Instructions:

Bland diet. No chillies/ Sour/ Fried foods. More of milk.

Avoid strong tea and coffee. If taken take with some food not on empty stomach, Also avoid very hot and very cold liquids.

Smoking and Alcohol strictly prohibited.

Avoid gastric irritant drugs like Aspirin All NSAID’s (Ibuprofen, Diclofenac, Oxyphenbutazone). Steroids.

Have regular meals. Avoid periods of starvationtake small snacks in between.

Avoid late night duties, Take regular sleep ad adequate rest – avoiding mental tension and taking transquillisers in acute phase.

Drug Treatment:

Digene 2 tsp x tds x till all symptoms disappear (Antacid)

Tab. Ranitidine 150mg bd x 8 weeks or

Tab. Famotidine 4mg H.S x 8 weeks or

Cap. Omeprazole 20mg. OD (in morning) x 4 weeks or

Cap. Lansol 30mg ODx 4 weeks.

Tab. ALPRAZOLAM 0.25mg HS x 10 days i.e during acute exacerbation (transquiliser)

Additional drugs that may be added:

Tab. ULCERFATE 1gm. Qid x before meals x 4 weeks.

Tab. Anternyl 1 Qid x if colicky pain (oxyphenonium)

After 8 weeks repeat Gastroscopy.

If the ulcer is healed.

Stop treatment. If disease is long standing or recurrent, advise maintenance therapy for 6 months to 1 year to prevent recurrence.

Tab. Ranitidine 150mg HS x 6 months or

Tab. Famotidin 20mg x 6 months or

Cap.Omeprazole 10mg. OX x 6 months.

Avoid all stress factors, irregular meals, late nights, starvation, smoking, alcohol and irritant drugs.

If ulcer is not healed in 8 weeks.

Change the drug used e.g If Ranitidine was given, give Omeprazloe.

Add-Tab. Sucralfate 1g Qid x before meals x 4 weeks.

Tab. Pylocid 1 bd x 4 weeks (collodialBismuth)

If ulcer does nor heal, Refer for surgery.

If Ulcer heals but recurs frequently:

Ask for H Pylori in Gastrotrophic aspirations. If H. Pylori are preset advise triple therapy.

Pylokit 1 kit daily x 7days (Lansopprazole + Clarithromycin + Trinidazole)

Other Combinations:

Omeprazole + Amoxycilin + TInidazole.

Lansoprazole + Amoxycyiln + Tinidazole.

PAntoprazole + Amoxycilin + Trinidazole

Each kit or combipack contains 3 tablets for the morning and 3 tablets for the night 1.e one day’s dose.

Most case of duodenal ulcer will be cured by medical treatment. Only be cured and complicated cases (e.g Pyloric stenosis or bleeding) will require surgery)

A gastric ulcer is potentially malignant. So, Biopsy and follow up with Gastroscopy is very essential, and operation is advisable.

Digene

Tab. Ranitidine

Tab. Famotidine

Cap. Omeprazole

Tab. Anternyl

Tab. Sucralfate

Tab. Pylocid