instruction: hello doctor I was diagnosed with peptic ulcers because I was having blood fresh in my stool I am on medication but the medication is not effective because my blood has not stopped for even one day it keeps coming every time I go to pass stool and at times my stool has blood in it too my stomach feels stretchy most of the times and I feel cramps too often a few days back I have started facing left side pain as well I do not really know what is the reason for the blood not stopping and my pains just to add I do not have constipation issues because I am having ispaghol every night before sleeping the medication I am taking are sucralfate enema once daily transamin 500 my twice daily mebever 200 my twice daily motilium 10 my twice daily caflam twice daily ciproxin 500 my twice daily and ispaghol before sleeping
output: hello well the peptic ulcer disease often presents with upper abdominal pain it does not present with per rectal bleeding unless some once has a brisk and huge amount of bleeding ulcers with the stomach or small bowel and the color of stools often appears dark tarry black if the source of bleeding in within the stomach or small bowel I understand you have fresh red color bleeding in stools which comes every day you pass stools plus cramps and pain over the left lower side of the abdomen suggest few possibilities infections with the parasites such as histolytica diverticulosis with diverticular bleeding ulcerative colitis is an autoimmune inflammatory disease causing ulcers in the rectum and large bowel colon I want you to stop caflam diclofenac since this is a painkiller and can cause ulcers within the stomach small bowel and large bowel it can also precipitate your peptic ulcer disease I recommend you to use tablet flagyl 400 my thrice daily for five days plus capsule cefspan cefixime 400 my once daily for five days I ask you to get the following tests and get back to me once they are done I would further guide on you what to do next you should also stop mebever motilium and cirpoxcin they would not be useful in your case rest of your medication can be continued plus take capsule esomeprazole 40 my half an hour before breakfast daily this is for your peptic ulcer disease I hope this helps infection colitis ulcerative colitis diverticulosis and diverticular bleeding solitary rectal ulcer syndrome anal fissure complete blood count stool for detail report stool for ova and parasites stool for diffcile antigen stool for fecal calprotectin ha titers for histolytica serum cop reactive protein level