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What Causes Burning And Gnawing In The Epigastria Region?
A 45-year-old store manager complained of a burning, gnawing pain, moderately severe, almost always in the epigastric region. The pain is absent when he awakens, appears in midmorning, and is relieved by food but recurs two to three hours after a meal. The pain often awakens him at 1 or 2 a.m. An endoscopic examination and x-ray studies with barium showed normal stomach function but the presence of duodenal ulcers. Gastric analysis demonstrated that the gastric juice pH fell to 1.9 with pentagastrin stimulation (6µg/kg s.c.). Fasting serum gastrin levels were normal. Recommended treatments for this individual follow.
Antacids: 15-30 mL of liquid or two to four tablets one to three hours after each meal and at bedtime for six weeks.
Histamine (H2) receptor antagonists: cimetidine (300 mg) or ranitidine (150 mg) with each meal and at bedtime for four to eight weeks.
1. What is the diagnosis of this individual?
2. What is the significance of doing a pentagastrin stimulation test?
3. What is the significance of doing a fasting serum gastrin level?
4. What is the function of taking antacids?
5. How do the H2 antagonists act in treating this disorder?
6. What type of dietary and behavioral recommendations would also be suggested for this person?
Antacids: 15-30 mL of liquid or two to four tablets one to three hours after each meal and at bedtime for six weeks.
Histamine (H2) receptor antagonists: cimetidine (300 mg) or ranitidine (150 mg) with each meal and at bedtime for four to eight weeks.
1. What is the diagnosis of this individual?
2. What is the significance of doing a pentagastrin stimulation test?
3. What is the significance of doing a fasting serum gastrin level?
4. What is the function of taking antacids?
5. How do the H2 antagonists act in treating this disorder?
6. What type of dietary and behavioral recommendations would also be suggested for this person?
posted on
Fri, 14 Mar 2014
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Sun, 10 Dec 2017
Answered on
Tue, 12 Dec 2017
Last reviewed on
Hello dear
Warm welcome to Healthcaremagic.com
I have evaluated your query in details .
* Kindly find answers herewith for all your queries in details .
1. Diagnosis is duodenal ulcer with duodenitis .
2. Pentagastrin stimulation test reveals basal and stimulated acid
production by the parietal cells of the stomach , pH felling to 1.9
indicates precise stomach functioning .
3. Fasting serum gastrin level normal indicates there is no rise of gastrin
release from the circulation .
4. Antacids reduce excess acid , relieves pain of ulcer , simethicone content
relieves gas .
5. H2 antagonists block the action of histamine on the H2 receptors ,
helping to heal the ulcer .
6. Dietary modifications recommended
- Drink plenty of liquids .
- Prefer soft , light diet .
- Avoid oily , spicy , non veg , hot beverages , junk foods etc .
Behavioral recommendations
- Avoid stress , anxiety .
- Maintain regular sound sleep of 8 hours .
- Avoid smoking , alcohol if using .
Hope this will help you for sure .
Wishing you fine recovery .
Welcome for any further guidance .
Regards .
Warm welcome to Healthcaremagic.com
I have evaluated your query in details .
* Kindly find answers herewith for all your queries in details .
1. Diagnosis is duodenal ulcer with duodenitis .
2. Pentagastrin stimulation test reveals basal and stimulated acid
production by the parietal cells of the stomach , pH felling to 1.9
indicates precise stomach functioning .
3. Fasting serum gastrin level normal indicates there is no rise of gastrin
release from the circulation .
4. Antacids reduce excess acid , relieves pain of ulcer , simethicone content
relieves gas .
5. H2 antagonists block the action of histamine on the H2 receptors ,
helping to heal the ulcer .
6. Dietary modifications recommended
- Drink plenty of liquids .
- Prefer soft , light diet .
- Avoid oily , spicy , non veg , hot beverages , junk foods etc .
Behavioral recommendations
- Avoid stress , anxiety .
- Maintain regular sound sleep of 8 hours .
- Avoid smoking , alcohol if using .
Hope this will help you for sure .
Wishing you fine recovery .
Welcome for any further guidance .
Regards .
I find this answer helpful
Hello dear
Warm welcome to Healthcaremagic.com
I have evaluated your query in details .
* Kindly find answers herewith for all your queries in details .
1. Diagnosis is duodenal ulcer with duodenitis .
2. Pentagastrin stimulation test reveals basal and stimulated acid
production by the parietal cells of the stomach , pH felling to 1.9
indicates precise stomach functioning .
3. Fasting serum gastrin level normal indicates there is no rise of gastrin
release from the circulation .
4. Antacids reduce excess acid , relieves pain of ulcer , simethicone content
relieves gas .
5. H2 antagonists block the action of histamine on the H2 receptors ,
helping to heal the ulcer .
6. Dietary modifications recommended
- Drink plenty of liquids .
- Prefer soft , light diet .
- Avoid oily , spicy , non veg , hot beverages , junk foods etc .
Behavioral recommendations
- Avoid stress , anxiety .
- Maintain regular sound sleep of 8 hours .
- Avoid smoking , alcohol if using .
Hope this will help you for sure .
Wishing you fine recovery .
Welcome for any further guidance .
Regards .
Warm welcome to Healthcaremagic.com
I have evaluated your query in details .
* Kindly find answers herewith for all your queries in details .
1. Diagnosis is duodenal ulcer with duodenitis .
2. Pentagastrin stimulation test reveals basal and stimulated acid
production by the parietal cells of the stomach , pH felling to 1.9
indicates precise stomach functioning .
3. Fasting serum gastrin level normal indicates there is no rise of gastrin
release from the circulation .
4. Antacids reduce excess acid , relieves pain of ulcer , simethicone content
relieves gas .
5. H2 antagonists block the action of histamine on the H2 receptors ,
helping to heal the ulcer .
6. Dietary modifications recommended
- Drink plenty of liquids .
- Prefer soft , light diet .
- Avoid oily , spicy , non veg , hot beverages , junk foods etc .
Behavioral recommendations
- Avoid stress , anxiety .
- Maintain regular sound sleep of 8 hours .
- Avoid smoking , alcohol if using .
Hope this will help you for sure .
Wishing you fine recovery .
Welcome for any further guidance .
Regards .
I find this answer helpful
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