  So I do understand what ulcers can do. I was out of work for about 2 wks.  Then the pain was still there until after the lst mth but I had to work since I am single and at the time was raising a child.  

[Tuckamore]

Hi Again,

You will never be able to vomit again. The surgery closed the "trap" that allows anything to flow or come up. I refused the surgery for that very reason. I know that sometimes when I have had the flu or eat something that didn't agree with me I felt better after I had an emesis.

I would certainly request the test for the bacteria. It couldn't hurt. I am still wondering if you are not experiencing esophageal spasms. It fits. And there are varying degrees of those spasms. They can become chronic and occur daily or be acute and come and go every few years. I have had both. It's also worth considering.

Good Luck. Take care, Tuck

[rocketship]

In reviewing my medical records from my gastroenterologist it seems they keep bouncing between a diagnoses of "non ulcer dyspepsia" and "peptic ulcer disease".  The non ulcer dyspepsia is a fancy term for ulcer like stomach pain without an ulcer and no clear cause.  Then I occasionally do show up with peptic ulcers, which I thought were from accidentally taking a migraine medication that had aspirin in it...but I've never been checked for the pylori bacteria.  

It's just annoying and frustrating.  I've dealt with this for 15 years and seen several doctors.  I had such horrible reflux and constant esphogitis that I had the reflux surgery done last January.  That was wonderful...except I can't vomit for the life of me now.  :)

[Tuckamore]

Hi Rocketship,

I am sorry you are in so much pain. We all know what pain is in this forum and can empathize with you. A peptic ulcer as you probably know is erosion in the lining of the stomach or duodenum (the first part of the small intestine). The word “peptic” refers to pepsin, a stomach enzyme that breaks down proteins. If a peptic ulcer is located in the stomach it is called a gastric ulcer.

I did some searching because it is not usual to have severe pain from peptic ulcer disease once treatment has begun. The following is some of what I found:

BEGIN..Treatment recommendations of the American College of Gastroenterology are based on the understanding that PUD is usually the result of H. pylori infection, or is caused by taking aspirin and other NSAIDs. Thus, the first step is to stop taking NSAIDs or aspirin. Successful elimination of H. pylori cures most patients who are not continuing to take aspirin or an NSAID

If the tests are negative for H. pylori infection, patients are treated with traditional ulcer therapy that blocks the production of stomach acid and protects the tissues lining the stomach and duodenum.... END

The Vicodin in short term may ease some of your pain but long term may actually make your condition worse. My concern is that if you are experiencing this much pain and have been properly treated for more than a week your condition should not cause so much pain. So is there something else going on? I would approach my gastroenterologist with that question. Why if your treatment is effective are you in so much pain?

I have had ulcers, several time. I know we are all different and conditions vary in location and severity but I did not have have significant pain once the cause was found and treatment began. So again I would question your physician as to why you continue to experience so much pain.

Good luck to you. Please let us know how you are doing. I will look forward to your future posts. Take care, Tuck