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Hi, I have been suffering from abdominal pain on and

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Gastroenterologist
Practicing since : 1986
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Hi,
I have been suffering from abdominal pain on and off for last 3-4 months.
I went to GP in July.He did sonography and he told me you have gastritis ( he said ulcers) and may be mild pancreatitis ( this feared up a lot ). He advised me to eat fruits veggies and low cal food. And prescribed me Raberprazole and Oxofloxcacin. And told me I will be alright in 10-15 days.

But I was scared with pancreatitis thing. So I went for serum amlyase and lipase twice and readings came normal.
Amalyse was 45 and 89 ( in two readings)
Lipase was 32 and 19.6 ( in two readings )

And Eventually the pain went away but reappeared like 10-15 days back with stomach pain, heartburn nauseated feeling, burps and more than regular bowel. I again went to gastroenterologist. He put me on Oflox OZ and Sompraz and did USG, Liver function test, Kidney Function tests, Urine and Occult Stool test and all the tests come normal. He didn't prescribe for Endoscopy though. I'm not feeling fine though with all the symptoms still persist ( He said gastroenteritis and Stomach infection). As this things are still on going it makes me physically unfit and mentally unstable too. Can this thing be something related to Stomach cancer or bowel cancer. It is now scaring me a lot. I'm a 27 years old guy, non smoker, non drinker and vegetarian. I do eat spicy foods but not anymore with less physical activity. Kindly help me out.
Posted Wed, 22 Nov 2017 in Digestion and Bowels
 
 
Answered by Dr. Ramesh Kumar 47 minutes later
Brief Answer:
Acid peptic disorder.

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone very carefully through your query.

After going through your questions i have some questions which i can't understand so please write a follow up with answers so that i could understand things better.

He did sonography......-Was an endoscopy ever performed on you?Gastritis or gastric ulcers can't be seen through sonography rather endoscopy has to be done for the same.

Secondly pancreatitis is something which should be taken care of immediately?How was mild pancreatitis diagnosed?Was a CT scan done at that time?
When lipase and Amylase are normal on two consecutive terms its not pancreatitis!

Now lets move to answer-
Frankly speaking after going through your narration and treatment,my differential is that you are having acid peptic disorder and thats why when you stop taking medications the symptoms reppears and flares up.


Acid peptic disorder should be treated by medication as well as life style modification.
Both of them are equally improtant for control of symptoms.
Increase in production of acid irritates the mucosa of gut and esophagus causing irritation and residual inflammation causing severe heartburn and pain.



Suggestion-
Go for an endoscopy to rule out ulcers and H.Pylori infection.

Rx
Till Endoscopy is done follow these medications-

1)Cap Rableprazole with Levosulpiride(Rablet L) once daily before breakfast -This will control the production and reflux of acid.

2)Syrup Antacid- 2 tsf thrice daily before break fast lunch and dinner(Mucaine gel is a good one).

3)Tablet Acogut 100 mg thrice daily(Acotiamide)


Start taking them all and inform me after 1 week how relieved you are.


Why Gastroenteritis?
Was stool test positive?
Do you have constipation or loose motions?

I don't think its enteritis.

Hope i was helpful.

Regards!
Above answer was peer-reviewed by
 
Follow-up: Hi, I have been suffering from abdominal pain on and 1 hour later

Sir,

I will describle it chronlogically.

I have had gastric issues on and off for so many years.

But it significantly started on July 2017. He only did USG and came to a conclusion that ulcers and feels like mild pancreatitis. It bothered me and I went to Amalyse & Lipase twice and both came normal. He put me on Oson, Sparacid and Pantoacid I think. As he said pancreatitis, I went to another GP in Zydus Hospital XXXXXXX He again went for USG and blood tests all came normal with Fatty infliration of liver of Grade 2 I guess. He put me on Oflox OZ, Sompraz and I took it for a week and eventually the pain subsided.


The pain again reappared on 5-6 October, And I went to gastroentrologist as previous one was not available. Same thing USG, Stool test, Urine test and all sort of blood tests. All came normal with Fattly liver thing only. He put me on same set of medicines and pain got reduced but never got fully recovered. For last the week the symptoms got increased may be due to irregular eating habits ( may be due to diwali festival sweets etc.).

I never had endoscopy nor any doctor has prescribed. No CT Scan. But all sorts of blood work.

I'm a non smoker and Non drinker with 90 kg weight.

Symptoms I face:

Acidity/Heartburn feeling & Nauseated when I'm emptty stomach
Burps.
Dull abdominal pain ( never severe but significant definitely )
Feeling to excrete stool
Burning sensation in upper back ( may be due to acidity I don't know)

 
 
Answered by Dr. Ramesh Kumar 2 hours later
Brief Answer:
Acid peptic disorder.

Detailed Answer:
Hi again,
Answers are-
1)He only did USG and came to a conclusion that ulcers-Usg can't help us see gastric ulcers.Most likely Dr arrived on that conclusion through your history.

2)feels like mild pancreatitis. It bothered me and I went to Amalyse & Lipase twice and both came normal.-Can't be pancreatitis in this scenario. If amlase and lipase are normal with patient being asymptomatic USG findings have no significance.

3)Oflox OZ, Sompraz and I took it for a week and eventually the pain subsided-Highly suggestive of acid peptic problem.

4)Stool test is normal so it can't be gastroenteritis.

5)Symptoms I face-A clear cut case of gastritis with reflux.
Endoscopy should be done to rule out H.pylori infection(a bacterium which causes gastritis) and to rule out ulcers.

Treatment-
1)Cap Rableprazole with Levosulpiride(Rablet L) once daily before breakfast -This will control the production and reflux of acid.

2)Syrup Antacid- 2 tsf thrice daily before break fast lunch and dinner(Mucaine gel is a good one).

3)Tablet Acogut 100 mg thrice daily(Acotiamide)

Start taking them and by the time endoscopy is done you would feel much better.
Apart from medicines few other life style changes are adviced-
- Increase warm water intake
- Do not drink water during and after meals
- Eat small meals (rich in fiber),Avoid spicy,oily and heavy meals.
- Eat plentiful "fresh oranges" and "pear "
- Drink COLD milk and and AVOID junk food.
- avoid beverages / alcohol/ soft drinks
- do some exercise early in the morning
- avoid carbonated drinks

Follow up after a week.

Above answer was peer-reviewed by
 
Follow-up: Hi, I have been suffering from abdominal pain on and 18 hours later
Thank you,

I will do as advised by you.

I want to ask whether endoscopy has any significant risks associated with it?

I feel full and tight after eating too for sometime which subsides in few minutes. What can be the problem?
 
 
Answered by Dr. Ramesh Kumar 7 hours later
Brief Answer:
follow up.

Detailed Answer:
Hello there,
Most likely gastritis is the cause of post prandial fullness in your case.
Bloating with fullness is termed as dyspepsia.

Endoscopy is a very safe procedure and most of the risks mentioned under this procedure are bookish and in clincal scenario patient can go hoke 45 minutes after the procedure.

Minor effects are pain in neck and chest area due to mild inflammation caused by endoscope.

Thanks!
Above answer was peer-reviewed by
 
Follow-up: Hi, I have been suffering from abdominal pain on and 6 days later
Hi Doc,

I went through Endoscopy last night.
I'm attaching the report too.
The doctor said somethings.
1) lap lex in esophagus. He said nothing to worry about.
2) severe Erthyma in stomach. No ulcers came. He did Biopsy for that and RUT test to find out H. Pylori. He give me something which was yellow in color and how it has turned into pink colour. That makes I have H. Pylori I guess.
I will be meeting my doctor tomorrow. In the meantime I want to show my reports and consult you as well. As I'm really stressed up think about things and this H. Pylori and thinking about gastric cancer as well.
I seek your help and consultation.

Regards,
Anshul XXXXXXX
 
 
Answered by Dr. Ramesh Kumar 3 hours later
Brief Answer:
Follow up.

Detailed Answer:
Hello there,
Thanks for follow up.

Please attach the reports dear i can't see any attachment.
If there is problem please mail it to YYYY@YYYY and intimate me.

lap lex in esophagus-Sorry but i think he must be using some other word.This is not a medical term.Will go through it in reports.

Please mail reports to me so that i can go through them.

Waiting
Above answer was peer-reviewed by
 
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