The document outlines a treatment plan for ulcers, including medications to take (ranitidine, omeprazole, amoxicillin), avoiding certain exercises and foods, quitting smoking, following up with a doctor, and seeking immediate care for severe symptoms like abdominal pain or bloody vomit. Exercise is recommended but to avoid straining the abdomen. The patient should reduce stress, not stop medications without consulting their doctor, and contact their doctor if symptoms worsen or new ones arise.

1. XI. Planning Discharge
Medications:
 Ranitidine 150 mg, Orally Once a day, before bedtime
 Omeprazole 20 mg orally Once a day, before meal
 Amoxicillin 500 mg Tab, Twice a Day
 Avoid drugs such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn).
Take acetaminophen (Tylenol) to relieve pain. Take all medicines with plenty of water.
Exercise:
 Abdominal exercises such as crunches and sit-ups are used to tighten abdominal muscles.
These exercises increase intra-abdominal pressure, which can worsen heartburn and other
symptoms of ulcers. Vigorous abdominal exercises may also cause existing ulcers to
perforate through the wall of the stomach. If you experience sudden severe abdominal
pain after engaging in abdominal exercises, seek immediate medical attention.
(http://www.livestrong.com)
Regular physical exercise can help improve ulcers and your overall health. Exercise also
prevents ulcers from becoming complicated. Participate in physical exercise such as
walking, bicycling, swimming, cycling and jogging. Avoid exercises that strain the
abdominal region. (According to a study published in the "Western Journal of Medicine)
Treatment:
 Stop smoking. Tobacco will slow the healing of your ulcer and increase the chance that
the ulcer will come back. Talk to your doctor about getting help for quitting tobacco.
Health Education:
 Try to reduce your stress level and learn ways to better manage stress.
 Do not just stop taking medicine without talking to your doctor first.
Out Patient Follow-Up:
 You will have follow-up visits with your doctor to see how your ulcer is healing.
 Your doctor may want to perform an upper endoscopy after treatment to make sure
healing has taken place.
 You will also need follow-up testing to check that the H. pylori bacteria are gone. You
should wait at least 2 weeks after therapy is completed to be retested. Test results before
that time may not be accurate.

2. Diet:
It does not help to eat more often or increase the amount of milk and dairy products you
consume. These changes may even cause more stomach acid.
 Avoid foods and drinks that cause discomfort for you these include alcohol, coffee,
caffeinated soda, fatty foods, chocolate, and spicy foods.
 Avoid eating late night snacks.
 Eat small meals more often rather than big meals less often. An empty stomach may
make your symptoms worse.
Social:
Contact your doctor if:
 You have a fever.
 You have diarrhea or constipation.
 Your stomach pain does not go away or gets worse after you take medicine.
 You have questions or concerns about your condition or care.
Seek care immediately if:
 You have a fast heartbeat, fast breathing, or are too dizzy or weak to stand up.
 You have severe pain in your stomach.
 Your vomit looks like coffee grounds or has blood in it.
 Your bowel movements are bloody or black
 You have sudden shortness of breath.