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Celecoxib
1%
1/75
Increase milk consumption
0%
0/75
Low-fat diet
13%
10/75
Octreotide
12%
9/75
Smoking cessation
68%
51/75
Select Answer to see Preferred Response
The patient is presenting with peptic ulcer disease confirmed by upper gastrointestinal endoscopy. Smoking cessation is most likely to decrease symptom recurrence. Peptic ulcer disease occurs when gastric acid secretion overcomes gastrointestinal mucosal defenses. Patients with gastric ulcers present with mid-epigastric pain that often worsens with meals. Lifestyle changes known to decrease recurrence of symptoms include smoking cessation and avoidance of NSAIDs. Pharmacologic management may include mucosal protectors such as bismuth or sucralfate and acid controllers such as proton pump inhibitors or H2 receptor antagonists. If Heliobacter pylori is found, antibiotics are used for eradication. Incorrect Answers: Answer 1: Celecoxib is selective COX-2 inhibitor that may be less likely to cause gastrointestinal harm compared to non-selective NSAIDs. However, it would not be prescribed to prevent symptom recurrence or to manage peptic ulcer disease. Answer 2: Increasing milk consumption has not been shown to decrease symptoms in patient with peptic ulcer disease. Answer 3: Low-fat diets as well as avoidance of alcohol or caffeine may decrease symptoms in some patients with peptic ulcer disease, but studies are inconsistent. Answer 4: Octreotide is a somatostatin analogue. It is used in the management of carcinoid syndrome and VIPomas, not in peptic ulcer disease caused by Heliobactor pylori. Bullet Summary: Smoking cessation can decrease the recurrence of symptoms in peptic ulcer disease.
3.0
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