Question

A 67-year-old retired businessman has a history of gastric ulcers and ulcerative colitis. He reports eating a well-balanced “mostly vegetarian” diet. He states he dislikes taking prescription drugs and prefers natural herbal remedies because they are “not toxic like drugs.” He takes a variety of herbal preparations to relieve his gastrointestinal problems although he admits he has not experienced any significant relief in symptoms. His doctor prescribed a proton pump inhibitor and sulfasalazine, which he states he takes “reluctantly.” He now reports frequent spells of nausea and occasional diarrhea and notes that he feels more tired than usual.

1. Based on his limited history, what are some common causes that may explain the patient’s nausea and diarrhea?

2. How would you caution him regarding the use of herbal products?

3. To whom would you advise this patient to report any problems or side effects he may experience with his medication?

Answer 1

• Gastric ulcers is a type of peptic ulcer that occur on the inside of the stomach , common clinical manifestations include nausea, vomiting and pain abdomen.
• Ulcerative colitis is an inflammatory bowel disease that causes inflammation and ulcers in your digestive tract. Ulcerative colitis affects the mainly innermost lining of our large intestine (colon) and rectum. common symptoms of ulcerative colitis are Diarrhea, with blood or pus, Abdominal pain and cramping, Rectal pain and Rectal bleeding
• based on the brief history of the patient he is suffering from gastric ulcer and ulcerative colits because of which he may be experiencing the symptoms such as nausea, vomiting and diarrhea. because of the frequent episodes of vomiting there will be fluid loss hence he is feeling tired and one more important point is, he is taking both herbal medicines and drugs prescribed by the doctor (proton pump inhibitor and sulfasalazine) together which might have aggravated the existing problems.it is  clear by his own words that the patient is not strict ih his treatment regimen and following both herbal medicines and allopthy medicines which further might have increased his problems.
• i would like to caution patient by quoting his own words as  he himself admits that he has not experienced any significant relief in symptoms by taking herbal medicines and he is taking it by his own without any presription.which might be dangerous and may cause other complications. and if the patient is so obsessed with the herbal medicines he will be advised to consult a doctor and take medicines as per the prescription.
• he should report to the treating doctor if he faces any problem related to his medication.