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Abstract: Gastric ulcer is a common digestive disorder, which mainly presents with paroxysmal pain in the upper abdomen, abdominal distension, and belching. The patient in this case is a 64 male patient who came to our department with the above symptoms 12 hours ago and was admitted with gastric ulcer. After quadruple therapy with tetracycline tablets, metronidazole tablets, bismuth citrate potassium capsules and omeprazole enteric soluble tablets, the patient’s condition gradually stabilized and his symptoms improved.
[Basic information] Male, 64 years old
Disease Type】Gastric ulcer (multiple gastric ulcers)
Hospital】The First Hospital of China Medical University
Date of consultation】February 2022
Treatment plan】Medication (tetracycline tablets, metronidazole tablets, bismuth citrate potassium capsules, omeprazole enteric coated tablets)
Treatment period】2 weeks of inpatient treatment, 1 month of outpatient follow-up
Treatment effect】The condition gradually stabilized and the symptoms improved
I. Initial consultation
The patient presented with epigastric paroxysmal pain without obvious cause about 12 hours ago, accompanied by abdominal distension and belching, no special treatment was performed outside, for further treatment, 120 was called urgently to the clinic. The patient was diagnosed with gastric ulcer (gastric multiple ulcers) and was admitted to our department. Since the onset of the disease, the patient had a clear consciousness, acceptable spirit, acceptable food intake, poor sleep, constipated stool and normal urine.
II. Treatment history
After the patient was admitted to the hospital, routine blood tests and H. pylori tests were completed, which showed elevated leukocytes and neutrophils, and positive H. pylori culture, suggesting the presence of inflammation and H. pylori infection. Clinically, the use of quadruple therapy is more effective for this type of disease, and after communicating with and gaining understanding from the patient, treatment was actively carried out. Tetracycline tablets and metronidazole tablets were given orally, combined with bismuth citrate potassium capsules, a gastric mucosal protector, and omeprazole enteric tablets, a proton pump inhibitor, for a 2-week dosing cycle. The patient was advised to have regular meals and a light diet, pay attention to vitamin and protein supplementation, and avoid the intake of greasy and spicy stimulating food.
Third, the treatment effect
After taking antibiotics, the patient’s blood was rechecked and the white blood cells and neutrophils returned to normal levels and the inflammation subsided. The patient took the proton pump inhibitor omeprazole enteric tablets orally to inhibit gastric acid secretion and reduce the irritation to the broken gastric mucosa, which relieved the patient’s epigastric paroxysmal pain symptoms. The gastric mucosal protector drug, bismuth citrate potassium capsule, can promote the healing of gastric mucosal ulcers. After the patient took the drug for 2 weeks and repeated endoscopy, the mucosal ulcers were basically healed, and the patient, abdominal pain and distension, belching and other discomfort symptoms were relieved.
IV. Precautions
After the patient’s condition improved, while I was happy for the patient, I did not forget to repeatedly emphasize to the patient and his family that gastric ulcer has a high tendency of recurrence and the following points need to be noted in life.
1, psychological factors may induce the occurrence of gastric ulcer, such as tension, anxiety, excitement, etc. Patients should pay attention to maintain a relaxed mood and avoid adverse emotions after discharge from the hospital.
2, to pay attention to dietary hygiene, reduce the opportunity to dine out, or choose clean and hygienic restaurant dining, pay attention to the regularity of the three meals, light diet, do not overeat, as well as the preference for spicy and stimulating food.
3. Avoid abusing drugs, such as dexamethasone and aspirin, which can cause damage to the gastric mucosa, and if such drugs are needed, they should be used under the guidance of a doctor.
V. Personal insight
Gastric ulcer is a common clinical disease of the digestive system, which can progress to gastric perforation and gastric bleeding when the condition is serious, causing serious adverse effects on the quality of life of patients. Therefore, once stomach pain, abdominal pain, bloating, anorexia, belching, acid reflux and other digestive reactions occur, attention should be paid to the hospital in a timely manner, under the guidance of a doctor to clarify the cause, and then actively carry out treatment measures, in the early stage of the disease is more effective, such as the patient in this paper, the onset of 24 hours to see a doctor, after treatment by a doctor effectively alleviated the symptoms, did not lead to more serious consequences.