Hi  – where exactly is the pain? Does the pain increase with different types of foods (higher fat for example). When exactly does the pain worsen? Immediately after eating or after 20-30 minutes? More details about timing will help.

If it is stomach pain, I’m suspicious of H Pylori infection. Has she done a functional stool test to rule this out?

Pain in the rib area (upper GI) after eating can come from a few different causes. If the pain is somewhat immediate, it is likely associated with gastritis or even the beginnings of an ulcer, which is often caused by an overgrowth of H Pylori bacteria, which causes thinning of the protective mucosal lining in the stomach, and/or NSAID use which does the same. Chronic stress (through the sympathetic nervous system) also promotes reduction in gastric acid production, thinning of this lining, and suppression of the immune system in fighting overgrowths such as H Pylori.
The order of operations should be:
• Heal the gut lining. Watch this video.
• Identify if H Pylori overgrowth is present and address if needed
• Support stomach acid or take other actions to prevent recurrence

Right away, I would begin with mucilaginous herb support to help repair the stomach lining. These agents are generally taken on an empty stomach (at least 30 minutes before, or two hours after meals). Combination products may differ, so check the label. Some mucilaginous herbs you may consider are:
• Deglycyrrhizinated licorice extract (DGL)
• Mastic gum
• Zinc carnosine
• Marshmallow root extract
• Slippery elm bark
• Aloe vera

Mastic gum in particular has shown effectiveness at healing duodenal ulcers.
There are several combination products available such as:
• GI Relief from Thorne
• Gastromend-HP from Designs for Health
• Glutagenics from Metagenics

Taking the full dose 2-3 times per day for at least two weeks usually helps heal the mucosal lining. Duration of use will depend on what is actually going on, how much healing needs to take place, and what other supportive measures, such as dietary changes, are taken.
Keep in mind any other factors that may affect the mucosal lining. Primarily address stress. Elevations in cortisol suppress the immune system and sustained stress reduces the production of secretory IgA antibodies. This is the body’s front line immune force in preventing the entry of threatening substances through our protective mucosal linings (such as in the intestines). If IgA is reduced enough (or frequently enough), it is more likely that an overgrowth or dysbiosis or infection can occur. These microbial imbalances may also be the cause of enhanced intestinal permeability. Ultimately stress is a Huge mediator of immune function. Also keep in mind that NSAIDs can directly thin the mucosal lining and can also be a key root cause for intestinal permeability, gastritis and ulcers as well.
For rapid relief, avoiding spicy foods and acidic foods (vinegars, tomato sauce, citrus, etc.) may help with symptoms. And a focus on easy-to-digest foods while healing the gut lining will ease digestion and allow for better absorption and digestion of nutrients. Examples are protein smoothies, blended soups, mashed or pureed vegetables such as sweet potatoes, cauliflower and butternut squash. Adding in bone broth and collagen and removing gluten will also help to address any intestinal permeability.
With my clients, after fully healing the mucosal lining and addressing H Pylori (if any), HCL stomach acid support can be considered but it has to be done slowly, starting with just one pill in the middle of a full, protein-containing meal. If there is any pain at all, they stop the HCl and continue the mucilaginous herbs and gut healing for another week or more. Their body guides the duration/process.
If your mom’s pain is more delayed post-eating (~20+ minutes after a meal), it could possible be gas build-up due to:
• Low stomach acid or digestive enzyme insufficiency (and resulting gas build up in the stomach itself due to carbohydrate fermentation)
• A food sensitivity or intolerance (for example, dairy)
• An intestinal bacterial overgrowth

For gas and bloating, I recommend carminative herbs (e.g. ginger, peppermint, fennel) and/or digestive enzymes or digestive bitters. Combination carminative herb formulations you may consider are:
• Gas and Bloating from Gaia Herbs
• Gas Stop from Renew Life
• Peppermint Gels from NOW Foods

As a final consideration, please have a chat with your mom about how persistent the pain feels and its particular placement and incident timing.  If it seems more acute after higher-fat meals, keep in mind the gallbladder might be at play. In this case, the pain would be typically limited to the upper right-hand side of the body, perhaps radiating to the back/shoulder blade. Anything acute needs immediate medical attention.
Hope this helps give some direction and areas to explore. Please let me know.

Hi ,

I can imagine you want the best for your mom! I hope the tips,  gave, you can help your mom with her stomach pain.

With what you have written, I am also curious about why your mom needed the aortic valve replacement. Do you know? Did her valve for example needed to be replaced because the valve was calcified and therefore started to leak blood back into the heart? Or was there some other reason?

Are there any medications your mum is taking, for example, painkillers to ease the pain caused by osteoarthritis? Or maybe medications for her heart like beta-blockers?

I am asking because painkillers might ease the pain, but chronic use of painkillers can do some damage to the GI tract as well.

Some beta-blockers can, with long-term use, cause problems with energy production. Beta-blockers can also cause stomach upset and other GI symptoms like nausea, diarrhea or constipation.

If she is using medications, it would help us to know which medications to give you the best possible advice!

Hey ,

I think  gave you really good advice. I would like to add that painkillers can cause some damage to the gut and the stomach. This article from 2006 are describing even elevations in liver enzymes from 2 weeks of use of Tylenol. Painkillers are usually treated as innocent, but they definitely are medications and they can have side effects!

If there is some damage to the lining of the stomach, building up the protective lining can be done by using a supplement like Thorne’s GI-Relief (click here). I usually recommend starting low in dose and when well tolerated, working up to higher doses between meals for at least 2 months.
 
It is however important to know if the damage to the lining of the gut was done by H. Pylori or painkillers. An infection with H. Pylori should be adressed first/
 
As an alternative to Tylenol, your mother could experiment with supplements if she is using painkillers to deal with the pain from her osteoarthritis. I sometimes recommend people try Meriva curcumin 2x per day. Boswellia is also an excellent targeted anti-inflammatory for arthritis. Pure encapsulations (click here) has Boswellia you can try.

A little side note to the list of medications you mentioned:

With long-term use of Pantoprazole nutrient deficiencies like calcium, magnesium, vitamin B12 and iron can occur.

Pravastatin can cause deficiencies in selenium, CoQ10 and vitamin E.

Obviously, my message is not to stop her use of medications. But maybe you can recommend to your mother the use of supplements like CoQ10 or a high-quality multivitamin as well!