Media personality Perez Hilton recently said he was hospitalized for 21 days after facing a life-threatening condition. Doctors who specialize in gastroenterology and family medicine say the case helps shed light on why it’s important to always communicate with your health care provider.

Hilton, born Mario Lavandeira, said in a video posted on YouTube Monday that he was hospitalized after taking medication for a week without food. He said he took the medication to treat the flu and “never” took it with food.

“And you’re supposed to take all of this medication with food because ... they can be hard on the stomach or the intestines,” he said in the video.

Hilton said that he developed an ulcer, which progressed to a perforation. The Cleveland Clinic states that a perforation is a “hole in your gastrointestinal (GI) tract” and that it requires “immediate medical care.”

The gossip blogger said that he experienced severe stomach pain the day before he was hospitalized and that he was taken to the hospital by ambulance the following morning when he got to the point where he “couldn’t walk.” He said he also developed sepsis.

When Hilton arrived at the hospital, he said he was given several tests, including an X-ray, CT scan and ultrasound to find the perforation. He said doctors initially were unable to locate the perforation and that he eventually underwent Laparoscopic surgery, which uses a camera to look inside the abdomen.

“And then I still had so much infection that I had to have another major procedure,” he said, before adding that he later developed another infection while staying at the hospital.

Hilton’s experience brings up important questions about best practices when taking medication. Dr. Jason Korenblit, a gastroenterologist and digestive health expert on JustAnswer, told HuffPost that it’s first important to note that Hilton did not name the medication he took, so therefore “no one should assume exactly which drug caused this.”

“That matters, because the two main FDA-approved prescription antivirals commonly used for influenza, oseltamivir (Tamiflu) and baloxavir (Xofluza), can both be taken with or without food,” he told HuffPost. “With oseltamivir, food is often recommended simply because it may reduce stomach upset, not because taking it on an empty stomach is known to commonly cause an ulcer.”

“Baloxavir can also be taken with or without food, although patients are told to avoid taking it with dairy products or supplements containing minerals like calcium or iron because those can interfere with absorption,” he continued.

Korenblit said that based on Hilton’s video, it’s possible he may have taken something with NSAID (non-steroidal anti-inflammatory medication) such as ibuprofen or naproxen.

“[Oftentimes] cold and flu medications, even over-the-counter ones, contain NSAIDs to help with muscle aches and fever, and it is easy to take too many if you don’t pay attention to what’s in it,” he said. “Or if you have a very sensitive stomach.”

He later noted that “the most common medication-related culprits for peptic ulcers are NSAIDs such as ibuprofen, naproxen and aspirin.”

“Those drugs can injure the stomach lining and increase ulcer risk whether or not they are taken with food, although taking them with food may reduce short-term irritation and discomfort,” he said.

Korenblit said he “would not say it is universally true that medications used to treat the flu must be taken with food.”

“Some are prescribed that way to reduce nausea or stomach irritation, but that is not the same as saying that skipping food commonly leads to a gastric ulcer,” he said.

But Korenblit said that it is important to note that “take with food” instructions are there for a reason. “Patients should follow them exactly, even when the reason is ‘only’ to reduce irritation or improve tolerability,” he said.

Korenblit said that while, generally speaking, it’s “absolutely important” to take certain medications with food when instructed, “developing a true peptic ulcer from taking a medication without food is not something I would call common in the average patient.”

“The most common overall cause of peptic ulcers remains H. pylori infection, with NSAID use another major cause,” he continued. Helicobacter pylori infection is a stomach infection. While most people don’t have symptoms, the infection can cause stomach pain, bloating and gas, the Mayo Clinic states.

Korenblit said that Hilton’s reported sequence of having an ulcer, then perforation, then sepsis is “a recognized medical pathway, but it is not common.”

“This is a complication pathway we worry about because it is dangerous, not because it is routine,” he said. “The vast majority [of] people who take prescription flu medication do not develop ulcers, and most ulcers do not progress to perforation and sepsis.”

Dr. Brintha Vasagar, a practicing family medicine physician, emphasized that “most people who take medication on an empty stomach will NOT develop an ulcer.”

“In fact, some medications are best absorbed on an empty stomach or require avoiding certain foods or drinks,” she said. “It is always best to discuss medications with your physician, who can help you understand the best way to take your medications based on your past medical problems and how the medication works in the body.”

“Less than 15% of ulcers lead to a perforation, but about a third of these perforations lead to sepsis,” she later added. “While these outcomes are uncommon with flu medications, sepsis is very dangerous and becomes even more dangerous with a delayed diagnosis.”

Vasagar said that it’s important to remember that “all medications and supplements, even those you can get over-the-counter, can have serious impacts on your health.”

“Make sure you consult your family physician, who you can trust and who knows your history and preferences, so they can help keep you healthy,” she said.

Korenblit said that an important takeaway from Hilton’s story is that severe abdominal pain should never be brushed off.

“Especially if it is escalating, associated with weakness, inability to stand or walk normally, vomiting, fever, rigid abdomen, or a dramatic decline in overall condition,” he said.

“A perforated ulcer can sometimes be difficult to localize quickly, which is why patients may undergo multiple imaging studies and, in some cases, surgery to identify the source,” he continued. ”[Hilton’s] description of extensive infection found during laparoscopic surgery is consistent with how serious a perforation can become once infection spreads through the abdomen.”

Korenblit said that it’s important to “never improvise with prescription instructions.”

“If the label says take it with food, do that. If you are too sick to eat, call your doctor or pharmacist and ask what to do rather than guessing,” he said.

He also emphasized that you should never assume all stomach pain is minor irritation from medication, and that experiencing persistent or severe pain deserves immediate medical attention.

Additionally, Korenblit said that patients should keep a list of all medications they are taking — including over-the-counter pain relievers. And lastly, he emphasized that having the flu or another infection can make complications harder to recognize.

“When people are ill with flu or another infection, dehydration, poor oral intake, and frequent use of multiple medicines can all make complications harder to recognize and harder for the body to tolerate,” he said.

Always remember to talk to your health care provider about any concerns or questions you may have regarding medication instructions or symptoms you may be experiencing.

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