Case study: Constipation and pharmacological management of peptic ulcer A 75-year-old female patient has visited the clinic with a presenting history of not having had a bowel movement for four days. She states that she is ‘always regular or every day. She lives in a residential home and suffered a sprained ankle two weeks ago, for which she has been taking co-codamol, which has been effective in managing the pain. She admits that the injury has restricted her movements, and she has been unable to ‘get about’ as she usually does. She also reveals that she has been experiencing heartburn regularly, especially after a spicy meal or after a glass of whisky, which she sometimes takes to help her to relax since the injury. She has been taking an antacid for the last few days, which initially helped, but she is still experiencing indigestion. She has a past medical history of hypertension and persistent atrial fibrillation (AF), for which she takes digoxin 125micrograms od, aspirin 75mg od, and ramipril 5mg od. On examination, she appears well. Her AF and blood pressure are well controlled, with BP 138/80mmHg, HR 72bpm, and ECG showing an irregularly irregular rhythm. Laxatives are prescribed for her. Consideration is given to withdrawing the co-codamol, but the patient states that she is still experiencing pain and that it is effective. She is also prescribed omeprazole to address the dyspepsia. A follow-up appointment is made for four weeks. QUESTIONS: What advice would you offer about taking antacids? What lifestyle advice would you discuss with the patient
Case study: Constipation and pharmacological management of peptic ulcer
A 75-year-old female patient has visited the clinic with a presenting history of not having had a bowel movement for four days. She states that she is ‘always regular or every day. She lives in a residential home and suffered a sprained ankle two weeks ago, for which she has been taking co-codamol, which has been effective in managing the pain. She admits that the injury has restricted her movements, and she has been unable to ‘get about’ as she usually does. She also reveals that she has been experiencing heartburn regularly, especially after a spicy meal or after a glass of whisky, which she sometimes takes to help her to relax since the injury. She has been taking an antacid for the last few days, which initially helped, but she is still experiencing indigestion. She has a past medical history of hypertension and persistent atrial fibrillation (AF), for which she takes digoxin 125micrograms od, aspirin 75mg od, and ramipril 5mg od. On examination, she appears well. Her AF and blood pressure are well controlled, with BP 138/80mmHg, HR 72bpm, and ECG showing an irregularly irregular rhythm. Laxatives are prescribed for her. Consideration is given to withdrawing the co-codamol, but the patient states that she is still experiencing pain and that it is effective. She is also prescribed omeprazole to address the dyspepsia. A follow-up appointment is made for four weeks.
QUESTIONS:
- What advice would you offer about taking antacids?
- What lifestyle advice would you discuss with the patient?
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