What are the signs of ulcers? How do you treat them?
Stomach ulcers, also known as peptic ulcers, often cause upper abdominal pain or discomfort. Approximately 80 percent of individuals with peptic ulcers have abdominal pain. The pain may radiate to the back.
Individuals with peptic ulcers generally have abdominal pain that worsens with eating, have belching after eating, upper abdominal fullness, an early decrease in appetite, nausea and, occasionally, vomiting. Individuals with ulcers in the duodenum, or first part of the small intestine, generally have worsening abdominal pain two to five hours after eating and at night between 11 p.m. and 2 a.m., when stomach acid secretion increases. Individuals with severe ulcer disease may have darkened stools, bloody stools, and/or blood-tinged vomit due to bleeding from the ulcers.
A perforated ulcer is a medical emergency as this creates a hole from the stomach or intestines into the abdominal cavity which can result in severe infection.
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Patients with peptic ulcers should be tested for a particular type of bacteria known as H. pylori, which can sometimes cause ulcers. Antibiotics would be necessary if the H. pylori bacteria are detected. Sometimes peptic ulcers can be caused or worsened by NSAID use, such as aspirin, ibuprofen (Motrin) or naproxen (Aleve) and others. Tylenol is not an NSAID. Smoking and alcohol consumption can also potentially cause and worsen peptic ulcers. Therefore, we usually suggest stopping NSAIDs, smoking, and stopping or decreasing alcohol consumption to no more than one drink daily. We also usually suggest a medicine to help with decreasing stomach acid production. If in the event that an ulcer has perforated, surgery would then be indicated.
What kind of information should I bring to you when I’m coming for an annual checkup? Should I have a list?
Great question. In all cases, you should have information ready about your past medical history, past surgical history, past hospitalizations, family history of medical or psychiatric problems, allergies and current medications with doses including over-the-counter medications, vitamins, supplements and holistic medications including herbals.
If you have a medical condition or conditions where information is collected outside the clinic or hospital, we ask that you bring those results with you as well, which can include but may not be limited to: blood pressures, blood sugar readings, sleep diary, food diary, headache diary, etc. If you are taking medication, we generally ask that you bring in your medication bottles with you to your appointments so we know exactly what you are taking and how much. As a general rule of thumb, if you think you won’t be able to remember all of this information, I would suggest making a list. Lists can be very helpful for both patient and doctor, especially for managing multiple medical and/or psychiatric issues.
How would I know when to go to urgent care and not the emergency room?
Generally, for issues that you think can be dealt with in the clinic setting, I would suggest going to an urgent care facility rather than the emergency room. For instance, coughs, colds, stomach bugs, minor injuries, etc. can often be effectively managed by urgent care. For instances of chest pain, trouble breathing, stroke-like symptoms, severe allergic reaction, acute changes in mental status such as confusion etc., moderate to severe injuries, or new severe pain of any nature, etc., I would suggest going to the emergency room rather than urgent care.
However, I know there’s often a “gray area” of uncertainty about the severity of a particular problem without speaking to or seeing a doctor or nurse first. In those instances of uncertainty, I have no specific recommendations because even if you were to go to urgent care and the problem couldn’t be effectively managed there, you would be referred to the emergency room for further care.
And of course, many urgent care facilities are not open 24/7, and so the emergency room may be your only option overnight or on weekends/holidays. What I would highly suggest is that everyone has a primary care doctor because many clinics have doctors and/or nurses on call 24/7 that you can call about any problem and a doctor or nurse can answer your questions and help direct you to the best location for care.
How many days can you go without sleeping before you start hurting your health?
Interesting question. In short: it doesn’t take much sleep deprivation to affect your health, but the actual number of hours without sleep it takes to worsen one’s health is difficult to calculate for an entire population in general. Sleep deprivation is simply defined as a change in mood, performance, and/or health due to lack of sleep. Moreover, the amount of sleep individuals need to stave away changes in mood, performance, and/or health is different from person to person.
One can think of sleep deprivation in two different ways: acute and chronic sleep deprivation. For example, with acute sleep deprivation, you normally get enough sleep but recently miss out on sleep over the course of one to a few nights. Chronic sleep deprivation happens when you don’t get enough sleep night after night for many weeks, months, or years. Sleep can also be thought of in terms of sleep quantity and sleep quality. Quantity is how many hours you sleep each night and quality and how “well” you sleep overnight. Both decreased quantity and quality of sleep can poorly affect your health. Most chronic health problems such as high blood pressure, being overweight or obese, and heart disease, for example, are all negatively affected by any amount of sleep deprivation.
There is no magic number on how much lost sleep it takes to cause impairments and/or health problems because each individual requires a different amount of sleep in other to prevent sleep deprivation. But generally speaking, most adults need seven to eight hours of good sleep each night to prevent sleep deprivation, which is again any amount of lost sleep that can negatively affect one’s mood, performance, and/or health. Therefore, it stands to reason that for the general population, going without sleep for just one night can have negative effects on your health.
