Medical Practice

Case: Agents for upper GI disorders. Questions – Answers

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

Heartburn in practice

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.

Mouth ulcers in practice

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.

The producer’s stomach ache

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.

Case: agents for lower GI disorders. Class

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.

Case: Agents for upper GI disorders. Class

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.

Case: Agents for upper GI disorders

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.

Jude’s sudden admission to hospital

Jude is a 22-year-old woman who was taken to hospital one morning complaining of knife-like, severe upper-abdominal pain, nausea, vomiting and fever. She stated that she had been feeling quite well until this morning, when her symptoms came on suddenly. On questioning, the patient admitted that she routinely consumed very large amounts of alcohol and that she had drunk rather more than usual during the preceding two weeks as she was ‘celebrating’.