Dear Ask The Doctor: I have just been diagnosed with a large peptic ulcer which has been bleeding. Ihave been prescribed 2 anti-biotics and a proton pump inhibitor and have to return for a repeat endoscopy in six weeks time.My question is should i take some time off work to aid my recovery? I do active active manual work which requires a fair amount of lifting and bending.
Dear Patient: You have been prescribed triple therapy following diagnosis of a bleeding peptic ulcer. Triple therapy consists of a course of two antibiotics and a proton pump inhibitor (PPI), for eradication of Helicobacter Pylori. The presence of this bacterium predisposes to peptic ulceration and requires eradication therapy, particularly in your case because of active bleeding and ulceration. It is important after being diagnosed and treated with triple therapy, for Helicobacter Pylori infection, to have a follow-up check to ensure eradication, as some patients require a repeat course. This can be carried out with a simple urea breath test, usually 4 weeks after treatment. In general, 6-8 weeks of therapy with a PPI is required for complete healing of a duodenal ulcer. Your follow-up endoscopy will determine the extent of ulcer healing, and if eradication therapy has been successful.
Regarding absence from work, this is dependent on many factors, such as your current Haemoglobin level, symptoms of anaemia, chest pain, shortness of breath, fatigue and whether you feel fit to perform regular occupational tasks. There are no guidelines in place regarding duration of sickness absence, following active peptic ulceration. However I would advise listening to your own body’s requirements, and if you do not feel able to perform manual labour, a week or two off work may be sensible, or adjustment to lighter duties, while you are recovering. Lifestyle measures to promote healing and prevent recurrence of ulceration include; avoiding alcohol and smoking, because they impair the gastric mucosal protection. It is important to avoid causative drugs including: aspirin, NSAID’s, COX 2 inhibitors, bisphosphonates and steroids. In addition, weight reduction, avoiding; coffee, high-fat foods, carbonated drinks, acidic foods such as tomatoes and citrus fruits and juices may help with reflux symptoms.