Recurrent Duodenal Ulceration —More Than Simple Peptic Ulcer Disease?

Question: A 77-year-old man with a pertinent medical history of dementia, recurrent small bowel obstruction resulting in small bowel resection secondary to intraabdominal adhesions related to a previous hernia repair resulting in small bowel resection, and nonsteroidal antiinflammatory drug (NSAID) –associated peptic ulcer disease presented with sharp epigastric abdominal pain, nausea, watery nonbloody diarrhea (approximately 4 bowel movements daily), weight loss, and intolerance to oral intake. Before admission, his medication regimen was 40 mg oral omeprazole daily, 1 g metformin twice dai ly, 1000 U cholecalciferol daily, 10 mg donepezil daily, and 5 mg metoclopramide as needed twice daily.
Source: Gastroenterology - Category: Gastroenterology Authors: Tags: Electronic Curbside Consult Source Type: research