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Abstract: Gastric ulcer is a common gastrointestinal disease, and the specific symptoms are related to the degree of ulceration. The patient in this note was seen for paroxysmal abdominal pain with dilute watery stool, weakness, shortness of breath, chest tightness, poor eating and other uncomfortable symptoms. The results of the examination indicated that the gastric ulcer was cured.
Basic information】Female, 55 years old
Disease Type】Gastric ulcer
Hospital】The First Hospital of China Medical University
Date of consultation】August 2021
【Treatment plan】Medication (sodium omeprazole for injection, calcium carbonate tablets, bismuth citrate potassium capsules, clarithromycin capsules, metronidazole tablets, omeprazole enteric-coated tablets)
[Treatment period] 1 week of inpatient treatment, 4 weeks of home medication, 3 months of outpatient follow-up
Treatment effect】Gastric ulcer healing, disappearance of discomfort symptoms
I. Initial consultation
The patient, female, 55 years old, complained of paroxysmal abdominal pain with no obvious cause 10 days ago, diarrhea 1-5 times a day, dilute watery stool, accompanied by fatigue, shortness of breath, chest tightness, poor eating and other uncomfortable symptoms, but no obvious heartburn, acid reflux, because there are more children at home, so first went to the nearest local hospital for treatment, the specific medication is not known, and the uncomfortable symptoms did not improve, so come to our outpatient clinic, according to the patient’s complaints, performed According to the patient’s complaint, a barium meal examination was performed, and the results showed that there were prominent outward niche shadows, and the mucosal lines were aggregated to the niche shadows, and the results were consistent with the manifestation of gastric ulcer. To provide a basis for further treatment and diagnosis.
II. Treatment history
After admission, H. pylori test and gastroscopy were performed for further diagnosis, and the presence of H. pylori infection was confirmed by breath test. Fortunately, the pathological results were benign, and after communicating with the patient and his family and combining with the patient’s own condition, it was decided to adopt pharmacological treatment, giving injectable omeprazole sodium to inhibit gastric acid secretion, oral calcium carbonate tablets, bismuth citrate potassium capsules, clarithromycin capsules, metronidazole tablets to neutralize gastric acid and protect gastric mucosa, and combined with esophageal varices then dynamic observation, regular follow-up, and temporarily no special treatment.
III. Treatment effect
One week after the patient was treated with medication, the paroxysmal abdominal pain basically disappeared, and the bowel movement was basically normal, in addition, weakness, shortness of breath, chest tightness, poor eating and other uncomfortable symptoms have also improved, the re-examination of the gastroscopic ulcer has not completely healed, and still can detect Helicobacter pylori, but considering that the patient has no other obvious symptoms of discomfort, and the patient because of too many things at home, strongly requested to be discharged, to be discharged, and instructed the patient to be discharged after the need to The patient was discharged from the hospital and instructed to take omeprazole enteric tablets, bismuth citrate potassium capsules, clarithromycin capsules and metronidazole tablets for anti-H. pylori treatment.
IV. Notes
The patient was very happy to learn that all the results of the follow-up examination were normal, and I also felt relieved for the patient’s improvement, and repeatedly told the patient that although his condition had improved, he should not take it lightly because there is a certain possibility of recurrence of gastric ulcer. In daily life, it is necessary to pay attention to the regularity of life and avoid too much work, because excessive work and exertion may lead to autonomic disorders, which is not conducive to food digestion. At the same time, you need to eat three meals on time and reduce the consumption of chili peppers, strong tea and other foods or drinks that are too stimulating. Finally, you can strengthen nutrition, eat more easily digestible, high protein, high vitamin food, such as soy milk, eggs, and fresh fruits and vegetables, etc.
V. Personal insight
Because there are often no obvious symptoms of discomfort at the beginning of the disease, or like the patient in this note, it only manifests as discomfort in the upper abdomen, so it is not paid much attention to, but if regular treatment is not carried out in time, it may lead to serious consequences such as bleeding, perforation, or even hemorrhagic shock. In addition, like the patient in this article, patients with gastric ulcers mostly have H. pylori infection, and because of the high rate of H. pylori infection in China, patients are advised to share meals or use communal chopsticks and spoons during and after treatment to avoid recurrence of infection, which can lead to recurrence of gastric ulcers.