ASK DOC: What do I eat now that my diet is worsening my ulcers?


ASK DOC: What do I eat now that my diet is worsening my ulcers?

Every time I eat, my stomach feels pain.

Dr Flo, I have a stomach problem. Every time I eat, my stomach feels pain. In addition, I am constantly passing foul-smelling gas. I sought medical advice, and I was told that I have ulcers. I was advised not to drink sour milk and not to eat kales, beans and some kienyeji vegetables. I don’t have anything else to eat, so I have been eating those forbidden foods. What advice can you give me?

Brian

Dr Flo, I have an 11-year-old daughter who was diagnosed with peptic ulcers in February. She complains of headache and stomachache. I have taken her to three different clinics but after she completes a dose of the prescribed medicine, the problem comes back. What’s the way forward?

Elisha

Dear Brian and Elisha,

Peptic ulcers are open sores or wounds in the lining of the stomach, the lower part of the oesophagus or the duodenum (first part of the small intestines), and these are formed due to the action of acid and also imbalance of some digestive enzymes.

Risk factors for the development of ulcers include excessive alcohol intake, smoking, prolonged use of some painkillers (non-steroidal anti-inflammatory drugs e.g. aspirin, ibuprofen, diclofenac, mefenamic acid), infection with the Helicobacter pylori bacteria, serious illness, radiotherapy in the stomach region or stomach tumours that produce a lot of acid. Some people seem to be genetically predisposed to produce a lot of stomach acid, while in others, no cause is ever identified.

When you have an ulcer, you may have a burning, or even stabbing pain on the upper part of your abdomen, which when severe, can go all the way to the back, or even cause chest pain.

The pain may be associated with hunger, or may come just after eating, or it may be worse at night. You may also experience heartburn, a lot of gas in the stomach, nausea or vomiting, constipation, or occasional diarrhoea.

If the ulcer is very severe, you may have blood in the vomit, dark coloured stool, weight loss and severe pain.

Most times, ulcers will heal on their own, or with medication. The symptoms may recur from time to time, especially when triggered e.g. by taking some painkillers, binge drinking, staying hungry or taking particular foods.

In rare cases, however, the ulcer can worsen with time leading to perforation, severe bleeding or even blockage of the stomach outlet or the small intestines due to formation of scars or due to swelling. All these are medical emergencies that need urgent intervention, as they can lead to death.

To manage the ulcer and prevent complications, stop taking alcohol, stop smoking and avoid use of NSAIDs (painkillers like aspirin, brufen, diclofenac, mefenamic acid).

There are also medications that help to manage the symptoms, including proton pump inhibitors, sucralfate, antacid syrups, and antibiotics (if you have the H.pylori infection).

For some people, there are particular foods that may trigger or worsen the symptoms. These foods vary from person to person. However, with proper treatment, you should be able to continue with your diet as normal. But if the foods and/or drinks are causing a problem, it is advisable to stay away from them until the stomach is back to normal, or to reduce them as much as possible.

One way to do this is by taking the offending foods together with others so that their effect is reduced e.g. mixing kales with spinach or with cabbage, or taking acidic fruits in a fruit salad with fruits that are not acidic.

Endoscopy (passing a small tube with a camera at the end into the stomach) can be done to diagnose the ulcer, and also to treat minor bleeding, if present.

Surgery is done to manage complications like perforation, blockage or severe bleeding.

Dr Flo, I have been having recurrent yeast infection for a while. It recurs immediately after treatment. I think I have an abnormality and this has lowered my self-esteem. What can I do to get rid of this infection once and for all? Mary

Dear Mary,
It is normal for all women, starting at puberty, to have a vaginal discharge.

It is a mixture of fluid and cells that help to keep the vagina clean and moist and to prevent infection. The appearance changes depending on the menstrual cycle, and can also be affected by exercise, stress, use of hormonal medication and sexual arousal.

The discharge may vary from white to clear, and from watery to thick, at different times of the cycle. It is also normal to have a brown or bloody discharge just before, during or after your periods, or sometimes in between your periods (spotting).

This means that when you have a vaginal discharge for a long time, there is the likelihood that it is just a normal discharge. The only way to manage it is to maintain hygiene and use a panty liner if necessary.

Yeast infection is also called candidiasis or thrush. Normally, there are yeast cells that live in the intestinal system, and a few in the vagina. The vagina has “good” bacteria called lactobacilli that protect it from getting infections.

If something happens that lowers the number of good bacteria, or causes an imbalance, then the other organisms take advantage and multiply and cause an infection.

This could be due to taking antibiotics, hormonal changes at particular times of the menstrual cycle or due to pregnancy, uncontrolled diabetes, weak immune system or even eating a lot of sugary foods.

When the yeast that is normally present in the body multiplies inside the vagina, it causes vaginal yeast infection. You may experience itching, burning sensation, swelling, a rash, or an abnormal vaginal discharge (white/cream/yellow/grey discharge that is usually thick and clumpy).

Since you have had recurrent infections, it would be advisable for you to have a high vaginal swab (HVS) culture test done. This will help you know if there is actually an infection present, and if so, which specific one it is.

Treatment is usually easy and effective, with either oral tablets or suppositories (tablets placed in the vagina).

To prevent the infections, wear cotton underwear, do not wear tight trousers, avoid douching and using feminine cleaning products.

If your sexual partner has any symptoms, he should also be treated, though the candidiasis is usually not transmitted sexually.

Lastly, you are not abnormal. About 75 per cent of women suffer from vaginal yeast infection at some point in their life, and it is recurrent in quite a number of people. In fact, some women have to take antifungal tablets every month at the start of their periods because of this.

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