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Guts: Kristen Johnston's Exploding Peptic Ulcer Warning

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Kristen Johnston

In a recent episode of the Dr. Oz Show, Kristen Johnston admits that because of her addiction to alcohol and painkillers that she nearly died from an exploding peptic ulcer in spite of the warning signs that she experienced and lists in her recently released book “Guts: The Endless Follies and Tiny Triumphs of a Giant Disaster."

“Plus there was that constant heartburn. Now the heartburn I’m talking about has nothing to do with those commercials featuring balding, shame-faced men being scolded by their nagging wives for eating too many meatballs. This heartburn meant business. The only way I can describe it is…imagine a thousand splinters in your throat. Or a hundred paper cuts being doused with lemon juice. Or being forced to listen to Sarah Palin discuss foreign policy. Let’s just say that it was exceedingly uncomfortable. I told myself I must have developed an allergy to some unknown substance (not alcohol, never alcohol) like MSG, tomatoes or peanuts.” - excerpt from “Guts: The Endless Follies and Tiny Triumphs of a Giant Disaster."

Kristen Johnston’s story is a mix of humor and raw self-revelation where she discusses the events in her life that led to alcohol and painkiller abuse that resulted in her subsequent, nearly fatal hemorrhaging and peritonitis from a peptic ulcer that burned a hole through her stomach and filled her abdominal cavity with flesh dissolving acid and infectious bacteria.

Her denial of the warning signs and symptoms of a stomach ulcer that was getting out of control and on its way to becoming a life-threatening event, is a common health denial among not just stereotypical addicts or Hollywood celebrities, but also that of everyday normal people who become “habituated” to taking too many painkillers and washing them down with a glass of wine.

While the use of the term “habituated” may seem euphemistic, some pain experts state that there is a difference between being addicted to a painkiller and being physically dependent upon a painkiller. Addiction they say involves a psychological component where the painkiller user (abuser) focuses on getting his or her next dose with the end goal of achieving a euphoric high. A person in chronic pain, however, may not achieve a euphoric high, but may need increasing levels of painkillers over time to cope with their pain.

Regardless of the underlying reason(s) for taking painkillers over a prolonged period, the toll on the human body is the same—an increased risk of developing a peptic ulcer. In fact, next to an infection by a common bacteria known as Helicobacter pylori, the use and abuse of prescription and non-prescription painkillers known as Non-steroidal Anti-Inflammatory Drugs (NSAID’s) is the second leading cause of ulcers.

Furthermore, hospitalizations and deaths due to ulcers induced by NSAID’s is a growing problem as pointed out in an article in The American Journal of Medicine that states:

“Conservative calculations estimate that approximately 107,000 patients are hospitalized annually for nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone. The figures of all NSAID users would be overwhelming, yet the scope of this problem is generally under-appreciated.”

How NSAID's Cause Ulcers

Prolonged use of both prescription and non-prescription NSAID's causes ulcers by interfering with the stomach's natural ability to protect itself. The stomach has three primary defenses to protect itself against acidic digestive juices:

• The protective mucus layer that coats the stomach lining and shields it from stomach acid.

• The chemical bicarbonate that neutralizes stomach acid.

• Blood circulation to the stomach lining that aids in cell renewal and repair.

When NSAID's interfere with these defense mechanisms, even normal levels of gastric acids (let alone increased acid levels) will damage the unprotected stomach lining and cause ulcers—especially if someone drinks coffee, is under stress, smokes or drinks a lot of alcohol as Kristen Johnston admits in her book “Guts.”

Exploding Peptic Ulcer

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An exploding peptic ulcer is one in which the ulceration in the stomach has eaten its way entirely through the stomach and is beginning to leak stomach acid and bacteria into the lining of the abdominal cavity called the peritoneum. Prior to an exploding peptic ulcer, a person will develop impending signs and symptoms such as severe stomach pain, nausea, vomit that has the appearance of bloody coffee grounds, and bloody, tarry-appearing dark feces.

Depending on the size of the ulceration through the stomach, once stomach acid, undigested food and bacteria enter the peritoneum a very painful inflammation process called peritonitis will occur and more likely than not incapacitate you to the point where it will be difficult to call for help. In Kristen Johnston’s case she passed out on the bathroom floor and remained unconscious for about 4 hours before waking up and seeking help. Her doctors told her that her survival was remarkable and that most people in her condition would have died.

Treatment for an exploding peptic ulcer requires emergency surgery to stop the bleeding and cleaning of the abdominal cavity to wash out harmful bacteria that can cause systemic infection.

Prescription and Non-prescription NSAID Warnings

Taking prescription and non-prescription painkillers is safe only when exercised with care under the guidance of a physician. The following is a list of warnings concerning taking painkillers:

• Do not use a nonprescription NSAID’s for longer than 10 days without talking to your doctor.

• The risk of developing an ulcer increases with the dose and period of taking a painkiller.

• People who are older than 65 or who have existing heart, stomach, kidney, liver, or intestinal disease are more susceptible to NSAID side effects.

• Do not take NSAID’s if you have had an allergic reaction to aspirin or other pain relievers.

• Do not take NSAID’s if you have ulcers or a history of bleeding in your stomach or intestines.

• Do not take NSAID’s if you have stomach pain, upset stomach, or chronic heartburn.

• Do not take NSAID’s if you have a habit of drinking more than 3 alcohol drinks a day.

• Do not take NSAID’s if you have anemia, high blood pressure, kidney, liver or heart disease, or bruise and bleed easily.

Kristen Johnston was lucky to have survived her exploding peptic ulcer and acknowledges that in her book “Guts: The Endless Follies and Tiny Triumphs of a Giant Disaster," which she hopes will serve as a warning to others that addictive behavior—even controlled addictive behavior—is a delusion that may fool your friends and yourself, but never your body.

Image Source: Courtesy of Wikipedia


“Recent Considerations in Nonsteroidal Anti-Inflammatory Drug Gastropathy”, The American Journal of Medicine, July 27, 1998; Singh, G.
The Dr. Oz Show