Medical Practice

The most common adverse effect of omeprazole is headache. Diarrhea, not constipation, is another common adverse effect.

I’ve been having trouble with heartburn. In fact, it is one of the reasons I wanted to lose weight. I used to get it every once in a while, but then it started to get more frequent.

Anthony Jarvis, a man in his early fifties, asks you to recommend something for painful mouth ulcers. On questioning, he tells you that he has two ulcers at the moment and has occasionally suffered from the problem over many years. Usually he gets one or two ulcers inside the cheek or lips and they last for about 1 week.

Patterson, a young TV producer, leads a high-pressure life, smoking more or less continuously, eating irregularly and drinking large amounts of strong coffee to keep him going. His alcohol consumption is also high as he often feels the need to ‘chill out’ with a bottle of wine in the evening.

The agents used for acute treatment of diarrhea of mild-to-moderate severity (Table: Antidiarrheal agents) may also be used for control of chronic diarrhea resulting from IBD and IBS (Table: Drugs used to treat bowel disorders). When constipation is predominant, laxatives,particularly osmotic laxatives (e.g., magnesium oxide), are used as stool softeners (Table: Antidiarrheal agents). Octreotide, an analog of somatostatin, is used primarily to treat diarrhea stemming from GI tumors, AIDS, short-bowel syndrome, vagotomy, and dumping syndrome.

Available antacid preparations are used primarily to treat heartburn and dyspepsia. When given concomitantly with other drugs, antacids may reduce their absorption through direct binding or, as a result of an increase in gastric pH, by altering their dissolution or solubility. PPIs are generally considered the first-line drugs for treating acid-peptic disease as a result of their superior efficacy and safety profile.

A 48-year-old man presents for evaluation of heartburn. He reports a burning feeling in his chest after eating. It is worse when he eats spicy foods or tomato sauce.