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Peptic Ulcer Disease

Case Study One


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?

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