How do know if it's an ulcer?

[Galixie]

I assume I'm being paranoid.

That said, I'm starting to wonder if I'm developing a stomach ulcer. It's been a few days (or longer? My memory is not fantastic about things I'm trying to ignore.) Since I started having an always full/bloated feeling combined with heartburn and loss of appetite.

I know nothing about ulcers except that they sometimes don't have symptoms. I have been feeling massively overwhelmed lately and stress could be contributing to whatever it is, so my mind went to ulcer.

Is there any way to know? How do doctors determine if it is?

This comic sums up how I feel: http://theawkwardyeti.com/comic/cancer/

 

[alex3619]

Stress, of itself, does not cause ulcers. That was disproved in 1983, and Barry Marshal shared a Nobel prize for that in 2005. I am unsure if psychological stress, as opposed to physiological stressors, might not aggravate an ulcer.

The two most common causes of ulcers are Helicobacter pylori, a bacteria, and non-steroidal antinflammatory drugs, like aspirin.

An ulcer can be confirmed by photographing it, but there may be other (easier) methods, I am not up to date on this.

 

[Galixie]

The two most common causes of ulcers are Helicobacter pylori, a bacteria, and non-steroi

Hm, well I stopped taking aspirin and ibuprofen when I started fludrocortisone because there is a moderate ulcer risk when combined. I take Tylenol instead. There didn't seem to be a similar risk attached to Tylenol.

It's been ten years since I was last tested for h. Pylori. I didn't have then, but who knows if that has changed.

I'm going to keep hoping that I wake up in the morning feeling normal (for me) and that whatever this is just magically goes away.

 

[alex3619]

My understanding is that Tylenol poses a lower risk than most drugs in that class, but not zero risk.

 

[confetti11]

I'm pretty sure I had an ulcer about a year or so ago. At the very least, it was gastritis. I didn't get scoped, but one of the hallmark symptoms I believe is a gnawing burning sensation that mimics hunger. I had this. So like, you'll eat plenty of food, then like 10 mins later have an intense hunger sensation in your stomach. At least, that's what a few doctors told me.

 

[Galixie]

I'm still leaning toward it being an ulcer because it hasn't gotten any better. Of course this is a holiday weekend, so going to a doctor isn't an option. How long is it ok to go before seeing a doctor about an ulcer? I think my symptoms are typical but not severe (I haven't been vomiting or anything). Regular heartburn has never made me feel bloated/full. The nausea comes and goes. As long as the symptoms aren't severe, is it ok to wait to see my regular doctor?

 

[Galixie]

Thought I would update.

Saturday I went to urgent care. They are limited in what they can do as far as testing, so no tests were run. The doctor seemed on the fence about whether it is an ulcer or pancreatitis. He described the symptoms of pancreatitis and they don't really match mine, so I came away with prescriptions for carafate and prilosec to treat the probable ulcer.

I started taking the carafate that day and it eased the heartburn right away. (I assume this further points toward an ulcer rather than pancreatitis.)

The next day, yesterday, I took a prilosec. Oh boy, was that a mistake!

I was miserable yesterday. I spent most of the day lying as still as possible with my eyes closed. I had a headache, bad nausea, and dizziness. I didn't begin to feel better until mid-afternoon, after I vomited.

So I'm continuing to take the carafate and avoiding the prilosec. I still have to get further testing done to determine the location and cause of the ulcer. I'm a little worried that it might be caused by the fludrocortisone. I really don't want to give up the benefits I've gained from taking that.

In comparison to yesterday, I feel much better today. All things are relative, right?

 

[Galixie]

My super-power of always having tests come out normal was in full effect today.

I've still been having symptoms and I finally got an appointment with a gastro. I had an upper endoscopy today. Guess what they found; Nothing!

I don't know what to think. On the plus side, it must not be anything too bad. On the minus side, I could do without the nausea and heartburn. And if I don't know what is causing it, I don't know how to fix it.

They did some labs on Monday and I got the results of those. They were mostly normal and the ones that were low (except for potassium, which is likely due to florinef), can all be easily dismissed as unimportant.

The liver function tests that came back low were BUN, BUN/Creatinine, and SGPT/ALT. I am sure the results will be dismissed. The only thing that maybe ties them together is possible malnutrition - except that doesn't make sense either.

The result that really has me scratching my head is my low MPV number. All the rest of my CBC results were in range (MCH and MCHC just barely in range, as always), so why would my platelets be too small?

There's no such thing as an ulcer too small to be visible on camera, is there?

 

[Galixie]

The twist ending to this particular episode is that I may have found a doctor who is knowledgeable about CFS. (Of course he's a specialist who I will probably not need to see again...)

All the endoscopy found was gastritis (with no obvious cause), but the gastro doc I saw finds CFS interesting and, apart from prescribing some medications to deal with the ongoing gut symptoms, he also recommended pterostilbene to reduce brain inflammation. Anyone tried that?

He also mentioned that some CFS patients do well on adrenal replacement even if they tested ok on adrenal function. I hadn't heard that. I was leary about the idea of adding a third new thing at once, which he understood, so I turned down the offer to take hydrocortisone instead of fludrocortisone for now. I am curious about this topic though.

I did question the doc about the low BUN result and pointed out that I had continued to eat normally, so it should not be showing malnutrition. His thought was that the reference range is based on the average nutrient consumption, and that I manage to somehow fall short of the typical amercian diet. I doubt that, but I have no alternative theories either.

 

[Galixie]

I should probably start a new thread for this new question, but it's related to this existing thread so I am adding here.

My ulcer-like symptoms showed up about a month after I had started eating gluten again. I have no way of knowing if they are actually related but there are some things that don't make sense and I'm hoping someone around here can help me figure out what is going on. I'm going to just quote myself from a different thread for minute:

I am currently back on gluten after having been off of it for a couple of years.

My possible issues with gluten are a convoluted story that started with finding out I was B12 deficient. Blood tests for celiac were done and *mostly* came back negative.

The one antibody result that came back positive was not considered a marker for celiac but could be a marker for non celiac gluten sensitivity. I didn't know that at the time. I was simply told I didn't have celiac. So I continued to eat gluten.

A year or two later I had an upper endoscopy done (still looking for the cause of the B12 deficiency) and that test also did not find celiac.

That all seemed pretty conclusive, but I had finally started to question the one positive antibody result and I decided that the only way I was going to find out if I really was sensitive to gluten was to go without it for three months and see if it made a difference.

I did that and I didn't think anything changed at all. So, after three months, I started eating gluten again. I got really dizzy. I went back through my journal and realized I hadn't been dizzy while I was off of gluten.

There is something called gluten ataxia that is known to affect celiacs, but it is unknown whether it affects non celiac gluten sensitive patients. I decided to operate under the assumption that it could, and I stopped eating gluten until a few months ago.

Having finally been diagnosed as having low blood volume and getting medication to address that problem, it brought up the possibility that my ataxia was never gluten related. In order to test that theory I needed to start eating it again.

Things seemed like they were going ok, but I've been having stomach problems for weeks. I never had stomach problems before (on or off gluten), so I hesitate to think they are related to gluten. It's possible that it's just bad timing. I ended up having a second upper endoscopy done. It was negative for celiac again.

It's pretty clear that I'm having trouble absorbing nutrients, so here is what my questions are:

1. Doesn't some form of atrophy have to occur in order to cause malabsorption? (So far no villous or gastric atrophy have ever been found.)
2. What else can cause a lack of nutrient absorption?