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Dr. Rick, MD
Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 11267
Experience:  20+ years as a doctor. Internal Medicine Internship in NYC
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I was diagnosed w/ a bleeding duodenal ulcer October of last

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I was diagnosed w/ a bleeding duodenal ulcer October of last year. I was hospitalized several days and needed blood transfusions. I had no pain really before this episode but did have fairly frequent reflux. I also was taking Aleve a few times a week.

Since last year I have been scoped 3 more times and sill have a persistent erosive duodenitis. I have consistently been on either Omeprazole 20mg BID or Dexilant once daily. I have had absolutely no NSAID's since last year.

All tests (biopsies, serology) have been negative for H. pylori. All biopsies have shown just inflammation - no neoplastic changes or any indications of IBD.

A fasting gastrin test earlier this year was within normal limits.

A prometheus IBD panel was all normal.

Now, my GI doc wants to refer me to the Mayo clinic for further tests. I have had no symptoms since my episode last year (No pain, no reflux). I am willing to do this - unfortunately the wait may be as much as 6 months. Thought I'd see if there were any suggestions to work on in the mean time.

1) It seems controversial how much of a roll diet plays in these. I drink 2-3 cups of coffee a day and average 1-2 beers or glasses of wine a day (never more, no spirits). Do I really have to cut all this out (they are certainly things I enjoy)? Maybe these things don't cause an ulcer but do delay healing?

2) Do some people respond to 1 PPI better than another? Should I consider switching to nexium or something else instead?

3) Should there be any consideration of just trying treatment for H. pylori even though all tests have been consistently negative? Looks like there's always a chance of false negatives occurring.

4) I am an active athlete. Guess the only time I feel any sort of symptom is after finishing a long (15+ mile) run. Sometimes feel a little nauseous at the end. Could this stress be keeping this inflammation active?

Not expecting any miracle answers. Just trying to see if any other things to try for now.
Hi. Dr Rick here. I completed an Internal medicine internship in NYC and have two decades of clinical experience.

I completely agree with a trip to Rochester,Mn and the Mayo Clinic...

Let me answer your questions in order:

1. Yes. You do. and Yes, the can.

2. That is a good thought but I bet your doctors have already considered it so I'd not switch meds at this point.

3. No. I would not do this....

4. I would continue enjoying your running. I do not believe that it plays any significant role in your condition.

Does this make sense to you?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS
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