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Have chronic IBS. Endoscopy and colonoscopy done. Found ulcer, h pylori and gastritis. Proper medication?

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Practicing since : 1962
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Hello Doctor,
XXXXXX I am 28 years old :) ...last 5 years living in Bangalore..and have stomach issue through out my life..but 1 year it is kind of out of control.
Medical History:
Chronic patient of IBS.
In last 4 years endoscopy done 3 times, once colonoscopy.
Mild ulcer was there , H Pylori , gastritis all that was medicated .
Used to have alcohol little, little stressed out personality.
Last one year :
The situation is worse, cannot digest most of the food.Have stopped drinking totally.
Excessive flatulence , bad breath.
No fat or greasy food, on bland diet.At the slightest stool not clear, pass many times, smelly , sticky , stool floats , tough to flush away.
At Night the discomfort in upper stomach bellow ribs too much , mild pain at times before or after food, everything in upper stomach area only.All very old symptoms, but last one year aggravated. GRED. Too much of pressure in chest from excessive gas , even tough to drink water at that time.Hunger pang very frequently.Sleeping trouble after 2:30 to 3 pm , very less sleep.
In last one year i have lost 4 kg of weight. 5 ft 7 inch last year i was 62 kg now 57.8 kg.

Medication History:
2008 to 2011 had medicines for H pilory, gastic ulcer, indigestion.
Omez, Colospa retard, IBset to name a few.
2011 to 2012 mid reduced medication.Started Ayurvedic , not much of help.
Extremely controlled diet with trial basis now, but still problem there.still evaluating what triggers problem.
more than 5 months on and off have had sorbillin in morning and sucralfate after food.
Had Hepa Merz after food 3 times for 2 months.
Rekood tablet at night on and off. And petril MD 0.25 at night sometimes for sleep.
Night before sleep Isabgool . Probiotic yukult drink int eh morning.

But offlate after trying some ayurvedic , situation even worse. No sleep at night , due to upper abdomen discomfort, and flatulence . And at the slightest of change in food results in very irregular motion with sticky stinky floating stool and bad breath.and the more concern is trouble in sleeping due to stomach discomfort , hunger pang and sweating at times. rellay clueless what to do. need some suggesstion.Some times i feel like i am passing more than what i eat. yet its not clear.

Food intolerance: Nonveg seems to create problem.Insoluble fibre also.wheat bread i am not sure. Milk try to avoid and have low fat curd. Ghee or any fatty item cant have atall.

Trying to do pranyam now a days .

Thanks & regards
Posted Tue, 7 May 2013 in Digestion and Bowels
Answered by Dr. Charles S Narasi 8 hours later

Thank you for your query.

I am sorry that you have been through so much in such a short interval. I am glad that your ulcer was treated properly with medications and also treating H.Pylori. That is very important. You have tried all kinds of medications including Ayurvedic, you have had probiotics and none seem to have helped your symptoms. I am also glad that you stopped drinking alcohol.

Some of your current symptoms are of concern to me. You describe your stool as foul smelling, floating and also from your description fatty and greasy. Combine these with your weight loss, you are having a condition of "Malabsorption Syndrome". There are a number of diseases that can cause this. Mostly, your small bowel is affected or your pancreas. First thing to do is to get a complete blood work , including blood count, Vit-B12 and Folic acid levels,Vit-D levels, Total protein,
Albumin , Globulin, Thyroid, Celiac blood tests and complete metabolic profile for kidney, liver and also pancreas blood tests like Amylase,Lipase etc. You also need to have your stool tested
for fat. They do a 72-hour quantitative analysis of stool to measure the fat content. If excessive , this tells us that you are lacking in enzymes that help digest fat. You also need to get a small bowel x-ray follow through to look for any problems such as "Crohn's Disease". If available in Bangalore,
you might consider "Capsule Endoscopy" where in a small capsule that you swallow will travel through the intestinal tract, take hundreds of pictures and after it comes out via stool, it is hooked up to a computer and all the pictures are analyzed. This can show early Crohn's or other small bowel problems.

These are all some of the things you must do before we can prescribe any treatment.

I would like to hear from you again with reports.

I wish you the very best.
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