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Abdominal pressure, increases after eating. All test normal. Found unfertilized egg in stool. Taking bifilac, somprez. Suggest?

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Gastroenterologist
Practicing since : 1985
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Hi,
From around 1.5 months now , I have been experiencing upper abdominal pressure as if
gas is accumulating right under my diaphgram. It increases after food intake. I had my CBC,
Ultrasound (abdomen), stool test, chest x-ray and abdomen (erect) x-ray done. Apart from
stool test everything was normal. They found Ascaris lumbricoides unfertilized eggs in the
stool.

For the time before the stool test I was prescribed Parit and Ganaton tablets alongwith vizylac
capsules after meals. After stool tests I was prescribed Sompraz capsules, Bifilac capsule, Aristogym
syrup and Albandazole (for worms). I took these but even after the worm course was over the abdominal
pressure has not ceased.

This has led a considerable amount of stress and anxiety. Can you please suggest what next should
I do ?
Posted Wed, 22 May 2013 in Digestion and Bowels
 
 
Answered by Dr. Dinesh Kumar Singal 1 hour later
Dear XXXXXXX

Thanks for contacting Healthcare Magic.

Discomfort in upper abdomen is labelled as Dyspepsia. There can be many causes of dyspepsia including reflux disease, duodenal and gastric ulcers, worms, gastritis, non-ulcer dyspepsia. Since your stool was positive for eggs of ascaris, it is possible that these are the cause of your symptoms. The medicines prescribed to you are fine. You should also repeat a course of albendazole, as single dose may not completely clear the worms.

Sometimes infections like giardiasis can also cause similar symptoms. It may be worthwhile taking a short course of ofloxacin and ornidazole combination.

If still the discomfort persists then probably you should undergo an upper GI endoscopy and they should also test for Helicobacter pylori during endoscopy. They should also consider taking a biopsy from second part of duodenum to rule out giardia and any other mucosal disease. The treatment can then be decided based on endoscopy findings.

Hope you get well soon. If you have any other query you can write back again.

Best wishes,

Dr Dinesh Singal
Above answer was peer-reviewed by
 
Follow-up: Abdominal pressure, increases after eating. All test normal. Found unfertilized egg in stool. Taking bifilac, somprez. Suggest? 6 minutes later
Dear Sir,

Thanks for your answer.

I took 3 tablets of albendazole and 1 tablet after 1 week of the first dose, so in
total took around 4 tablets. Is there a need to repeat it, or should I get a stool
test done again. Also, can you tell me some trade names for ofloxacin and ornidazole combination.

I have scheduled an endoscopy for 3 week of April to further the investigations.

regards, XXXXXXX XXXXXXX
 
 
Answered by Dr. Dinesh Kumar Singal 11 hours later
Dear XXXXXXX

Thanks for getting in touch again.

There is no need to repeat Albendazole if you have already taken it for 4 times. You should take one tablet every 6 months.

Ornidazole - ofloxacin combination comes in the name of Ornof / Orni-O / Ornoxin etc. It is to be taken twice a day after meals for 5 days.

Best wishes,

Dr Dinesh Singal
Above answer was peer-reviewed by
 
Follow-up: Abdominal pressure, increases after eating. All test normal. Found unfertilized egg in stool. Taking bifilac, somprez. Suggest? 37 hours later
Hello Dr Singal

I have a few more questions :-

1. Would barium meal xray be of any help in my case, since I am
a little apprehensive about endoscopy. I have heard its a bit painful
and may sometimes cause XXXXXXX damage like perforation etc.

2. Also whenever I eat spicy, oily food there's a slight burning sensation at
Upper abdomen reaching upto throat sometimes. Is it indicative of anything?

3. If I get diagnosed with some form of IBS, is it true that it may be incurable?

Thanks and regards

XXXXXX
 
 
Answered by Dr. Dinesh Kumar Singal 9 hours later
Dear XXXXXXX

Thanks for contacting again.

1. You should not worry much about endoscopy. Most doctors now a days do it under sedation, here patients doesnot feel anything. Hence there is no pain. Even if it is done without sedation there is only mild discomfort for 5 to 6 minutes. Certainly complications like perforations are very very rare. Hence you should not worry.
Investigations like barium meal are useless.

2. Burning / pain starting in upper abdomen reaching till throat indicates reflux disease.

3. You do not seem to have IBS. IBS may not be cureable but it can certainly be controled.

Best wishes,

Dr Dinesh Singal
Above answer was peer-reviewed by
 
Follow-up: Abdominal pressure, increases after eating. All test normal. Found unfertilized egg in stool. Taking bifilac, somprez. Suggest? 37 hours later
Thanks Dr. Singal , will follow up with you once I have my
Endoscopy results.

Regards
XXXXXX
 
 
Answered by Dr. Dinesh Kumar Singal 23 hours later
Dear XXXXXXX

Best wishes.

Dr Dinesh Singal
Above answer was peer-reviewed by
 
Follow-up: Abdominal pressure, increases after eating. All test normal. Found unfertilized egg in stool. Taking bifilac, somprez. Suggest? 18 days later
Hello Dr. Singal,

Since our last chat I have had my endoscopy done. The results of which I am writing below, I wanted to show you the file but I am not being able to upload in
the question here (I have sent those to an email that customer care told me)

Endoscopy Findings in brief :-

1. Cricopharynx - appeared normal
2. Esophagus - Lower esophagealmucosa appeared edematous
No varix, ulcer, stricture, web, ring, polyp or growth appreciated

3. GE junction - XXXXXXX appeared lax

4. Stomach - distensibility appeared normal
mucus residues seen in situ
mucosa appeared edematous with patchy hyperemic and few erosions
No fundal varix, polyp, ulcer or growth or bleed appreciated
biopsy taken for H.pylori

5. Duodenum D1 - mucosa appeared edematous and hyperemic
no ulcer or bleed appreciated
D2 - mucosal folds appeared normal


Biopsy - Gastric
Pylo dry rapid urease test - POSITIVE


Kindly address my queries :-

1. I have had this problem from about 2.5 months now, before that my stomach was pretty normal. Only lifestyle changes from earlier were starting gym with stress on abdominal exercises and an increase eating certain street foods (which were not that hygienic). Can that be a trigger to h pylori infection and can it happen so suddenly?

2. Does my report imply that I have severe gastritis ?


3. Can you advise on a food regimen for the infection I have, because I am not being able to draw out a plan as to which foods to it and which to cut, are their any dieticians for this purpose (if you can refer me to someone..)

4. The anti h.pylori therapy I was put on comprised of the following :-

A. tb. Ducopan 40 mg (2 + 2 each day before meals)
B. tb. Tilpride - SR 75 mg (1 each day empty stomach)
C. Cap. Gutstar - probiotic (1 each day)
D. tb. Alsarex (1 each day)
E. Cap. Novamox 500mg (2+2 each day after meals for 5 days)
F. Tb. Tinib 500 mg (2 each day after meals for 5 days)
G. Tb. Clarimin 500mg (2 each day after meals for 5 days)

H. cap. Ducopan DSR and Alsarex to be continued for 10 days after antibiotic therapy

Kindly let me know alternative trade names of Ducopan DSR cap. , tb. Tilpride, cap. Gutstar as I was unable to procure them in Delhi-NCR.


5. Is it wrong to expect complete healing in a quick time, how much time does it generally take for such infections to heal. I've never had such an ailment of the stomach during my lifetime, that is why I am a bit concerned.

6. I was smoking for around 1.5 years and drinking (occasionally) for around 2.5 years, has that contributed to my infection? I have put a stop to both since last 3 months.

7. For how much time should I wait for infection to heal before I go for another check up, and is their going to be a need for another endoscopy to find if h pylori has been eliminated or not.

8. Both my antibiotic courses are over but still the fullness feeling hasn't been eliminated and whenever I eat spicy , oily foods burning sensation begins again, kindly do prescribe me a food regimen

XXXXXX
 
 
Answered by Dr. Dinesh Kumar Singal 22 hours later
Dear XXXXXXX

Thanks for contacting again. I will answer your queries one by one.

1. Sudden abdominal exercises with out any training / priming can lead on to muscular pains of abdominal wall. This does not aggravates H.pylori though. Unhygienic food can trigger as well as cause H.pylori infection. This infection can happen suddenly.

2. Your report does suggest gastritis, though just on the basis of report I can not comment whether it is severe or not. Only the person who has done it can comment on this.

3. No particular food items are required. In general less of fatty, less of spicy and less of sour food should be taken. Tea and coffee should be minimized. Above all what ever you feel gives you symptoms those food items should be avoided.

4. Even I have not heard names of some of these medicines. I will suggest that you should ask the alternatives from your physician. Also Novamox, Clarimin and Tinib should be taken for 2 weeks instead of 5 days for treating H.pylori infection.

5. Definitely 2 weeks treatment should be taken. But one or two medicines may have to be taken for a longer time to suppress acid as I think you also have reflux disease.

6. Smoking certainly adds to gastritis. it is nice that you have stopped these.

7. You should see your doctor every week, repeat endoscopy may be needed if symptoms persist.

8. I have already discussed about food in one of the above questions. Since you have reflux as well you should try to avoid spicy and oily food.

Best wishes, I hope my answers help you.

Dr Dinesh Singal
Above answer was peer-reviewed by
 
Follow-up: Abdominal pressure, increases after eating. All test normal. Found unfertilized egg in stool. Taking bifilac, somprez. Suggest? 14 hours later
Hello Dr Singal

Thanks for your replies.

Ducopan DSR is basically enteric coated pantoprazole & domperidone SR capsules.. the names
my physician told me are not available here with the same trade names, that is why if you could tell some alternative names it'd be helpful

XXXXXX
 
 
Answered by Dr. Dinesh Kumar Singal 2 hours later
Dear XXXXXXX

In that case you can take Cap Pantocid DSR which should be easily available allover India.

Best wishes,

Dr Dinesh Singal
Above answer was peer-reviewed by
 
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