Brief Answer:
Continue multivitamin for at least a month .. detailed answer as follows..

Detailed Answer:
Hello XXXXXXX Welcome to HCM,

I've gone through your query, also reviewed the images,

Well it looks like Aphthous ulceration. Now i'd like you to take a moment here and go through the following questions and answer them for a better approach to this scenario-

You have mentioned that the ulcers tend to recur every 2-3 months, so previously what all treatments have you taken for them ?

For how long have you continued the multivitamin supplement ?

Any particular history of medical illness(apart from the peptic ulcers) ?

How is your peptic ulcer problem now ? Any trouble currently ?

Any history of fever or loose motion in recent past ?

Please answer them so that I can guide you better.

However, for the ulcers please follow the advises as mentioned -

1. Change Becosule to COBADEX CZS (if not available then try to get a multivitamin supplement containing Zinc & Selenium ) and continue once daily after breakfast for at least a month from now.

2. Apply KENALOG Orabase solution over the ulcers 3-4 times a day instead of Smyle

3. Most importantly, try to use the Toothbrush with the softest of bristles (extrasoft ) preferably baby brushes not only for the time being but also for always. As Oro-dental trauma during inappropriate technique remains one of the most common causes for these.

4. Use Chlorhexidine mouth wash 2-3 times a day for the time being.

5. If you're still having acidity, sour brush , indigestion issues then restart Cap PANTOPRAZOLE 40mg 1 cap daily on empty stomach (15min before breakfast) for 10days

6. Avoid salty and deep fried foods instead take home cooked soft diet including lot of fresh green leafy vegetables along with a diet rich in animal protein.

7. Try to Maintain a regular bowel habits, as prolonged constipation tend to worsen the scenario in long term , try to have a high fiber diet.

You should be feeling better within a few days with all these. However , You need to be checked for Sr. Iron profile, Folic Acid as well as Vitamin B12 level since this is happening repeatedly.

Please let me know if there're any further queries.

Don't worry you'll be fine in a few days.

Take Care
Regards

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Brief Answer:
follow the advises.. maintain a healthy lifestyle..

Detailed Answer:
Hello Dear XXXXXXX

Welcome back to HCM,

Well , all those answers provided by you actually concludes the diagnosis, so nothing to worry.

Just go back to my previous reply , you'll find all the answers as well as management there.

Simply follow them like I've advised and don't suddenly stop them without consulting.

Since you're shift changes and you're again experiencing acid reflux so it's avdisable to restart the Pantoprazole as I've already mentioned but you must not skip breakfast / lunch . Eat light but eat something . Keep some biscuits/apple/ground nuts and chew them up , it'll be filling also and serve the purpose also.

It's good that you haven't experienced any fever/loose motion.

Maintain a healthy life style, eat in small portions but in frequent interval, try to have your dinner at least 2-2.5hrs before bedtime..

Avoid too spicy , outside junk foods , eat home cooked simple meal.

You'll be better in a few days only, but remember to maintain all these ..

Take care
Regards

In future, for any further queries you can contact me in my direct link, I'll be glad to help you

http://www.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=71041

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Brief Answer:
please follow the advises....

Detailed Answer:
Hello dear XXXXXXX Welcome back to HCM,

You can search in the pharmacy for TRIAMCINOLONE ACETONIDE 0.1% Oral paste (Generic Name) , there are several brands, like KENACORT Oral paste, XXXXXXX 0.1% oral Paste etc. you will find them , try the generic name otherwise..

I'm afraid Dentogel won't serve the purpose in this case, ask the pharmacist by generic name , you'll find it..

You can consume tea but not more than 2-3 cups a day, else it'll give you further acid reflux. Also don't drink it too hot(otherwise it'll aggravate pain and further burning of the ulcer) , mild/luke warm is fine.

Also try to follow all the advice at the same time as I've already mentioned to get a quicker response and relief..

Don't worry , you'll be fine..

Take Care
Regards


In future for any kind of queries you're having , you can simply click on my direct link to ask me, I'll be glad to help you, below is my direct link :
http://www.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=71041

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