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الأربعاء، 19 أبريل 2017

6 Things I Learned About Ulcers مدونتي

 
مشكلة قرحة المعدة وشرحها للدكتور
 Halfway through February, I could no longer sleep through the night. At 2 a.m., I’d find myself chugging milk from the carton to extinguish a fire at the top of my rib cage. The gnawing feeling high in my stomach alternated with nausea so arresting I kept a bucket next to my laptop and considered taking a pregnancy test, even though I was 99 percent sure I wasn’t expecting.

One day on the subway platform, I doubled over and let out a groan so pathetic it prompted a complete stranger to ask, “Are you all right?” Then I knew it was time to seek medical attention. New Yorkers don’t address strangers on the subway, I told myself. It’s like breaking the fourth wall.

The next day, my primary care doctor told me I probably had an ulcer, a raw spot or sore in the lining of the stomach or small intestine. Here are some of the things I learned about ulcers during the odyssey that followed.

■ Anyone can get an ulcer. Back in the 1980s, when doctors and most everyone else thought psychological stress or spicy foods led to ulcers, two Australian scientists discovered that the main culprit was actually a bacterium called Helicobacter pylori. That discovery eventually won them a Nobel Prize in 2005, and ushered in an era of using antibiotics to cure ulcers.

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But that didn’t wipe out ulcers altogether. Far from it. Indeed, my tribe of fellow sufferers are legion. Nearly 16 million adults nationwide reported having an ulcer in 2014,according to the Centers for Disease Control and Prevention’s National Center for Health Statistics. The largest group, roughly 6.2 million, were 45 to 64 years old. Those 18 to 44 accounted for 4.6 million, 65- to 74-year-olds for 2.6 million, and those 75 and older for 2.4 million.

I got a blood test to see if I was infected with H. pylori; the test came back negative, so I didn’t need antibiotics. Regular use of nonsteroidal anti-inflammatory drugs, like ibuprofen or aspirin, can also lead to an ulcer, but I wasn’t taking those medicines. My ulcer turned out to be “idiopathic,” which is a fancy way of saying that doctors have no idea why it happened.

■ It takes time to figure out what you can eat. My doctor told me I needed standard therapy: Take omeprazole, an acid-suppressing drug, for a month to give the open sore in my stomach time to heal. While some untreated ulcers start bleeding heavily or require surgery or hospitalization, he assured me I’d feel better soon.

In the meantime, I needed to figure out how to get nourishment.
 But having an ulcer, I’d learned, is like being a contestant on
 a twisted game show called “What to Eat?”. Choose poorly, and my
 stomach would burn like lava, leaving me listless. Choose wisely,
 and I’d be rewarded with a momentary reprieve, until hunger
 struck again. Every few hours the “game” would start over.

Maddeningly, I wasn’t sure
which foods might be safe to eat until I tried them. For instance,
 why did a seemingly innocuous bag of salted peanuts lead to agony?

The truth
 is gastroenterologists don’t know why certain food causes indigestion
 and heartburn for patients with stomach ulcers. There are a few rules
 of the road: Avoid alcohol, or anything with caffeine or high in fat.

Fatty foods “sit in the
 stomach for a long time and fester,” said Lori Welstead, a registered
dietitian who works at the digestive disease center at University
 of Chicago Medicine. Perhaps that was the trouble with peanuts?

Dr. David Y. Graham, a past president of the American College of Gastroenterology, perhaps summed it
up most succinctly, “There’s a general rule: Don’t eat what hurts you.”

Ulcer patients must
 serve as their own guinea pigs, experimenting on their guts until
they find sustenance that doesn’t come with a side of discomfort
for them. I didn’t realize that until weeks after my diagnosis.

■ An empty stomach won’t help — and probably will hurt. Like a heartbroken soul who swears off dating to avoid future pain, I started eating less
 and less. So did Megan McMillen, a nurse in Morgantown, W.Va.,
 after she discovered she had an ulcer around Valentine’s Day.

“You’re scared if you eat something what the consequences will be,” she said, so she quit eating for two days. But the dow

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