Dear Dr. Garner,
I enjoy reading your column, and now I am writing in to see if you can help me.
I have a terrible, nagging pain on the left side of my stomach. It gets so bad sometimes that it feels like I have a knife in my side. This has been going on for a couple of weeks.
The pain gets better when I eat and antacids work somewhat, but I am often awakened at night.
My doctor seems to think it is an ulcer. I have bad arthritis and was taking Motrin for quite a while, but I have now switched to Tylenol.
What do you think?
Painful Ulcer in
Prospect Heights
Dear Painful Ulcer,
The symptoms you are describing can definitely be associated with an ulcer. An ulcer is basically a hole in the lining of the stomach, the duodenum (small intestine) or the esophagus (canal connecting the throat to the stomach).
There are some myths about ulcer disease, which are important to review.
For one, it used to be thought that an ulcer was caused by stress or worry. In fact, it is usually caused by a bacteria, and antibiotics are needed to make it go away.
Another possible cause is use of pain killers like Motrin, Aleve or aspirin. Tylenol is safe to use and a better choice for pain relief in those with ulcers.
Another misconception is that milk is good for ulcers. Drinking milk initially may make the pain go away but then causes increased acid to be produced, which ultimately worsens the ulcer.
Ulcers are almost always benign, and there is only a small chance of an ulcer being cancerous.
Another myth is that spicy foods or a stressful job can cause ulcers. To reiterate, ulcers are caused by bacteria or by the use of pain medications, not stress.
The most common symptom of an ulcer is what you described – pain in the left side of the stomach, usually from the navel to the breastbone. It is worse when the stomach is empty and flares up at night.
Often the pain is temporarily relieved by eating certain foods that buffer stomach acid or by taking an acid reducing medication.
The pain may disappear and then return for a few days or weeks.
Sometimes there are no symptoms at all, and suspicion is aroused by finding anemia (low-blood count) or blood in the stools.
Lifestyle is an important part of treatment. Quitting smoking and cutting out regular use of alcohol is a good place to start. Exercise and relaxation techniques are also good at improving the condition.
There are several ways to diagnose an ulcer. An upper GI involves drinking barium and taking X-ray pictures of the area.
Another approach is to put a small tube down the throat to look directly at the esophagus, stomach and first portion of the small intestine. During this procedure, your doctor may biopsy the ulcer to see if there is bacteria (H. pylori) present and to rule out the remote possibility that it is cancerous.
Finally, there are blood tests as well as breath tests to determine if one has the bacteria associated with ulcer disease (H. pylori). If it is found to be present, your doctor may decide to treat it without doing any other testing.
Most ulcers will go away on their own or with medication to reduce acid in the stomach. There are many different treatment options to discuss with your doctor.
Thank you for your question. Keep me updated on your progress.[hr] Dr. Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on The NET, Tuesdays at 8 p.m. on Channel 97 Time Warner and Channel 30 Cablevision.