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Hypertension, Thyroid Problem, Abdominal Pain, Hick Ups, On Acid Suppressing Medication

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Posted on Wed, 30 May 2012
Question: Dear Dr.
I am Dr. S. XXXXXXX M. Sc. PH. D. working as Head of Bioinformatics in a CSIR Lab, NBRI, Lucknow.
She is taking Losar 50 one tab daily for BP for last 4 years.
Her thyroid is in control but She takes Elthroxin one tab daily for last 10 years as per advice of Doctor.
We have consulted and taken several prescriptions in KGMC, SGPGI Lucknow, Jaslok Mumbai, Sir XXXXXXX XXXXXXX New Delhi in Gasto and completed several test Like endo scopy, ultra sound, CT Scans, MRI , Vitamin prfile etc. but so far no relief for her.
She ash abdominal pain and hick ups . Her pain and Hick ups are not coming in control. We feel that perhaps her real cause of disease is not diagnosed properly.
She has taken Ayruvedic treatment too.
At the moment She has pain in her abdomen and hick ups . We are thinking to get Sono elestography which help in detection of cancers with out Biopsy.
Where we can get her proper
reply on my email
YYYY@YYYY
doctor
Answered by Dr. Vaibhav Banait (26 hours later)
Hi Dr. XXXXXXX

Thanks for posting query.

Normally prolonged abdominal pain makes diagnosis of cancer and infection less likely .

So relax. At least she is least likely to have your worst feared thing.

Now the question is what she has?

I would be obliged if you provide me following information which will help me to answer your query better.

1. The exact site, periodicity and duration of pain episode ?
2. The effect of meals pn pain?
3. Presence or absence of 'motion' / defection problems.
4. Relation of menstrual cycle with the pain.
5. Treatment or medical drugs tried so far.
6. Any other associated symptom .
7. I would also like to know details of investigations done. It would be better if you could send me the scanned reports of the investigations done to my attention at YYYY@YYYY

Awaiting your reply

Regards,

Dr. Vaibhav Banait
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Vaibhav Banait (12 hours later)
Dear Dr. XXXXXXX XXXXXXX

Thank you very much.

I am sending point wise answer to your questions.

Q1.     
The exact site of pain-     It is almost whole abdomen. On standing lower abdomen gives feeling of heaviness as of some water logging.
The periodicity of pain-     it is almost regular except one or two days in a week when it is not there. The duration of pain is for about 4-5 hours.

Q2.
The affect of meal-     when she takes food, she has to take unienzyme, omez and Pantuprazole and Domke etc. after meal to digestion it. If she does not take these digestive medicines, then pain will increase after taking meal.

Q3.
If she does not take medicine, then she faces constipation problem.

Q4.
Menstrual cycle is closed from 4 years.

Q5.
Medication so far with few alterations-
•     Razo -20
•     Moza MPS
•     Rcitam 200mg
•     Nexito 5mg
•     Naturolan Powder
•     Remer
•     Masnicae
•     Liofun

Q6.
•     Stomach spread simultaneously to pain feeling of water tension is there.     
•     Felt “chakar” in sleeping occasionally.
•     Felt pain which transfers in hands while walking.
•     Hick-ups are constant since two years.

Annexure:
She has so many last reports; few reports are enclosed as pdf.
•     Blood Report
•     MRI

Full reports (CT scan, Thyroid and Endoscopy) can be sent on through courier if required. She can answer any further questions on her mobile also.
I have also sent an email containing all the above mentioned docs.

Will wait for your kind reply.

Thankyou
doctor
Answered by Dr. Vaibhav Banait (24 hours later)
Hello Dr. XXXXXXX

Thanks for your reply.

I am sorry, I have not received any pdf 's, reports or any other relevant documents from you till now.

You have a feature to upload the reports / image by yourself at the right side of the query page, please utilize that so that I can answer your queries better.

It seems she is on many medications from many doctors, which are not only similar but unlike your convictions, does not help in digestion.

The Prazoles , Rabeprazole or Esomeprazole are acid suppressing drugs. From the history of diffuse abdominal pain I could make out that she does not have acidity or ulcer disease. I expect her upper Gastrointestinal Endoscopy to be normal.

The long standing diffuse intermittent crampy abdominal pain in a patient whose ultrasound scan of the abdomen and CT scan are normal, suggests to be arising from large bowel. As you mentioned she is constipated at times. This gives strength to my suggestion also.

These patients usually feel better in the day when there is satisfactory defecation/passing of stool. Please clarify if that is not the case.

I will elaborate shortly regarding treatment principles and expected response.

Regards,
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
Dr.
Dr. Vaibhav Banait

Gastroenterologist

Practicing since :1997

Answered : 65 Questions

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Hypertension, Thyroid Problem, Abdominal Pain, Hick Ups, On Acid Suppressing Medication

Hi Dr. XXXXXXX

Thanks for posting query.

Normally prolonged abdominal pain makes diagnosis of cancer and infection less likely .

So relax. At least she is least likely to have your worst feared thing.

Now the question is what she has?

I would be obliged if you provide me following information which will help me to answer your query better.

1. The exact site, periodicity and duration of pain episode ?
2. The effect of meals pn pain?
3. Presence or absence of 'motion' / defection problems.
4. Relation of menstrual cycle with the pain.
5. Treatment or medical drugs tried so far.
6. Any other associated symptom .
7. I would also like to know details of investigations done. It would be better if you could send me the scanned reports of the investigations done to my attention at YYYY@YYYY

Awaiting your reply

Regards,

Dr. Vaibhav Banait