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Suffer from lower abdominal pain and pain in gall bladder region. Have constipation problem. Using nutorolax fiber. Suggestions?

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Gastroenterologist
Practicing since : 2000
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Hi doctor,
I am XXXXX , Age 29 yrs. i have been suffering from lower abdominal pain from past 5 yrs.
When i do a full night sitting journey. I feel my galbladdre is dropped and gas got stucked in it. Then follows pain
in the galbladder region. Pain lost for 3-4 days (not very severe pain i go to work , but very discomfort and irritation). I have a constipation problem from childhood. but it became worst in these 5 yrs. I have done colono scopy and few bloodtest 5 yrs back, results came normal.

Peppermint tea gives little relief. Colospa D-S also give little relief from pain.
Using nutorolax fiber for constipation.

Is it gas stone problem ? please prescribe medicine to get pain relief and gas stuck problem. I am asking this question from Bangalore india.
Posted Sat, 3 Aug 2013 in Abdominal Pain
 
 
Answered by Dr. Amit Jain 3 hours later
Hello! Mr XXXXXXX Thanks for putting your query in XXXXXXX I am a Gastroenterologist (DM).

I think you are suffering from IBS-C (Irritable bowel syndrome- constipation predominant) since you don't have any alarming features and twice colonoscopy is normal.

Few things to know about IBS:
1. Is a chronic disease which has relapsing and remitting course
2. It will never harm you even if it will persist for whole life
3. Stress, life events, and anxiety leads to aggravation of symptoms
4. Intestine becomes hypersensitive so even discomfort is perceived as pain
5. Increase gas production leading to abdominal fullness and bloating
6. No alarming features like weight loss, gastrointestinal bleeding, or fever

What all you have to do:
1.Take lots of fibres in your diet. Take psyllium fibres
2. take lots of liquid
3. Take some laxative like combination of milk of magnesia, liquid paraffin and sodium picosulphate may be Syrup Cremaffin plus (titrate its dose to make your stool soft)
4. Cap Gasex an ayurvedic medicine by Himalaya
5. Take antispasmodic like Tab Librax


I hope I have answered your query and this will help you. Remain in touch and get-well soon.
Above answer was peer-reviewed by
 
Follow-up: Suffer from lower abdominal pain and pain in gall bladder region. Have constipation problem. Using nutorolax fiber. Suggestions? 1 hour later
Dear Dr. XXXXXXX
Thanks for your valuable reply for my problem. Below are my questions.

I was told that I have IBS-C by my doctor after seeing the reports and prescribed Naturolax psyllium fiber for constipation.

Q1) can I use Naturolax psyllium fiber with milk and consume at bedtime?(currently using with water)

Q2) I pass lot of gas daily from down, When I do long journey or work on computer long time, generated gas is getting stuck and will not come out, which leads to pain in my lower obdominal. My doctor suggested to use Lesuride MPS chewable tablets, but its not releasing the gas. Could you please prescribe good tablet to release the gas completely ?

Q3) Colospa*Retard 200mg tablets are using for pain (SOS) ? shall i continue with this or any other suggestions , shall i try Tab Librax ?

Q4) I fee my large intestine is pulling down when symptoms trigger. is it because of Gas stuck in my colon?
Are you sure it is not gal bladder stone problem? how to confirm?


Kindly help me to findout answers to my questions.Thanks in advance.

Regards,
XXXXX
 
 
Answered by Dr. Amit Jain 46 minutes later
Hello! Mr. XXXXXXX Thanks for feedback.

Ans 1:Please avoid milk as the enzyme required for digestion of lactose disappear from our body and it is then digested by bacteria present in our GUT and produces lots of gas. So instead take Naturolax powder with water at bed time

Ans2. Cap Gasex tds from Himalaya Company and avoid milk

Ans3. Almost the same thing you may continue with colospa retard also but not on sos basis take it thrice a day

Ans4: Yes I am sure as Gallstone (ie stone in gall bladder pain is different known as biliary colic which occurs acutely reaches its peak in 1 hr and subsides with in 6 hours. And if it Cholecystitis then pain will be severe and will be associated with fever, jaundice and this pain will not remain for so many years.
However still to confirm you may simply get an ultrasound abdomen which may show stone or thickened wall of gallbladder

I hope I have answered your query, if still in doubt then let me know
Above answer was peer-reviewed by
 
Follow-up: Suffer from lower abdominal pain and pain in gall bladder region. Have constipation problem. Using nutorolax fiber. Suggestions? 1 hour later
Dear Doctor,
Thank you very much for you detail reply.

I have a quick question on your Answer 3

Currently i am using Colospa when ever the pain comes ( 2,3 tablets in 10 days).
You are suggesting to have trice a day after meals right?

How many days i should continue ?
If i continue say 1 month pain would not be there in this month. but say after 4 months if i get pain again, should i use the same tablet for 1 month or SOS basis?

Kindly help me to clear my doubt. Thanks in advance.


Regards,
XXXXX
 
 
Answered by Dr. Amit Jain 45 minutes later
Hello! Mr. XXXXXXX Thanks for feedback.

Initially take thrice a day, then after 4weeks, it may be reduced to twice a day and see for pain, if pain did not appear on twice a day for 4 weeks then it may be reduced to once. I mean to say that minimum dose as maintainence is required. This medicine has very minimal side effect and can be taken for a prolonged period

May be it may be started with Cap Meb -SR 200mg which is to be taken only once in a day as it is sustained release capsule
One more thing this tablet( Colospa or Meb SR) is to be taken 30 minutes before meals not after meals
Above answer was peer-reviewed by
 
Follow-up: Suffer from lower abdominal pain and pain in gall bladder region. Have constipation problem. Using nutorolax fiber. Suggestions? 3 days later
Hi Doctor,

yesterday afternoon, I spent 3 hrs on my computer to finish some pending work.

from evening 5 pm gas is not coming out (I used to pass gas frequently), it got trapped inside and it was very uneasy. So at 8 pm i had colospa and i had my dinner at 8:30. at 9:30 still gas did not come out, So i had "Himalaya Gasex" (2 tablets) still no use. I slept around 11:30 with uneasyness. Around 3 am i wakeup and had Dabur Pudina XXXXXXX liquid then little gas passed out. I could not sleep from 3 am.

Still lot of gas is trapped in my intestine. Kindly help me with some medicine to release my gas completely.

Regards,
XXXXX

 
 
Answered by Dr. Amit Jain 3 hours later
Thanks! Mr XXXXXXX

I hope you are taking medicine as prescribed above.

Avoid fibres for a meanwhile, and instead take some laxative like combination of milk of magnesia, sodium picosulphate, liquid paraffin (Syp Cremaffin plus)

Wish you getwell soon. Keep in touch
Above answer was peer-reviewed by
 
Follow-up: Suffer from lower abdominal pain and pain in gall bladder region. Have constipation problem. Using nutorolax fiber. Suggestions? 55 minutes later

Please suggest me exact medicine name.

Q1 ) What do you mean by combination of milk of magnesia ?
Q2 ) What do you mean sodium picosulphate?


I am able to pass stools, only problem is gas is trapped inside.

If i use Cremaffin Plus, I have to use it in bed time ? How much i should use?

Till night I can not wait, Please suggest me some medicine(tablet) which gives moment to my bowl and release the gas completely?

 
 
Answered by Dr. Amit Jain 4 hours later
Hello. Mr XXXXXXX

Syrup cremaffin is a combination of milk of magnesia, sodium picosulphate and liquid paraffiin. This syrup is laxative which contain all the three as I mentioned. These all have different mechanism of action and will lead to passage of gas and stool.

You can right now take 3 tea spoon of this syrup. If not relieved till evening then at night also you can take.

Take rest of the medicine as mentioned before

Hope this will help you. Remain in touch
Above answer was peer-reviewed by
 
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