Question

Mike is a 46 year old who presents with a complaint of heartburn for the past 3 months. He describes the pain as burning and located in the epigastric area. The pain improves after he takes an antacid or drinks milk. He has been taken either over-the-counter famotidine or Ranitidine off and on for the past two months and he still has recurring epigastric pain. He has lost six pounds since his last visit. He is a nonsmoker. His examination is unremarkable. His blood pressure is 118/ 72. Laboratory values are normal including CBC and his serum H pylori test is positive. What is the plan of care for Mike? What education does he need?

Answer 1

Heart burn

A burning pain in the chest that is caused by stomach acid entering the gullet ( oesophagus).

Antacids

An agent that neutralizes or counteracts acidity, especially in the stomach is called antacids.

H. pylori

H. pylori bacteria belongs to Helicobacter family. This bacteria colonize in the stomach after entering into body, through ingestion. It remains harmless in some individuals, but in some people it causes ulcerations in the stomach mucosa. Stomach acids leaks into damaged mucosa, causes pain. Acid production is more in H. pylori infected persons, it result in reflux oesophagitis.

plan of care

* Administration of:

antibiotics ( metronidazole, amoxicillin),

H2 blockers antagonists( ranitidine, famotidine) to decrease acid production and proton pump inhibitors( pantoprazole, omeprazole) as per Doctor's order.

* Treatment may extend upto 2 weeks

Patient education

* Teach about H pylori infection and its causes and symptoms and management

* proper and timely intake of medicine without fail helps in faster recovery.

* Avoid spicy food and oily foods

* Yoghurt consumption will reduce the ulceration

* Stress may worsen the symptoms

* Avoid over use of NSAIDs( non steroidal Anti-inflammatory drugs)