Ulcer symptoms

Although there is no need for a special diet, patients should avoid foods and beverages that cause dyspepsia or exacerbate ulcer symptoms (e.g., spicy foods, caffeine, alcohol). 

Circunstantial evidence directly implicating dopamine in the pathogenesis of duodenal ulcer in man is the unusual incidence of peptic ulcer disease in dopamine-deficient disorders. From purely descriptive clinical and epidemiologic studies we know that patients with Parkinson s disease, before the introduction of dopamine therapy, had an excess of ulcer disease (72). One report even comments on the curiosity that after initiation of L-DOPA administration the ulcer symptoms have virtually disappeared (72 ). On the other hand, less clearly, schizophrenia which is associated with dopamine excess and/or receptor hyperactivity is accompanied by virtual lack, or decreased prevalence, of peptic ulcer (73-76). Schizophrenia associated with ulcer disease has been viewed as a reportable curiosity in medical literature (75). At present, possibly because of the widespread therapeutic application of neuroleptics, the lack of peptic ulcer disease in schizophrenics is less striking than in the past. On the other hand, we recently observed in our autopsy series perforated duodenal ulcers in two schizophrenic patients who had been on large doses of haloperidol therapy (Szabo, unpublished observation). Thus, even in man, dopamine may indeed be implicated in the pathogenesis of duodenal ulcer disease. 

Pepcid AC anticipated customers from two distinct but related markets traditional OTC antacids and the prescription H2 market. The overlap between the two categories was substantial, as physicians had increasingly prescribed H2 blockers for the relief of GERD and heartburn, even when no ulcer symptoms were present. 

Intravenous administration (in the treatment of ureteric colic) is effective and well tolerated. However, in 90% of patients who receive slow (5 minutes) intravenous injection, hypertension, nausea, vertigo, vomiting, and peptic ulcer symptoms have been documented (65). Intravenous administration should be avoided in patients with heart failure. 

Patients with peptic ulcer disease should reduce psychological stress, cigarette smoking, and nonsteroidal antiinflammatory drug (NSAID) use, and should avoid foods and beverages that exacerbate ulcer symptoms. 

Ulcer-related perforation into the peritoneal cavity occurs in about 7% of patients with PUD. The incidence of perforation is increasing with the increased use of NSAIDs. Mortality is usually higher for perforated gastric ulcer than duodenal ulcer. The pain of perforation is usually sudden, sharp, and severe, beginning first in the epigastrium, but quickly spreading over the entire abdomen. Most patients experience ulcer symptoms prior to perforation. However, older patients who experience perforation in association with NSAID use may be asymptomatic. Penetration occurs when an ulcer burrows... 

Patients with PUD should eUminate or reduce psychological stress, cigarette smoking, and the use of nonselective NSAIDs (including aspirin). Although there is no antiulcer diet, the patient should avoid foods and beverages (e.g., spicy foods, caffeine, and alcohol) that cause dyspepsia or that exacerbate ulcer symptoms. If possible, alternative agents such as acetaminophen, nonacetylated... 

All five PPIs provide similar ulcer-healing rates, maintenance of ulcer-healing rates, and relief of ulcer symptoms when used in recommended dosages (see Table 33-8). When higher dosages are indicated, the daily dose should be divided in order to obtain better 24-hour pH control. A dosage reduction is not necessary in renal impairment or older adults, but should be considered in severe hepatic disease. ... 

The ingestion of salicylates may result in epigastric distress, nausea, and vomiting. Salicylates also may cause gastric ulceration, exacerbation of peptic ulcer symptoms (heartburn, dyspepsia),... 

Anyone can get an ulcer. Most ulcers are caused by an infection with the bacterium Helicobacter pylori— not spicy food, acid, or stress—and can be cured with antibiotics in about two weeks. The most common ulcer symptom is burning pain in the stomach V2-IV2 hours after eating with gastric ulcers 2-3 hours for a duodenal ulcer. 

Cardiovascular A 17-year-old man with a 3-year history of ulcer symptoms, diarrhea, and bouts of abdominal colic developed severe hypotension (50/20 mmHg) after receiving intravenous metoclopramide for acute vomiting with diarrhea [9 ]. He then developed pneumonia, rhabdomyolysis, renal tubular necrosis, and disseminated intravascular coagulation. A diagnosis of gastrinoma was made. During hormonal assessment, he received a second dose of... 

---