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Suffer acidity. Consuming Cyntodac. Sufer weight loss. Do you think IBS patients loose weight normally?

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Answered by

Gastroenterologist
Practicing since : 1985
Answered : 140 Questions
Question
Hello Doctor,

Hope you are doing good :) .
I am writing to you after a long time again.
You had asked me go through many of the tests. I went to Asian Institute of Gastroentrology Hyderabad.
COlonoscopy and Endoscopy showed no problem.

Amylase,Lipase these tests were fine.(done more 8 months back)

Fecal Fat testing i could not get it done .In India Very rare places they do, and its vety expensive.
I will get it done later.
The liver function tests were fine , Total bilirubin 1.9 mg/dL , direct (0.4) indirect (1.5) , my bilirubin label is consistently marginally high for last 1 and half years.
(i used to take Hepa Merge last year)
I am on VB12 shots (each month one injection) take calcium tablets frequently , so those vitamin tests are fine.

However my acidity problem tends to come back wherevr i give a break to the medication (PIP or antacid)
Night i get up with upper abdomain discomfort at times.I take petril MD at times to have sleep.
Flatulence , constipation (if any fat items , even chicken also at times) ,bloating , hunger pang, i feel pressure in my chest area due to too much of gas pressure.
Lower back pain in the early morning , or night also..whenever my stool is not clear , and i pass smelly winds (even while having loose motion i pass smelly wind).After having food sometimes my stomach starts making sounds.AT times I feel little nauseated after food.Sour feeling in the tongue. And the lower back pain is a very old problem which is related to my motion and gas.

last more than 3 mnths I have been consuming Cyntodac.
And my weightloss is one issue. with slight change in the daily routine , like less sleep or anyting i see good amount of weightloss, i was 65 KG in 2011 now I am
55 kg, and its decreasing. In b/t i had dengue and Tonsil operation.which reduced my weight more.

Do you think IBS patients loose weight normally?
I have been prescribed Ganaton Total , Fluxetine Cap(Neurozac) ,Normaxin .

Before staring Ganaton I wanted your advice.Heard people taking this drug might develop Atrophic gastritis.

The long term usage of Pantoprazol , do they aggravate the Gastritis?

If you think of any other better medication , please suggest.
Or any food diet , for proper nutrition.
For liver related , do you think i should have some more investigation?

I know typical IBS patients have to deal with the symtoms for their life time.But i am little bothered about the weightloss.
Offlate my diet is very plain.

I avoid wheat stuff.Here the tests for Lactose intolerace or Gluten intolerace is not available.Anyway I try to avoid them.
I dnt eat any fat items. even chicken also i have reduced.I Have Tofu and egg white for protein.
There are some fat burner enzymes. do they have side effects , do you think i can try them?

I have Eerectile problem.
And I know taking Neurozac might worsen it, but at this point i m not much concerned about my sexual life. I am homosexual. And have a boyfriend. who lives abroad right now.for a year.

Thanks & Regards XXXXXXX
Posted Mon, 14 Oct 2013 in Digestion and Bowels
 
 
Answered by Dr. Dinesh Kumar Singal 1 hour later
Brief Answer:
Please see detailed answer.

Detailed Answer:
Dear XXXXXXX

Thanks for getting in touch again.

Normal endoscopy and colonoscopy reinforce the diagnosis of IBS in your case. Weight loss can happen in IBS patients since they make many dietary restrictions. But one should try to rule out any other cause of weight loss like hyperthyroidism, diabetes, malignancy etc.

There are no significant long term side effects wither with pantoprazole or ganaton. You can safely take these with out thinking much. There can be some vitamin D or symptoms like noises, gases or flatulence etc, you can take a 2 - 4 week course of Rifaximin (400 mg thrice a day). This will help in case there is bacterial proliferation.

Neurozac is a chinese herbal medicine and I have no experience with it, so I will not be able to comment on this. I do not think you should try any fat burning enzymes.

You do not need any investigations for raised bilirubin. Your indirect bilirubin is high, which suggests that either you have XXXXXXX syndrome (it is a harmless condition, no treatment is needed) or there is breakage of red blood cells. in case of breakage (haemolysis can occur due to thalassemia trait, B12 deficiency etc) your Hb should have been low which is not there. hence I do not think you should bother about it.

Best wishes,

Please let me know if you have any other query.

Dr Dinesh Singal


Above answer was peer-reviewed by
 
Follow-up: Suffer acidity. Consuming Cyntodac. Sufer weight loss. Do you think IBS patients loose weight normally? 20 minutes later
Hello Doctor ,

Thanks for the reply.
So do you think I should go through any more tests to rule out hyperthyroidism, diabetes, malignancy?

I am taking lactifiber (fiber supplement ) each night before going to bed.
And since i started taking the anti depressant , I feel good. Last night i didnt wake up , after a long time.

Food wise any suggestion ?Things i should avoid ?

Thanks & Regards XXXXXXX
 
 
Answered by Dr. Dinesh Kumar Singal 7 hours later
Brief Answer:
Please see reply below.

Detailed Answer:
Dear XXXXXXX

If you continue to lose weight then you should get investigated further for its cause.

Its nice that you felt better after anti-depressants.

You should avoid milk and juices. You should also avoid fried, fatty, spicy things. You should reduce tea and coffee intake. In general you should avoid what ever you think gives you trouble.

Best wishes.

Dr Dinesh Singal
Above answer was peer-reviewed by
 
Follow-up: Suffer acidity. Consuming Cyntodac. Sufer weight loss. Do you think IBS patients loose weight normally? 13 hours later
Hello Doctor,

Little panicked now.Last week my weight was 55 kg , and now today i checked its 53 KG.
this unintentional weightloss , i dont know what to do.
What check for malignancy would you suggest? Are they very expensive.

I need some rationalization or explanation for this weightless , otherwise not having peace of mind.

Thanks & Regards XXXXXXX
 
 
Answered by Dr. Dinesh Kumar Singal 10 hours later
Brief Answer:
Please see reply below.

Detailed Answer:
Dear XXXXXXX

If the weight loss is unintentional, then certainly it should be investigated.

Ideally a physician should examine you and then decide what needs to be done.

In general I will like to get the following.

Haemogram, LFT, KFT, Blood sugars, T3, T4, TSH, HIV 1 and 2,
X XXXXXXX chest PA view
USG whole abdomen

If these are normal then
CECT abdomen and chest.

Hope this helps you.

Dr Dinesh Singal
Above answer was peer-reviewed by
 
Follow-up: Suffer acidity. Consuming Cyntodac. Sufer weight loss. Do you think IBS patients loose weight normally? 2 days later
Hello Doctor,

I am not sure its my anxiety that casing the problem or something else.As u suggested I went to the physician , my weightloss might be due to less sleep and anxiety. since 2011 end till today i have lost 13 KG so far. So he asked me to wait and continue the medication. All my life I was underweight. Then 2009 end to 2011 1st i gained lot of weight , had no stomach problem (after H pilory medication). and now again i am underweight with all the IBS symtomps much severe.

Anyway thing is last 2 days i have throat sore and chest pain.with yellow mucus , which are not coming out.while coughing it pians in the middle of the chest and throat also.
Had mild fever last night and chill, I had little hot milk with little turmeric , and then Tulsi and ginger and clove , later i took calpol and one cintodac cap (i didnt take Normaxin ) , had lacti fiber 2 scoop before going to pin.
night i felt pain in my upper stomach , later around 2 i slept off. I was passing winds.problem is due my sensitive stomach i cant have most of the things like honey or peeper and milk.

Now morning while passing stool , i saw it was whitish yellow in color , and stain of blood on the surface of stool , Little.
I got so much panicked.

But the blood looked like fresh , need to confirm once more whn i go to stool , What do you think about it.God forbidden if it reappears.last week i had colonoscopy , and liver function test also , all were fine.even now i have mild pain in upper stomach.
need your suggestion.I am not much hungry also .
HIV testing i got it done last week , I am negative.

Will get chest xray done today.

Doctor I need some sugestion s to how to deal with this. Should I wait and see ? any food habit. like i know giving little too much of gap between my food intake produces more gas.

Thanks & Regards XXXXXXX
 
 
Answered by Dr. Dinesh Kumar Singal 6 hours later
Brief Answer:
See detailed answer below.

Detailed Answer:
Dear XXXXXXX

First of all do not panic. You have been examined and tested by a physician hence do not worry.

Throat symptoms, yellow sputum and fever appear to be due to throat infection. If it persists then your physician may prescribe some antibiotics. X XXXXXXX chest will rule out any serious infection in chest.

Since you had colonoscopy last week, so do not panic about little blood in stool. This can happen due to straining at stools due to fissure or piles. Both of these are innocuous problems.

Gas is a typical symptom of IBS and when ever there is stress it may aggravate. Milk, juices, excess of fibres in diet increase gas fomation, so avoid these.

It was re assuring to know that you are HIV negative.

Best wishes,

Dr Dinesh Singal
Above answer was peer-reviewed by
 
Follow-up: Suffer acidity. Consuming Cyntodac. Sufer weight loss. Do you think IBS patients loose weight normally? 22 hours later
Hello Doctor,

Thanks for your reply.
For my coughing problem i was asked to get CT scan done.

PLAIN CT SCAN -THORAX (chest)

impression: A tiny calcigic focus of about 1 mm is seen across the segment IVa.
Visualised liver , spleen and adrenals otherwise appear normal.

Probable tiny old calcified granuloma across the hepatic Segment IVa.

========================================================
What significance can it have? Do you think I would need more investigation for this , specially considering my weightloss and IBS problem .

Thanks & Regards XXXXXXX
 
 
Answered by Dr. Dinesh Kumar Singal 1 hour later
Brief Answer:
No significance, nothing needed

Detailed Answer:
Dear XXXXXXX

These findings have no significance, and no further investigations are needed in this respect.

Dr Dinesh Singal
Above answer was peer-reviewed by
 
Follow-up: Suffer acidity. Consuming Cyntodac. Sufer weight loss. Do you think IBS patients loose weight normally? 29 hours later
Hello Doctor,

I am sorry .Everytime I think its over , I will not think about it anymore , but something comes up.

Due to my mild fever (just 2 days) , chill , coughing and cough syrup.

And ever since I have started taking the medicine for IBS ( Ganaton Total , Fluxetine Cap(Neurozac) ,Normaxin) , I feel very drowsy the whole day , specially since morning till afternoon .

Since this cold cough and fever started, my motion was not clear.
And today stomach was making lot of noise whole day , specially after having food.
Night just rushed to the toilet with sudden urgency to pass.
It was soft stool , floating , yellow in color, and i saw little red blood once again.

Doctor what would you suggest in this case.

I never saw blood before , 1 and half week back had endoscopy and colonoscopy done.
And after that this is the 2nd time I am seeing blood in stool.That is red and looked fresh.

Thanks & Regards XXXXXXX

 
 
Answered by Dr. Dinesh Kumar Singal 8 minutes later
Brief Answer:
Just relax, nothing to be done.

Detailed Answer:
Dear XXXXXXX

Do not panic. Loose motion may be either because of antibiotics or due to viral infection as well. Slight blood may be due to piles, as I have already discussed. Since colonoscopy was normal do not worry at all.

Drowsiness is probably due to normaxin and Flouxetine. Both can cause sedation.

I will advise you to relax.

Dr Dinesh Singal
Above answer was peer-reviewed by
 
Follow-up: Suffer acidity. Consuming Cyntodac. Sufer weight loss. Do you think IBS patients loose weight normally? 5 days later
Hello Doctor,

One more time , here I am .
I got CT scan of my abdomain done , with contrast .

Impression : No Significant abnormality noted.

everything seemed normal in the result , but it says like below:

"Multiple small subcentimeter sized lymphnodes are noted in the mesentery - ? significance."

With my weightloss and sensitive stomach symptoms of upper abdominal discomfort at night and flatulence , do you find any significance of this report?

Thanks & Regards XXXXXXX
 
 
Answered by Dr. Dinesh Kumar Singal 37 hours later
Brief Answer:
Nothing needs to be done

Detailed Answer:
Dear XXXXXXX

Sorry for being late in replying as I was out of country.

I think this CT report is perfectly normal. Small multiple lymphnodes in mesentery usually have no clinical significance, hence no further action is needed.

Best wishes,

Dr Dinesh Singal
Above answer was peer-reviewed by
 
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