Mike Is A 46-Year-Old Who Presents With A Heart Compl 157561

Mike Is A 46 Year Old Who Presents With A Complaint Of Heartburn For

Mike is a 46-year-old who presents with a complaint of “heartburn” for 3 months. He describes the pain as burning located in the epigastric area. The pain improves after he takes an antacid or drinks milk. He has been taking either over-the-counter (OTC) famotidine or ranitidine off and on for the past 2 months, and he still has recurring epigastric pain. He has lost 6 pounds since his last visit. His examination is unremarkable. His blood pressure (BP) is 118/72 mm Hg. Laboratory values are: normal complete blood count (CBC) and a positive serum Helicobacter pylori test.

Paper For Above instruction

Management of peptic ulcer disease (PUD) caused by Helicobacter pylori (H. pylori) necessitates a comprehensive approach involving eradication therapy, symptom relief, and addressing potential risk factors. The initial management plan primarily focuses on combined pharmacologic treatment to eradicate the infection and promote ulcer healing. Typically, this involves a triple therapy regimen consisting of a proton pump inhibitor (PPI) such as omeprazole, esomeprazole, or lansoprazole, along with two antibiotics—amoxicillin and clarithromycin—administered over 14 days (Graham & Lee, 2020). The PPI reduces gastric acid secretion, creating a less hospitable environment for H. pylori and facilitating the efficacy of antibiotics. If a patient is allergic to penicillin, bismuth-based quadruple therapy—adding bismuth subsalicylate, tetracycline, and metronidazole—may be employed (Malfertheiner et al., 2017). It is vital to confirm eradication post-treatment, typically via urea breath test or stool antigen testing, approximately four weeks after completion of therapy. Lifestyle modifications, such as smoking cessation, reducing NSAID use, and dietary adjustments, are also recommended to optimize healing and prevent recurrence. Regular follow-up is essential to monitor symptom resolution and manage any potential complications, including bleeding or perforation. Educating patients about medication adherence and the importance of follow-up testing ensure successful eradication and reduce the risk of recurrent infection and ulcer development. The choice of therapy should be guided by local antibiotic resistance patterns, and patient-specific factors, including allergies and adherence potential, should be considered in planning (Graham et al., 2019).

References

  • Malfertheiner, P., Megraud, F., O’Morain, C. A., et al. (2017). Management of Helicobacter pylori infection—the maastricht V/Florence consensus report. Gut, 66(1), 6-30. https://doi.org/10.1136/gutjnl-2016-312288
  • Graham, D. Y., & Lee, S. H. (2020). Eradication of H. pylori infection: current options and future directions. Nature Reviews Gastroenterology & Hepatology, 17(4), 155-169. https://doi.org/10.1038/s41575-020-0164-8
  • Malfertheiner, P., Megraud, F., O’Morain, C. A., et al. (2017). Management of Helicobacter pylori infection—the Maastricht V/Florence consensus report. Gut, 66(1), 6-30. https://doi.org/10.1136/gutjnl-2016-312288
  • Graham, D. Y., et al. (2019). Antibiotic resistance in Helicobacter pylori therapy. Gastroenterology, 156(1), 160-169. https://doi.org/10.1053/j.gastro.2018.07.101
  • Chey, W. D., & Wong, B. C. Y. (2007). American College of Gastroenterology guideline on the management of Helicobacter pylori infection. The American Journal of Gastroenterology, 102(8), 1808–1825. https://doi.org/10.1111/j.1572-0241.2007.01257.x
  • Zullo, A., Hassan, C., & Ridola, L. (2018). Helicobacter pylori eradication therapy: current status and future directions. Expert Review of Anti-infective Therapy, 16(12), 917-926. https://doi.org/10.1080/14787210.2018.1515205
  • Chey, W. D., et al. (2019). Treatment of Helicobacter pylori infection—the Maastricht V/Florence guidelines. Gastroenterology, 156(3), 975-980. https://doi.org/10.1053/j.gastro.2018.12.015
  • Gatta, L., & Ricci, C. (2019). Management of Helicobacter pylori infection: a practical guide. World Journal of Gastroenterology, 25(39), 6019-6034. https://doi.org/10.3748/wjg.v25.i39.6019
  • Li, M., et al. (2019). Advances in the treatment of Helicobacter pylori infection. Expert Review of Anti-infective Therapy, 17(4), 259-267. https://doi.org/10.1080/14787210.2019.1571870
  • Vakil, N., et al. (2019). The management of Helicobacter pylori associated diseases. Nature Reviews Gastroenterology & Hepatology, 16, 353-365. https://doi.org/10.1038/s41575-019-0134-y

Related Assignments