S: Patient return often undergoing upper GI; not in as much discomfort as last visit. States...

S: Patient return often undergoing upper GI; not in as much discomfort as last visit. States he has been taking clear liquids and soft foods. Says he is hungry
O: lab results are back Chem 7shows slightly elevated glucose at 133. CBC and UA normal. Upper GI shows two small areas of ulceration.
A: Gastric ulcer.
P: Reduce omeprazole to 10 mg every day. Recheck glucose at return visits in 4 weeks.
E: Patient was advised not to smoke or chew tobacco, limit alcohol intake, and avoid aspirin, ibuprofen, and naproxen. Try acetaminophen instead. No diet restrictions indicated.
R: Patient was relieved, indicates there is no problem following the above plan and recommendation. MM/Tim

Expert Solution

This patient is suffering from a gastric ulcer.
Gastric ulcer is a condition characterized by denudation of the protective gastric mucosa in the stomach.
This patient has been prescribed omeprazole because it is a proton pump inhibitor. This drug blocks the H+/K+ ATPase pump. This helps to reduce gastric acidity.
Reduction in gastric acidity is an important measure to reduce the intensity and recurrence of the peptic ulcer. High gastric acidity overcomes the protective mechanisms in place to prevent acid damage to the mucosa
The patient has been advised against consuming aspirin, ibuprofen, and naproxen. These are non-steroidal anti-inflammatory drugs. They reduce the prostaglandins on the gastric mucosa (by inhibiting COX-1). Prostaglandins are cytoprotective. Loss of prostaglandins leads to gastric ulcer formation.
Assessment of complete blood count (CBC) is important. Sometimes, these ulcers may bleed. This bleed can cause anemia.

Nightingale answered 1 year ago

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