pt sx not responsive to dietary changes or stress reduction. stress (cortisol) decreases prostaglandins 327 (roles of cortisol). so were told that shes reduced her stress so logically her cortisol would be less, disinhibiting prostaglandin production. But her Sx still persist? thats why i ruled out misoprosol. also i remember from sketchy that ppis are irreversible tbh im not really sure if my logical flow is right, but like the guy in the other comments said, omeprazole always. just like ACEi and octreotide baby
well...in FA2018 said misoprostol increase production of GASTRIC mucosa and the question said ESOPHAGUS mucosa....maaaay be is that reason
just a hunch.... Omeprazole is always the right answer
submitted by โhpsbwz(98)
Omeprazole heals gastric and duodenal ulcers more effectively than misoprostol, whereas misoprostol was more effective in patients with erosions alone.
https://www.nejm.org/doi/full/10.1056/NEJM199803123381105