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RK
RK, Doctor
Category: Medical
Satisfied Customers: 4151
Experience:  MD, DM
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I have what I think is gastritis. I’m due for a gastroscopy

Customer Question

I have what I think is gastritis. I’m due for a gastroscopy on May 12. I’m on 30 mg Lanzoprazol but am having a severe flare up with pain in upper abdomen, strong nausea and I’m vomiting. Can’t eat.What can I do? Temporarily updose the Lanzoprazol? Eat bland? Potato starch?Any help appreciated!
Submitted: 15 days ago.
Category: Medical
Customer: replied 15 days ago.
I need to talk to a gastro
Expert:  RK replied 15 days ago.

Hi,

Thanks for posting your query.

I am Dr.Ratkin and I am pleased to assist you.

Your age and gender?

Customer: replied 15 days ago.
44 Female
Expert:  RK replied 15 days ago.

How long you have these symptoms?

Lansoprazole once or twice a day?

H. pylori infection ruled out?

Are you on any painkiller (NSAID) medications?

Customer: replied 15 days ago.
It started after I discontinued Amitriptyline and started Paroxetine + for a week took Ibuprofen. I had my first episode in November. It’s been on/off since and definitely better when I eat bland.H Pyroli, no as I’ve been on Lanzoprazol 30 mg (once daily) since January and so they say they can’t do the test.
Customer: replied 15 days ago.
Right now I have barely been eating or drinking since 1.5 days ago as I’m extremely nauseous and vomit everything up
Expert:  RK replied 15 days ago.

Your symptoms are probably due to Ibuprofen you took.

You can take Lansoprazole 30 mg twice a day or Lansoprazole 30 mg in the morning and Zantac or Pepcid in the night.

You can also take TUMS to neutralize acid and provide symptom relief.

Avoid NSAID painkillers, coffee, citrus, chocolates, tomatoes.

Take bland diet

Customer: replied 15 days ago.
After all these months? Only a week worth of ibuprofen? I thought it might be stopping Amitriptyline (that apparently is used to help gastric issues?) and starting Paroxetine (have stopped taking that 6 weeks ago).We don’t have Zantac or Pepcid in Denmark ‍♀️
Customer: replied 15 days ago.
We don’t have TUMS either, sigh.
Expert:  RK replied 15 days ago.

In that case you can take Lansoprazole twice a day.

If you have Peptobismol, you can take it.

Even one tablet of Ibuprofen can cause gastritis.

You can get tested for H.pylori also.

Customer: replied 15 days ago.
Ok. So Lanzoprazol twice daily. When will this start to help?How about Sucralfate? And will it make sense to start Amitriptyline again or doesn’t it work for gastritis?Can I have an ulcer that is not caused by h pyroli and is treatment the same?
Expert:  RK replied 15 days ago.

Since you are already taking Lansoprazole, increasing the dose will show the effect from day 1 itself.

Sucralfate will provide relief if there is an ulcer or if there is bile reflux.

Amitriptyline would be helpful to some extent, if your symptom is mainly functional ( and endoscopy does not show anything abnormal and H.pylori is negative).

Yes you can have an ulcer not caused by H.pylori. You need PPI and sucralfate to treat that. If it is due to H.pylori, you need to treat H.pylori also with Triple/quadruple therapy

Customer: replied 15 days ago.
What does it mean that “my symptom is mainly functional”, please?Bike reflux: I vomit up bile, is that it?So you wouldn’t encourage me to start Amitriptyline again just now?
Customer: replied 15 days ago.
isn’t 2 x 30 mg Lanzoprazol too much?
Expert:  RK replied 15 days ago.

Functional - The meaning I have mentioned within brackets there - when all tests are inconclusive.

Yes, you might be having bile reflux and bile reflux gastritis in which case sucralfate along with PPI will be helpful

No amitriptyline till all tests are done.

Expert:  RK replied 15 days ago.

60 mg is not too much

Expert:  RK replied 15 days ago.

Any more questions?

Customer: replied 15 days ago.
How is it possible to get such a flare when already taking Lanzoprazol? I mean — seems they do not help so why take more,
Expert:  RK replied 15 days ago.

In gastritis, if the response with 30 mg Lansoprazole is partial, increasing the dose will be helpful.

If there is no response at all with 30 mg lansoprazole, then increasing the dose might not be helpful.

And also there are a few high acidity conditions where high doses of PPI has to be taken for control of symptoms.

Endoscopy is done to find if the cause of pain in the upper abdomen is due to gastritis or not.

If endoscopy is normal, H pylori is negative, scan shows normal other organs, then functional dyspepsia is diagnosed and in addition to PPI, you may have to take Amitriptyline.

Alternatively if you have been on Lansoprazole for a longer time, you can switch over to another PPI like Nexium.

Customer: replied 15 days ago.
I tried switching to Nexium 20 mg a week ago and had issues after taking them for 3 days. So back to Lanzoprazol. Can this be the culprit?
Expert:  RK replied 15 days ago.

What issues you had?

Customer: replied 15 days ago.
Well, I had a flare. Nausea, pain, vomiting.Then back to Lanzoprazol and after two days ate pizza. And here we are.If I take 60 mg Lanzoprazol will I be able to reduce again when flare is over or will I get rebound?
Expert:  RK replied 15 days ago.

You can reduce again. No rebound