Dear Dr. Garner,
I am a loyal reader of your weekly column and I am writing because I have been experiencing a nagging pain on the left side of my stomach.
Sometimes it gets so bad that it feels like a knife is sticking in me.
This has been going on for a couple of weeks. I have noticed that it gets better when I eat. Antacids also seem to help somewhat, but I am often awakened by pain in the middle of the night.
My doctor seems to think it is an ulcer. What do you think?
Painful Ulcers in
The symptoms you are describing can definitely be associated with an ulcer.
Ulcers are basically a hole in the lining of the stomach, duodenum (small intestine) or esophagus (food pipe that runs from the mouth to stomach).
Bacteria, Not Stress
There are some myths about ulcer disease that are important to review. For one, it used to be thought that the ulcer was caused by stress or worry. In fact, it is usually caused by bacteria, and antibiotics are needed to make it go away.
Another possible cause is use of painkillers 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 and only serves to worsen the ulcer.
The good news is that ulcers are almost always benign, with 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, not spicy foods or the burden of stress.
The most common symptom of an ulcer is exactly what you described – an annoying pain in the left side of the stomach, from the navel to the breastbone. It is worse when the stomach is empty and flares up at night.
Often it is temporarily relieved by eating certain foods that buffer stomach acid or by taking an acid-reducing medication.
The pain may disappear for a time 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 regular use of alcohol is a good place to start. Exercise and relaxation techniques are also good at improving the condition.
Methods of Diagnosis
There are several ways to diagnose an ulcer. An upper GI involves drinking barium and taking X-rays of the area.
Another approach is to insert 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 and I look forward to hearing of your progress.
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 Time Warner Channel 97 and Cablevision Channel 30.