According to the assessment, Mike's blood pressure is 118/72. His blood count is also normal, according to the lab values. The H. pylori test shows a positive serum. Initially, I would prescribe 40 mg of Famotidine at bedtime. The dosage would be ideal for a peptic ulcer case coupled with heartburn complaints as well as epigastric pain along with unexplained weight loss. I would prescribe the Famotidine medication for eight weeks. The famotidine prescription would not be enough to address the other side effects. In this case, I would prescribe other medication to alleviate the side effects. The medication includes tetracycline 375mg, metronidazole 375mg as well as subcitrate 420mg. The dosage would be taking each of the three medicines four times every day for ten days. I would also advise Mike to take the medication at bedtime and after taking meals. The medication would be aimed at treating ulcers to eradicate H-pylori.
If the patient had GERD, it is obvious that the treatment would vary. In the case of GERD, I would manage the condition by teaching Mike to avoid any factor likely to aggravate his condition. Some of these factors include taking carbonated beverages, tobacco, caffeine. Instead of these foods, I would advise Mike to take food rich in fiber as well as low fat. I would also prescribe Famotidine, but in this case, the length of time would be longer. The ideal time would be for three months.
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Discussion Question
Confirmation of GERD would require a differential diagnosis. The diagnosis would help in ruling out the other possible condition. The differential diagnosis would include Angina Pectoris, as well as Reflux esophagitis. According to Mayo Clinic, 2019, the Angina pectoris would result from reduced flow to the heart. Some of the symptoms that would be sweating, dizziness, shortness of breath, nausea, pain in back or shoulder, jaw, neck, as well as in the arm. Reflux esophagitis entails an inflammation that damages the esophagus tissues. Some of the symptoms, according to Mayo Clinic, include painful swallowing as well as difficulty swallowing. The peptic ulcers are characterized by the ulceration of the small intestines coupled with burning stomach pain, nausea, heartburn, belching, or bloating as well as fullness feeling (Mayo Clinic, 2019).
GERD can be treated using over the counter options with the most popular being antacids ("Gastroesophageal reflux disease (GERD) - Diagnosis and treatment - Mayo Clinic," 2019). The antacids act as bases neutralizing the acid in the stomach. The ache production can be dealt with using ranitidine as well as Famotidine. Prilosec medicine is crucial in blocking the production of acid as well as healing the esophagus. One can also use H-2 receptor blockers, proton pump inhibitors as well as Baclofen. The H-2 receptor blockers are good in decreasing acid production and providing longer relief. The proton-pump inhibitors allow the damaged esophageal tissue to heal while Baclofen strengthens the lower esophageal sphincter.
GERD confirmatory test includes Upper endoscopy, ambulatory acid (pH) probe test, esophageal manometry test, as well as an x-ray of the patient's upper digestive system. During the endoscopy test, the doctor inserts a flexible, thin tube with lighting down the patient's throat to examine the inner side of the stomach as well as the esophagus. The ambulatory acid (pH) probe test gives information on how, as well as when the stomach acid regurgitates.
References
Gastroesophageal reflux disease (GERD) - Diagnosis and treatment - Mayo Clinic. (2019). Retrieved 2 December 2019, from https://www.mayoclinic.org/diseases- conditions/gerd/diagnosis-treatment/drc-20361959
Peptic ulcer - Symptoms and causes. (2019). Retrieved 2 December 2019, from https://www.mayoclinic.org/diseases-conditions/peptic-ulcer/symptoms-causes/syc- 20354223
