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Suggest Treatment For Gouty Arthritis, Upset Stomach And Reduced Food Intake

Posted on Fri, 22 May 2015

Question: My Dad is 82 yrs old with MM, gouty arthritis, diagnosed 3 months ago opted out chemotherapy. His complaining of upset stomach, hardly eat, not much liquid intake.
His stools is black with very strong odor for the past 2 days, is that indicate anything? Does he need to go to the hospital right away? Please help!

Thanks,
Vie

Answered by Dr. S. Samanta (10 minutes later)

Brief Answer:
High chance of bleeding from a stomach ulcer...

Detailed Answer:
Hi! thanks for writing to us sharing your father's health problem.

Black malodorous stools are indicative of upper gut bleeding could be in stomach or duodenum and underlying causes are: painkillers, esophageal varices, gastric or duodenal ulcers, infections, liver disease/cirrhosis etc.

I would suggest to stop painkillers if any and opt for tramadol-based/steroid based painkillers and take pantoprazole like anti-ulcer medicines and sucralfate-like syrup for ulcer healing.

It is an emergency medical condition and regarding his age, he needs close monitoring and fluids/blood; please attend ER ASAP.

Feedback welcome; regards,

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. S. Samanta (17 minutes later)

Thank you so much Dr. Samanta for your quick response. Hospital is 2hrs away by boat. For the main time should I give him pantoprazole? or wait until we see the doctor?

Thanks,
Vie

Answered by Dr. S. Samanta (8 minutes later)

Brief Answer:
Sure!

Detailed Answer:
Hi! please give him oral rehydration solution as much as possible if he can take by mouth and also omeprazole 4 m or pantoprazole 40 mg by oral route ....

regards,

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. S. Samanta (4 hours later)

Dr. Samanta,

Thank you very much for your help! we will give him omeprazole 4mg as directed.
Should he take it once a day? with or without meal? He drinks 1/2 milk (insure gold) twice a day. What's the best liquid intake we can give him besides water? He also drinks ginger tea every meal, is that good for him?

Thank you again,
Vie

Answered by Dr. S. Samanta (3 hours later)

Brief Answer:
Omeprazole 20 mg twice daily on empty stomach or 1 hr before foods

Detailed Answer:
Hi! 40 mg once daily or 20 mg twice daily, before foods or on empty stomach, with water.

the milk you mentioned is okay; any high calorie/glucose /semisolid mix foods are good for him.

ginger tea is okay.

Wishing him good health,

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Above answer was peer-reviewed by : Dr. Prasad