What's the treatment and management?
40y/ M, complain upper abdominal pain since 2month. Chief Complaints Pain in upper abdomen. History Alcohol and ganja adicted near about 12-15 years and still now. Vitals Puls 92 bpm. SpO2 97% BP 130/80 mm/ hg Physical Examination Anorexia, loss of appetite. Weight loss with in 3-6month minimum 4kg.mind irritated, Sleep normal. Stool and urine normal. Investigations Upper GI Endoscopy If necessary investigation?? Diagnosis Ulcer?? Management Please suggest
Endoscopy suggests peptic ulcer and yes very well seen so cause of pain abdomen that is epigastric is understood Mental irritation is subject to his addictions alcohol and ganza Ganza is central stimulant hence increase puffing of ganza makes more excitable and irritant Also check LFTS Peptic ulcer to be treated by antibiotics like amoxyclav625mg 1bd Or clerithromicin 500mg 1bd for 15days Tab meteronidazole or ornidazole Deworming Antispasmodics Ppis Antacids with local anaesthetic like mucaine gel suspension or ulgel A suspension Tranquillisers for irritation Take help of deaddicticion centre
Peptic ulcer management clarithromycin 5 oo mg 1 bd for 14 days metrogyl 400 mg 1bd for 14 days omiprazole 20 mg hs. After 14 continue omiprazole sos. cyclospasmole sos for coliky pain avoid smoking and slcohole .
Started with behaviour therapy with dietary supplements... Treatment metronidazole 400 mg Cefixime 200mg Thaimine 100mg OD Omeprazole. 20 mg of Folic acid 5mg Lorazepam 3 mg sos Cont on 5 day course... With inj DNS 500ml with neurobion forte 1 ampule.iv of for 3 day... investigation LFT RFT usg Then can be started anti craving@ with withdrawal symptoms prevention medicine.... rehabilitation and couselling .
Peptic Ulcer just give jeshthamadh shankha bhasma combination for 3 months pt will be ok
Upper GI Endoscopy revealed Peptic ulcer. Key points: Ix: CBC,LFT,S.Amylase,S.creatinine,RBS,H.Pylori Tx: *Antibiotics *Antiulcerants + Antiemetic *Antipsychotic * Antispasmodic *Deworming Others drugs (if needed) will be used on the basis of reports. Advice: ● Take plenty of water ●Avoid addiction ( if it craves more, Psychological consultation ) ● Busy with work and building up social connections.
Inv: Upper abdominal USG should be done to rule out liver pathology. Blood for LFT Also needed. Follow standard guidelines for peptic ulcer disease. Advise to quit alcohol and ganja.
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