Brief Answer: Can be due to infection/food allergy, get tests Detailed Answer: hello and welcome to HCM! I have read the question carefully and can see that you are having indigestion, disturbed bowel functioning and have difficulty in eating many food items...you are already anemic. You have not mentioned if you are taking any kind of medicine or got any investigations done. From my clinical experience I can say that these symptoms can be either due to - some chronic bowel infection OR due to irritable bowel syndrome OR due to food allergy. Had I been treating you, I would like to get few tests done - ultrasound abdomen, complete blood count (see if cells are raised- infective pathology), level function test ( impaired liver can result in indigestion), kidney test and thyroid levels (as you are anemic), and if possible, get food and drug allergy tested in blood ( as you have difficulty in eating many items now a days). I would also like to know how do you feel usually, the predominant mood? are you stressed out or sad? As in IBS one can have comorbid anxiety and indigestion, episodic diarrhoea, etc. For now, you should atleast start a good proton pump inhibitor- like: pantoprazole 40 mg with domperidone , empty stomach in morning, for week or two; I have seen good response with Metronidazole 400 mg Thrice a day OR Nitazoxamide 500 mg Twice a day, for five days in similar complaints. Further management can be given only after seeing the results of investigations mentioned above. Try to take more of fruits, low oil and low spice diet, eat less in one sitting (half of what you normally eat) but eat more frequent (4-5 times a day). Avoid eating outside or market food. Hope the reply is useful please feel free to ask mo questions for clarifictaion Dr. Manisha Gopal

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