Patient 28yrs old male was diagnosed by typhoid and had taken the treatment regularly but having abdominal pain and vomiting after meals. He is also regular smoker. And is taking plenty of Juices.

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These reports are normal hence no relation with presenting complaints so far pain abd and vomiting is concerned that may gastritis or your clinical examination will help in diagnosis you can treat it symptomatically

Thanx dr Aftab Alam
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reports are normal there may be drug induced gastritis . advice only cap pantop dsr 1 od a/c for 10 days tab. neurobion forte 1 od for 20 days. ask him to quite smoking. also stop taking juices as they are acidic cause gastric irritation more better to drink milk. if patient had severe pain abdomen or distension with tenderness go for x ray abdomen erect and usg whole abdomen to see if perforation which might be one of the complication of typhoid.

Usg whole abdomen is normal
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As serum bilirubin is normal we have to consider this case as a c / o gastritis .Treat the patient with antacids, pentodac and Domstal. If pain and vomiting doesn't subside by this measures keep eyes open for perforation as it is common in enteric fever. Than go for plain x ray of abdomen in standing position.

The vomiting and pain maybe due to drug induced gastritis If you feel that he has not been treated properly for enteric fever Give iv ceftriaxone 2 gems iv bd for at least 10 days There's no point giving any drug orally as the patient is vomiting

Advise, USG.abdoman, post typhos gastritis, or enteritis is possible,meantime ,rabiprazole+domperidone SR. may be given with running medicines.

Thank you doctor.
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These reports are normal, no relation with presenting complains.

Adv USG FULL ABDOMEN Confirm gasttritis या same things other (typhoid perforation) cause pain Then manage

Most likely hiatus hernia or ulcer endoscopy 4 hr fasting requires with h pylori

We can do a upper GI endoscopy to ruleout diseases of Oesophagus,Stomach and Duodenum.Severe Gastritis,Oesophagitis, Duodenal ulcer etc are possibilities.

Gastritis Peptic ulcer/ H pylori to rule out Required upper Gi scopy/urea breath and biopsy

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