28
Ԑ̈Ⴌਜ
AVOIDING PITFALLS OF PEPTIC ULCER TREATMENT: INTERVIEWING CHIEF CONSULTANT
GASTRO-ENTEROLOGIST PROF GU TONGJIN OF THE SHANGHAI HUADONG HOSPITAL
According to Prof Gu Tongjin, a State-class gastro-enterologist of the Shanghai Huadong Hospital, the common gastric / duode-
nal ulcers are from acid erosion, then invasion by H pylori; eradicated by potent antibiotics. Pitfalls are: (1) Prolonged anti-ulcer
drug use: no better; as non-steroidal anti-inflammatory drug use, smoking, stress, etc., also counts; anti-ulcer drugs have ~70%
relapse rates; highest with "proton pump inhibitors" and lowest with bismuth preparations and Sulcralfate. (2) Combining Cimetidine
with Sulcralfate, Ranitidine, etc.: no better (3) Unaware that antacids prevents absorption of H2-receptor antagonists (4) Pro-
longed antibiotics use (>7-14 days: already 92% efficacy):invites side effects and resistance. Long-term bismuth affects the
brain: numbness of hands, tiredness, agitation, poor concentration and memory, etc. (5) Misbelief that no pain means healing. (6)
Diet therapy contributes little. Have regular meals; chew carefully; avoid snacks, especially before retiring; never overeat; refrain
from smoking; avoid excessive drinking, especially spirits; take less concentrated tea or coffee - all of these stimulate gastric
secretion!
ڮ
ආᆖဴᓹΥf
Ш݊d৷ই
ٴ
e
৷ஐͣ
ي
Ϙఱ
ቮ͛ኪ
ה
щ
֛fᎇഹlzᗝҦ
ஔٙ೯࢝eҵა
ᖹ
ي
ٙႡϓ̌dԴᆖဴٙᖹ
طي
ᐕৎəɓϣࠧնf
νʦdɽεᅰਖ਼Ⴉ
މ
භᐕ
ج
࿁ᆖဴٙ
ط
ᐕЪ͜
ܘ
ʃdᏐ༈ོᎸઃ٫͍੬භfఱ݊Ⴍdෂ୕ٙᐕ˙
ό̙˸ʔ͜əfШ݊dίභ˙ࠦ
ࠅ
ਂՑධ
ء
จj
ɓeϞ
ܛ
ή֛ࣛආd˸ၪ͍ܵ੬ऊʷҡ
ܛ
dҚַ
፰ආfɚeᘍ࿔ۚdආʔ֝ཀ
ܢ
fէᘍ̙˸ᄣ
̋ఌ૰ʱ
ؤ
dঐᙑձʕձ
ߞ
აdԨ̙˸৷
ߞ
ῡ
ᇫٙ܈ღЪ͜fৰϤʘ̮dᒔც
ءࠅ
จᒒеཧdွ
ۃ
ʔආdභʔ֝ཀཱིf௰ࠠ
ࠅ
ٙ݊і٫̀
ҡdϞɛਂཀˢ༰dᆖဴઃ٫
ط
ᓹ
ܝ
ɓϋᝈ࿀d೯
ତі٫ɓଡ଼ٙూ೯ଟ৷༺
80%
d
ڢ
іɓଡ଼ూ೯ଟ
݊
52%
dɚ٫ࢨମᜑfᒔ
ࠅ
Қडৢձዢdৢঐ
Դ
ߞ
აʱ
ؤ
ᄣ̋dৢɰঐฦ
ߞ
ῡᇫ܈ღdฦ
ܓ
ၾৢၚўඎϓ͍ˢfዢఀդਥɰঐՐዧ
ߞ
აʱ
ؤ
dɰᏐ༈ቇࠢՓf
೨ߞ
ऊ̰у৾ᖹ
ᚥϼࢪႭdவ݊ɓ
ࡈ
၌ԐΣ̤ɓ
ࡈ
၌əfϞٙ
ɛ˸
މ
d
ߞ
ʔ೨ədषఱλədఱʔც
ࠅ
͜ᖹədவ
ɰ݊፹Ⴌٙfऊʷᆖဴ
90%
̸̛МϞ໖೨dఱ݊
ڳ
၈ٙ
ߞ
़dഗषɛ੭Ը೨߮fவ၇
ߞ
़ՈϞ
ڗ
ಂe
ˀూeಂeື
ܛ
ഃतᓃdɰ݊ᆖဴष
ط
ᐕٙ
ࠅ
ͦᅺfШ݊dᆖဴष
ط
ᐕٙͦᅺ݊
ڮ
ආᆖဴ
ᓹΥdԣ˟Ԩ೯सձཫԣూ೯f͜ᖹ˸
ܝ
d
ߞ
़̙ঐ
ऊ̰ədШᒔʔഃᆖဴᓹΥdΪϤdʔঐཀϘ৾
ᖹfɓԬҤ
აᖹ
ي
ΪՉϞʕ
ձ
ߞ
აٙЪ͜d
˟़ࣖ
؈
ᜑd
ᒱ್
ߞ
ʔ़əd
ᒔც
ࠅ
ܲᐕ
ᅺ͜ᖹd˸ಂ
༺ՑᆖဴᓹΥٙ
ͦᅺf
ऊʷᆖဴც
ࠅ
ᐕk
භᐕ
ج
ಀႩ
މ
݊
ط
ᐕऊʷᆖဴٙϞࣖ˓
ݬ
d
˴
ࠅ
݊ஷཀ৷ই
ٴ
e৷ஐͣሯ
ي
ᙑձʕձ
ߞ
აd