Peptic ulcer is over diagnosed. Careful history and examination are essential. Lack of rapid symptomatic response to antacids makes peptic ulceration an unlikely diagnosis. Symptoms of many unrelated conditions mimic those of peptic ulcer. Protracted treatment without investigation to establish the diagnosis is wasteful and potentially harmful.
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NOTE
• H2-receptor antagonists should be prescribed only for ulcers proven on endoscopy or barium meal. Where appropriate, simpler measures indicated below should be tried first.
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1. “Ulcer diets” are unnecessary. Reduce spices, and avoid foods that exacerbate pain in individual patients.
2. Stop smoking and avoid alcohol.
3. Limit coffee/tea to 1 cup per day. Avoid carbonated drinks.
4. Drugs to be avoided: all non-steroidal anti-inflammatory agents, aspirin/aspirin compounds, steroids.
5. Encourage relaxation and regular exercise.
6. Antacids will alleviate symptoms in most cases; when given as shown below:-
Magnesium trisilicate (O) (2 chewable tablets) or 20 ml mixture as necessary upto 6 times daily.
Or
Aluminium hydroxide (O) 20 ml mixture (2 chewable tablets) taken as necessary up to 6 times a day.
