How can I reduce the risk of an upset stomach after treatment?

Some medications used in the treatment of skin conditions can cause irritation of the stomach and oesophagus. This can usually be prevented by taking the medication carefully.

Antibiotics such as doxycycline and erythromycin and, to a lesser extent, vitamin B3 (nicotinamide) are the skin care medications that most commonly cause irritation of the gastrointestinal system.

Symptoms of stomach irritation include abdominal pain, nausea, a bloated sensation and sometimes vomiting. The main symptom of oesophageal irritation is chest pain (“heartburn). These symptoms can often be managed by fairly simple measures:

• Take medication with food: Take tablets or capsules with meals. Eat a few mouthfuls of food, then take the medication. Follow with more food and a glass of water to ensure the medication has reached the stomach.
• Don’t lie down: To avoid reflux of the medication into the oesophagus, keep sitting up or standing for 20-30 minutes after taking it.
• Divided doses: If your medication is in tablet form, you may be able to split it into more frequent, smaller doses. For example, instead of taking two 500mg vitamin B3 tablets once daily, take one 500mg tablet twice daily.

If these measures don’t work and you continue to experience symptoms of stomach or oesophageal irritation, contact your doctor for advice.