Stomach pain, headache and anaemia - A triple Whammy

I have observed among my female patients in their late thirties and mid-forties who suffer simultaneously from  these conditions, namely an epigastric pain (stomach pain), headache and malaise and weakness which is found , upon blood investigation, to be anaemia (  haemoglobin  lower than 12 g/l ).

Their description of the recurrent headache is not unlike the migraine features. Most of them have suffered from these stress-related malady from their teens. Some have aura prior to the headache while others do not report any such event. Most of these patients have such a bad attack that they self-medicate. As they are not properly followed up by a doctor, they just keep buying those painkillers over the counter (OTC), at times from various pharmacies. In Malaysia, there is no stringent control over the use of these drugs.

And so over the years they gradually suffer from the effects of these drugs, referred to as  non-steroidal anti-inflammatory drugs (NSAIDs) such as mefenamic acid and ibuprofen. These drugs have an erosive effect on the stomach mucosa (lining) and causing gastritis and later peptic ulcers.

Unremitting stomach ulcers gradually leads to recurrent bleeding and over time the chronic blood loss leads to anaemia.

And so such a patient has the three medical conditions simultaneously. And the history is almost always similar.

I have made it my practice to really educate those young girls who come to me with recurrent headache or recurrent stomach pain to avoid the unnecessary use of pain killers to prevent this triple whammy later in their life. It is traumatising for these people to finally end up coming to the clinic/hospital  frequently at the peak of their life.

The cliché,  "prevention is better than cure" cannot be overemphasised. A simple knowledge on how to manage your sentinel medical condition will help a long way in maintaining your quality of life.