A Family Doctor's Tale - THE MILK DRIP

THE MILK DRIP

In the early 1970 one of the medical treatment of acute exacerbation or mild bleeding from gastric peptic ulcer(A Simple Guide to Gastritis) was the milk drip. 

Our ward consultant was a gastroenterologist specializing in stomach, intestinal, liver and gallbladder(A Simple Guide to Gallbladder Diseases) problems. 
Many of his patients who had a diagnosis of acute exacerbation of peptic ulcer were sent to the ward for a milk drip as treatment for the hyperacidity of the stomach.

Provided the patient is not lactulose intolerant ( not able to tolerate the lactulose in cow's milk), a nasogastric tube was inserted from the nose into the stomach of the affected patient. Milk was allowed to flow continuously into the stomach acting as an alkaline lotion to neutralize the acid in the stomach. It was first introduced as a treatment in one of the British journal in 1950 and has since been a popular way of treating peptic ulcer in Singapore hospitals in the 1960-80.  

I also incorporate a continuous use of antacid suspension every half hourly to my gastric or peptic ulcer patient nowadays until their symptoms are relieved. 
This seems to work better than giving medicines 3 or 4 times a day. 

However medicines like cimetidine (H2 antagonists) and ranitidine which are first used from 1976 in United Kingdom and 1979 in USA became the drug of choice for treatment of gastric and duodenal ulcers. This was followed by the proton pump inhibitors like omeprazole and nexium from 1986 onwards. 

However the use of these strong acid reduction medications does not mean antacids are not necessary for the countering the acid in the stomach. 

In addition a new cause of gastric ulcer was found to be a bacteria called helicobacter pylori. 
So for some of these gastric patients an 6 week course of antibiotics have to be given together with H2 antagonist or proton pump inhibitor and antacid. 

All too often many specialists just prefer to give the strongest medication like omeprazole alone without the antacid and hope the gastric disease will be cured. 

In fact the cause of gastric disease is multifactoral including irregular meals, stress, hereditary and bacterial. 

Unless the cause is also treated, the gastric problem will never go away. 

In fact the milk drip has many advantages to the treatment of gastric ulcers. A continuous flow of alkaline liquid, a good bacteria (lactobacteria) which may counter the hylobacter pylori bacteria and rest in bed all help to cure the gastric problem. The only problem are people with lactulose intolerance and the high cholesterol (A Simple Guide to Cholesterol)in the cream of the milk.