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Stomach bloating, abdominal pain. on esoguard, prepro medication. undergone treatment for diverticulitis. Should I continue with medication ?

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Gastroenterologist
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DOCTOR I AM HAVING REGULAR STOMACH DISCOMFORT (BLOATING /TIGHTNESS ) WHICH IS SOMETIMES CAUSING LEFT ABDOMIN PAIN AND I HAVE UNDERGONE TREATMENT FOR SUSPECTED DIVERTICULITIS WITH ANTIBIOTICS BUT AFTER TREATEMENT ALSO ONCE IN A WEEK THE SYMPTOMS ARE THERE, NOW I AM ON MEDICATION WITH FOLLOWING DRUGS
ESOGUARD,PREPRO HS FYBOGEL
AFTER TAKING THE ABOVE ANTIBIOTICS FOR 5 DAYS ALSO THE STOMACH DISCOMFORT PROBLEM PERSISTS ESPECIALLY IN NIGHT AFTER TAKING FOOD, AND MEDICATION ALSO CAUSES ALLERGY ie LIPS DRYING FREQUENTLY INSPITE OF APPLYING LIP GEL,REGION AROUND BOTH EYES BECOMING DARK,AND SHRUNKEN.
SHOULD I STOP MEDICATION ,WHAT COULD BE THE CAUSES I NEED ADVISE DOCTOR,IF PAIN AND TIGHTNESS IN STOMACH OCCURS WHAT IS SOS REMEADY.

Posted Sun, 29 Apr 2012 in Abdominal Pain
 
 
Answered by Dr. Poorna Chandra K.S 20 hours later
Hello.

Thanks for posting your query.

I understand that your concern is regarding suspected Diverticulitis and currently on treatment with ESOGUARD (Rabiprazole), PREPRO HS (Lactobacillus Acidophilus), FYBOGEL ( Ispaghula husk).

Usually, this is a mild condition that responds well to treatment. Some people will have more than one attack of diverticulitis.

You are on the right treatment and can continue with that.

But, I would suggest you to get the Colonoscopy done at the earliest to confirm the diagnosis.

During acute attacks, you can follow these measures.

1. Rest in bed and possibly use a heating pad on your belly.

2. You can try Anti-inflammatory drugs for pain after discussion with your treating doctor.

3. Drink only fluids for a day or two, and then slowly begin drinking thicker liquids and then eating foods.

4. Eating more fiber can help prevent future attacks.

Keep yourself well hydrated with plenty of fluids. Dehydration could be the cause for your dry lips and shrunken eyes. Avoid constipation.

To help you further, I need some more details to give you more specific suggestions.

1. Type of pain and duration.
2. Your age.
3. Bowel habits and stool consistency.
4. Basis of the diagnosis of diverticulitis.

I hope, you find my recommendations helpful. Awaiting your reply with the answers to above question and possible colonoscopy report.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Stomach bloating, abdominal pain. on esoguard, prepro medication. undergone treatment for diverticulitis. Should I continue with medication ? 2 hours later
I HAD LEFT ABDOMEN PAIN WITH BLOATING WITH FEVER AND CT SCAN WAS DONE AND FINDINGS OF CT SCAN (WHOLE ABDOMEN (PLAIN) AS GIVEN BELOW.
MULTIPLE TINY OUT POUCHING COLONIC WALL NOTED IN DESCENDING COLON?
FOCAL WALL THICKENING AND AJACENT FAT STRANDING NOTED INVOLVING PROXIMAL SIGMOID COLON?
FEATURES IN FAVOUR OF DIVERTICULTIS WITH PERFORATION? SEALED WITH LOCALIZED COLLECTION.

GOT ADMITTED (DURING 20TH AUG 2011) AND TREATED WITH ANTIBIOTICS AND MEDICATIONS (TAB.AUGUMENTIN,FLAGYL,ECONORM,FYBOGEL)

1.NOW I DON'T HAVE PAIN BUT EVERYDAY EVENING ABDOMMINAL BLOATING AND DISCOMFORT.
2.MY AGE IS 49 YEARS
3. I TAKE NORMAL VEG.DIET (SOUTH VEG MEALS,CHAPATHI ETC] ,STOOL CONSISTENCY NORMAL NO LOOSE STOOL OR CONTISIPATION PROBLEM.

4.CT SCAN REPORT FINDINGS FURNISHED FOR SUSPECTED DIVERTICULTIS?

MY FOLLOWUP QUESTION REASON FOR ABDOMINAL BLOATING AND DISCOMOFRT EVERYDAY,WHAT COULD BE THE CAUSES?

 
 
Answered by Dr. Poorna Chandra K.S 23 hours later
Hello XXXXXXX

Thanks for the clarifications.

The CT description indeed suggests diverticulitis. The Fat stranding may suggest a localised leak / sealed of perforation or may be the sympathetic reaction of the sorrounding fat.

Diverticulitis is usually associated with intestinal motility problems and secondary bacterial overgrowth.

Dysmotility as well as bacterial overgrowth cause a sense of bloating and abdominal discomfort by altering the elasticity of the intestines and also by certain chemical release.

A high fibre diet is said to improve motility and prevent as well as retard development of diverticulae.

Fybogel - fibre is fermented in some people and can worsen the bloated feeling.

As for management, I would suggest - increase dietary fibres, add prokinetics and avoid milk and milk products except the fermented ones. You can also discuss the treatment of bacterial overgrowth with your doctor.

I hope, this answers your query.

Wish you good health.

Regards.
Dr XXXXXXX
Above answer was peer-reviewed by
 
Follow-up: Stomach bloating, abdominal pain. on esoguard, prepro medication. undergone treatment for diverticulitis. Should I continue with medication ? 25 hours later
Today I have done as per family physician suggestion, CT-WHOLE ABDOMEN WITH CONTRAST AND THE FINDINGS ARE

1.FATTY LIVER WITH NO FOCAL LESION
2.LEFT COLONIC DIVERTICULOSIS (MULTIPLE DIVERTICULA ARE SEEN IN THE DESCENDING AND SIGMOID COLON)
3.FEW SMALL MESENTERIC LYMPH NODES

SINCE I HAVE FREQUENT ABDOMEN BLOATING AND DISCOMFORT DOCTOR
SHOULD I GO FOR SURGERY TO REMOVE DIVERTICULTIS WHETHER SURGERY LASER AVAILABLE OR RECOMMENDED.WHAT WILL BE THE POST SURGERY COMPLICATIONS/MANAGEMENT SUGGESTED.
SHOULD I AVOID SURGERY AND ON MEDICAL MANAGEMENT WILL IT HELP WHAT WOULD SUGGEST?
WHETHER COLONSCOPE SHOULD BE DONE IMMEDIATELY OR LATER WHAT IS YOUR
SUGGESTION?

PL ADVISE DOCTOR AND I AWAIT YOUR SUGGESTION



 
 
Answered by Dr. Poorna Chandra K.S 2 hours later
Hi XXXXXXX

Thanks for writing back.

Surgery for diverticular disease is advised only in case of recurrent diverticular bleed or complications of diverticulutis like stricture development, perforation or fistula.

Historically and by the CT results there isn't much of inflammation.

The symptoms that you have described are quite mild to merit a surgery.

As I had written earlier removal of (L) colon may not totally relieve the symptoms ( but reduce the severity) as the abnormal motility in the rest of colon will persist.

Colonoscopy helps to rule out other causes and confirms the diagnsis. It is best done when there is no diverticulitis (When there is no active inflammation going on).

Removal of only (L) colon doesnot cause much serious problems, there may be some increase in bowel movements and some fluidity of the stools. Rest are the routine surgical risks for your age (which can best be discussed with your treating doctor).

hence i feel you should discuss all the possible treatment approaches with your doctor as he knows you best and decide on further management

Wishing you a speedy recovery.

Regards
Dr. XXXXXXX
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