Joshua M., 15

Joshua Mumo is a 15-year-old boy living in a Children’s Home. He is well-behaved, kind and academically gifted, enjoys football and making friends, and dreams of becoming a lecturer. Joshua was abandoned by his parents in a Nairobi informal settlement in 2021 and struggled on the streets until a church leader connected him to the Children’s Home, where he found shelter and support. The home later learnt about Helpster Charity during a visit by a Helpster volunteer and medical personnel from Rheemah Hospital. Five days before admission, Joshua developed poor appetite, persistent abdominal pain and nausea. Despite receiving medication for four days, his symptoms progressively worsened. He became increasingly weak, ate and drank very little and developed features of significant dehydration. The home’s matron took him to Rheemah Hospital, where clinical assessment and investigations confirmed exacerbated peptic ulcer disease with severe dehydration. He was admitted and commenced on IV fluids, anti-ulcer medication, pain management and supportive care, with close monitoring of his hydration, nutrition and response to treatment.

With the assistance of Virginia, the matron at the children's home, Stephen was brought to Rheemah Hospital for further evaluation. Upon arrival, he underwent a comprehensive clinical examination and the necessary investigations. The findings confirmed a diagnosis of peptic ulcer disease. Following the diagnosis, Stephen was admitted for inpatient care, and treatment was initiated immediately. His management included intravenous Esomeprazole 40 mg, intravenous Ringer's Lactate 500 mL, and intravenous Hyoscine 2 mg. He was closely monitored throughout his admission, with regular assessment of his symptoms, hydration status, nutritional intake, and response to treatment. Upon discharge, Stephen was prescribed oral medications, including Pylotrip Kit, Ulgicid suspension, and Buscopan tablets to continue his treatment and support recovery. Following treatment, Stephen's condition gradually improved, with a reduction in abdominal pain and nausea and an improvement in appetite. He was advised to continue taking the prescribed medications, follow dietary recommendations, and attend follow-up appointments to monitor his recovery and ensure complete healing of the ulcer disease.

Joshua was diagnosed with exacerbated peptic ulcer disease with severe dehydration after persistent abdominal pain, nausea and markedly reduced oral intake. Severe dehydration can compromise circulation and kidney function, while worsening PUD may cause gastrointestinal bleeding or perforation. Admission for IV fluids, anti-ulcer therapy, pain control, nutritional support and close monitoring was appropriate. With timely treatment and adequate rehydration, Joshua’s prognosis is favourable, although follow-up is important to prevent recurrence.