Pretend you are a teacher preparing a quiz for the text I will provide. 
            Each quiz question should follow the format below. 
            Ensure that you carefully recheck the questions and answers for accuracy. 
            The output should be a ready-to-use list of dictionaries for the Python eval function:

            [

                    "question": "WRITE THE QUESTION HERE",
                    "options": ["A) OPTION_1", "B) OPTION_2", "C) OPTION_3", "D) OPTION_4"],
                    "answer": INDEX_OF_CORRECT_ANSWER_IN_OPTIONS_LIST,
                    "explanation": "EXPLAIN WHY THE ANSWER IS CORRECT"

            ]

            Text:
            rapid and reversible inhibition of H+, K+ ATPase enzyme of the pumps (prevent 
H+, K+ exchange) and therefore acid secretion. 
III. Cytoprotective agents 
Misoprostol 
◼ Prostaglandin E2 produced by the gastric mucosa: 
       - Inhibits secretion of HCI. 
       - Stimulates secretion of mucus & bicarbonate  
                       (Cytoprotective Effect). 
◼ Misoprostol a stable analog of PGE1 
◼ It is less effective than H2 antagonists and the PPls   for acute treatment of peptic 
ulcers. 
 
Pharmacology-2          Dietitian Program         2024-2025                Prof Dr Manar A Nader
 
 
66 | P a g e  
 
◼ Prophylactic use of misoprostol in patients who are taking NSAIDs, elderly or 
patients with ulcer complications are at high risk of NSAIDinduced ulcers. 
◼ Adverse effects: 
           - Dose-related diarrhea and nausea. 
           - Contraindicated during pregnancy.  
        misoprostol produces uterine contractions. 
 
Management of IBD 
General management considerations 
a. Rule out possible infectious causes of bloody diarrhea in patients with acute 
symptoms. 
b. Most patients will receive colonoscopy to confirm diagnosis and extent of disease. 
c.   Surgery is a viable option when complications (abscess, fistula, perforation) occur 
or when fulminant disease is unresponsive to medical treatment. 
d.  Distribution and severity of disease will dictate the initial choice of therapeutic 
agents. 
e.  Most patients will require maintenance therapy because of the high incidence of 
relapse after induction therapy; the relapse rate is 35%–80% at 2 years for CD and 50%–
70% at 1 year for UC. 
Non-Pharmacologic Management of IBD 
 Doctors may recommend vitamin (B12) and mineral supplements in CD.  
 Most other vitamins and minerals are absorbed in the upper part of the small bowel, 
which is less commonly affected by CD.  
 Iron supplements may also be necessary in patients who have bled from the bowel.  
 Some patients with extensive CD may require supplements of fat-soluble vitamins 
(vitamins A, D or K).  
 
Pharmacology-2          Dietitian Program         2024-2025                Prof Dr Manar A Nader
 
 
67 | P a g e  
 
Diet restriction in IBD 
In general, people who have either UC or CD should: 
1. Eat smaller portions regularly at shorter time  
2. Reduce intake of fat 
3. Reduce intake of simple sugars 
4. Reduce or avoid intake of milk and dairy products: 
5. Avoid spicy, preserved meals and semi-finished products 
7. Avoid artificial sweeteners  
8. Avoid nuts and seeds 
9. Avoid greasy and fried foods 
10. Cook high fiber foods before eating 
11. Avoid foods that can cause gas su 
Generally balanced diet is required 
Surgery  
 Surgery is usually necessary only for people who have intestinal blockage or very 
severe symptoms that are not relieved by medication.  
 When IBDs causes severe damage to the colon, presence of an abscess or certain 
types of fistula, it may need to be surgically removed.  
 This can cure UC, 

            Quiz: