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Med_Hive Series || Doctor Talk: Menstrual Pain and Peptic Ulcers

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I had just finished my launch in the cafe and returning to my consulting room when I heard a noise on the floor,
"Doctor, Doctor" the Nursing Assistant had screamed
"E M E R G E N C Y"

Quickly I dashed out, I felt my stomach rumble as my just recently eaten food was still acclimating to the terrain of my stomach, and I was recovering from the sudden hypoglycemia of the day. But this wasnt about me was it?, so I totally forgot about myself and reached for some gloves and off to the resusce room. There she was losing, browning in pain and coursing .. She was in severe abdominal pain, first of its kind, never felt it that bad.
I tried to calm her and those with her down and did the needful.

About 30% of population at some point complain to have menstrual pain, these pain varies from lower abdomen to generalized abdominal pain often resulting in usage of stronger analgesics for pain relief. Some of them get better but some don't until after several doses of the medication.
As a Dr, I have seen several of these cases and the one spotted above is just a representation of them all.


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They often have a history of chronic pain, usually menstrual pain in women of reproductive age group, or after a surgery. For some, it is just self medication, which is still a very common practice in this part of the world. They use a group of drugs called Non Steroidal Antiinflammatory Drugs,(NSAIDS for short, e.g. diclofenac) which a very good causing them relief, but causes another kind of pain it can not suite, Gastric ulcer.

An easier way to see it is this. NSAIDS reduce the protective layer in the stomach against acid burns, by reducing the level of protective prostaglandins (a proteinous substance known to help insulate the stomach walls from acid burns) in the gastric mucosa, making them prone to burns, from the highly concentrated gastric (stomach) acid, which contains HydroChloric acid mostly. This acid is secreted very "hot" at PH 1, before it subsequently gets diluted by gastric juices. Still, the acid can still do its harm if the protective mucin layer is lost.

Now the ulcer pain kicks in, while the menstrual pain has resolved. Thats like robbing peter to pay Paul right.. Only in this case, its a side effect clearly written on the drugs, and more so if it were prescribed by a Doctor, you would have been told how to take such drugs if it were last resort.

2 days she was much better, she had felt the pain subside after some proper assessment and adequate medications for the peptic ulcer was commenced, however, she knows better to finish her dosage and to also never self medicate with drugs that need to be prescribed.


This is Med-Hive, A new series of medical case stories and short explanations on the case, symptoms and slight clinical insight.
This does not aim at giving any medical advice as your doctor would do that after proper review involving history taking, physical examination and necessary investigations. However, a healthy society can only thrive with healthy information's like this.
I will also love to entertain your questions in the comment section.
Thanks for Reading.

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