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Internally®
A Publication
of Atlanta South
Gastroenterology, P.C.

Anulcerisasore,orrawarea,intheliningofsome stools.Massivebleedingmaycauseshockandisamedical
part of the intestinal tract. Peptic ulcers typically occur in either the stomach or in the duodenum,
Less commonly, an ulcer may erode completely through which is the first several inches of the small intestine just the wall of the stomach or duodenum. This perforation re-below the stomach.
quires immediate surgery, and can be life-threatening.
The exact cause of all ulcers is unclear, but appears to If you think you may have an ulcer, you may obtain relief involve the combined effects of stomach acid, digestive by taking antacids or over-the-counter medications such as
enzymes, irritating medications, in some cases possibly bile, Tagamet-HB, Zantac-75,Pepcid AC,or Prilosec OTC. Avoid-
and in many cases a bacterial infection caused by an organism ing cigarettes, alcohol and medications such as aspirin and
named Helicobacter pylori.
ibuprofen will also help. Many ulcers may be healed by this The typical symptom of an ulcer is pain. Ulcer pain is often If symptoms worsen or persist beyond several days, how- gnawing, hunger-like sensation ever, consult your physician. Tests such as endoscopy or x-in the upper abdomen. Alterna- rays may be indicated to obtain a diagnosis and to ensure thattively, the painmay belocated in a more serious condition, such as cancer, is not present.
the upper chest, or radiate into Medical therapy may consist of the prescription strength the back. Ulcer pain is often of one of the same drugs available over-the-counter, or moremost intense when the stomach likely, a stronger agent such as Protonix, Prevacid, Aciphex oris empty, because there is noth- Nexium.
ing present to neutralize stom- Ulcers caused by Helicobacter pylori will be treated with ach acid, which induces pain when it comes into contact with a combination of ulcerthe ulcer. Pain is then relieved by eating or by taking an medication plus usuallyantacid. In other cases, however, especially with an ulcer in two antibiotics for a to-the stomach, eating may make the pain worse because eating tal of 7-14 days, oftencauses the stomach to produce more acid.
Additional symptoms of an ulcer may include nausea, loss of appetite, bloating after meals, and vomiting.
Ulcers occur in over 10 percent of the population, and tend to be morecommon in men than in women.Cigarette smoking, Nowadays, patients with ulcers are generally not advised heavy alcohol use, and the use of irritating medications such to restrict their diet, other than to avoid any specific foodsas aspirin, ibuprofen and other arthritis drugs, all seem to which worsen seem to their symptoms. A “bland” or “ulcer”increase the risk of developing an ulcer. Emotional stress and diet, which used to be prescribed before ulcer medicationsirregular, hurried meals may also play a role.
became available, is no longer recommended. In all cases, Complications from ulcers, other than pain, are rare.
however, tobacco products, alcoholic beverages and irritating Bleeding from ulcers may be slow and unnoticed, leading to medications such as aspirin and ibuprofen, should be avoidedthe development of anemia. Sudden, heavy bleeding may in order to accelerate healing and reduce the risk of ulcercause the vomiting of blood, or the passage of black, tarry recurrence.

Source: http://www.atlantasouthgastro.com/pdf/ulcer.pdf

Effective date:

University Care Advantage (HMO SNP) Step Therapy Webfile EFFECTIVE DATE: 04/01/2013 STEP THERAPY GROUP DESCRIPTION GLP-1 ANALOGS DRUG NAME BYDUREON STEP THERAPY CRITERIA PRIOR CLAIM FOR EITHER METFORMIN, METFORMIN ER, A SULFONYLUREA AGENT (E.G. GLYBURIDE, GLIPIZIDE), COMBINATION OF A SULFONYLUREA AND METFORMIN, A THIAZOLIDINEDIONE (E.G. PIOGLITAZONE, ROSIGLITAZONE),

College admission result

BOARD OF INTERMEDIATE AND SECONDARY EDUCATION, DINAJPUR List of Students of HSC Admission (Session 2013-2014) COLLEGE/THANA/ZILLA (EIIN): DINAJPUR ADARSHA COLLEGE/DINAJPUR SADAR/DINAJPUR (120820) SHIFT: DAY (BANGLA) EXPECTED GROUP: SCIENCE SL NO ROLL NO SSC PASS BOARD SSC PASS YEAR SELECTION STATUS N.B.: OWN - SAME SCHOOL & COLLEGE, DQ - DIVISIONAL QUOTA, ZQ - ZILLA QU

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