The Indian Practitioner

Kaushal Vyas ¹

Affiliations
1 Department of Gastromedicine, Sheth V. S. Hospital and N.H.L. Muni. Medical College, Ahmedabad, IN

Abstract

Peptic ulcer disease is a common GI disorder. In the last few decades infection with H. Pylori was associated with most ulcers in duodenum. NSAIDs use is another common cause for peptic ulcers. With advent of effective anti-secretory drugs and antibiotic regimen against H. Pylori, complete cure of peptic ulcer is possible in majority of cases. Antacids were initially used for ulcer diseases, which is now replaced almost completely by proton pump inhibitor (PPI). PPI remains the mainstay of therapy in uncomplicated peptic ulcer in addition to treating H. Pylori infection when present. Histamin-2 receptor antagonist (H2RA) and muco-protective agents are used in selective cases. Use of non NSAID analgesics and identifying high risk group patients on long term aspirin can minimize peptic ulcer disease. Role of diet in inducing or treating peptic ulcer disease remains controversial at best. Endoscopy remains the investigation of choice for diagnosis of peptic ulcer, as it also allows biopsy for H. Pylori and from suspicious area as well. Complications like bleeding and mortality from peptic ulcer disease also has decreased over time due to effective treatment strategies.

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Kaushal Vyas ¹

Affiliations
1 Department of Gastromedicine, Sheth V. S. Hospital and N.H.L. Municipal Medical College, Ahmedabad, Gujarat, IN

Abstract

Acute upper GI bleed is a common emergency in gastrointestinal practice. In primary clinic setup these patients can be managed initially for stabilizing them clinically and transferring them to speciality center for further management.

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Kaushal Vyas ¹

Affiliations
1 Dept. of Gastromedicine, V.S. Hospital, Ahmedabad, IN

Abstract

IBS is one of the commonest diagnoses made in OPD practice of a GI physician. Even primary care physicians encounter such patients very frequently in their day to day practice. Abdominal pain associated with altered bowel habit is a characteristic feature of this disorder. IBS is a clinical diagnosis, and many diagnostic criteria are available. IBS is sub-grouped as diarrhoea predominant, constipation predominant and mixed type. The exact cause of IBS is not certain. However, many factors including genetic predisposition to psychological stress is implicated. Most investigations ordered in IBS patients are to rule out other serious underlying diseases, and in majority of the cases, they are superfluous. The treatment options available are mainly symptomatic, and that’s why tailor-made therapy is required in each patient. There are numerous pharmacological and non-pharmacological options, which give significant benefit to the patients of IBS in symptom relief if used judiciously. Disease modifying therapy for IBS is not available currently, so the “cure” for the disease is not feasible with current medications.

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