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Mr. JSM, a 63-year-old businessman, visited his general practitioner complaining of recurrent abdominal pain in his umbilical region, especially at night, that was relieved by food but not over-the-counter antacids. An endoscopy revealed acute ulcerations in his duodenum. He drinks 10 units of alcohol per day and takes medications including piroxicam and ciprofloxacin.
Mr. JSM, a 63-year-old businessman, visited his general practitioner complaining of recurrent abdominal pain in his umbilical region, especially at night, that was relieved by food but not over-the-counter antacids. An endoscopy revealed acute ulcerations in his duodenum. He drinks 10 units of alcohol per day and takes medications including piroxicam and ciprofloxacin.
Mr. JSM, a 63-year-old businessman, visited his general practitioner complaining of recurrent abdominal pain in his umbilical region, especially at night, that was relieved by food but not over-the-counter antacids. An endoscopy revealed acute ulcerations in his duodenum. He drinks 10 units of alcohol per day and takes medications including piroxicam and ciprofloxacin.
Mr JSM is a 63 year old active business man with a history of osteoarthritis. He visited his General Practitioner complaining of recurrent but mild pain at the umbilical region. The pain is extremely severe at night and relieved by food. However his symptoms did not respond to the over the counter Antacids he purchased from the pharmacy. SH: Mr JSM is married with three children, a non smoker and drinks 10 units of alcohol a day. Current medications Piroxicam 20mg daily for the management of Osteoarthritis Ciprofloxacin 500mg two times daily for the management of salmonella typhi infection Maalox Suspension Physical examination Normal: BMI- 30kg/m2 BP: 120/80 Laboratory investigations Hb 16g/dl PCV- 0.50 14 C Urea Breath Test negative GIT Examination Endoscopy Acute ulcerations in the duodenum just below the pylorus Stomach normal Diagnosis Duodenal Ulceration Now answer the following questions 1. What are the risk factors for Mr JSM duodenal Ulcer? 2. What are the signs and symptoms indicative of duodenal ulcer? 3. What therapy would you recommend for Mr JSMs Duodenal Ulcer? 4. Do Mr JSMs Current medications require review in light of his diagnosis and condition? Explain 5. How would you monitor Mr. JSMS therapy? 6. In direct Speech how would you counsel Mr JSM?