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Suffering From Abdominal Cramps And Loss Of Appetite. Diagnosed With Vitamin D Deficiency. Concerned

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Posted on Thu, 25 Oct 2012
Question: Sir,

I have been suffering from left upper abdominal cramping/ squeezing sensation.

Intially Cramping/ squeezing at left upper abdomin is very severe at instance I move to sleep and could not resist myself from sitting immediately the symptom lasted for few days. Added to that some sort of uncomfortableness at the same location after having food during day time.

Upon diagnosis it is discovered as Vitamin D deficiency

25-hydroxyvitamin D - level is diagnosed as L 4.18
Hepatic Calcification (Liver Right lobe) observed in ct-kub.

I am now taking Shelcal hd (1-0-1) and calcirol (cholecalciferol granules)(once in a week) for the past two weeks. Symptoms are addresed mostly.

Yesterday morning I have forgotten to take Shelcal hd and after lunch I experienced very light squeezing/ cramping sensation at upper left abdomen but this is more severe than I usually I have during day time before we started the medication. Later I have taken shelcal hd medicine at 5 pm evening and feel better.

Can you let me know if my health problem has responded to medication?

I also have problems like feeling high bp after snoring sleep.

Difficult to constipate, some sort of upward pressure in head when tried to constipate.

Also when I go for urination I need to wait for more time for complete urination. I mean to say if I pass urine and think urination completed I feel some more urine to pass within in a minute second and will go for some more urination, later feel comfortable.

I am also experiencing, loss of appetitie.
Weight loss by 8kgs in 5 months.
doctor
Answered by Dr. Charles S Narasi (3 hours later)
Hello, XXXXXX,
Glad to receive a question from my favorite place in India.
May Lord Srinivasa bless you with good health. You are a
young gentleman and a very long life ahead of you.
On your left side of the upper abdomen there are a few organs
that we would be concerned with. The spleen is on that side and
for any reason , that is enlarged or bruised ,that can give you pain.
Calcifications that are seen in the liver may indicate old burnt out
parasitic infection. Sometimes granulomatous conditions such as
sarcoidosis, rarely Tuberculosis can cause calcium scars.
Again, these are harless except if the disease is active.
Another organ that is on the left side is the left part of the colon
or large bowel called the transverse colon, the part is called
"Splenic flexure". Sometimes gas gets trapped in that part of the
colon and gives intense pain which is relieved after passing gas.
You tell me they have found you are Vit-D deficient. You also have
had loss of weight and changes of your stool consistency. I will
be concerned about "Malabsorption Syndrome". Something that
you have has affected the digestive process. You are losing
nutrients. I would recommend that you get tested for Celiac Sprue.
Blood tests can rule that out.
The calcium supplement that you are taking is O.K. But as I mentioned
you have to find out what is causing the deficiency. I don't know how
your consumption of dairy products that contain calcium.
You may ask your doctor to arrange for X-rays of your small intestine.
This can show changes if you have small bowel disorder.
Please follow through .
Wish you well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Charles S Narasi (4 days later)
Sir,
The recent report of test 25-HydroxyVitamin D shows the value as 31.60 (which is just in the range of sufficiency, sufficiency range shown in report as 30.0 - 100.0 ) tested on 6/9/2012.
Yesterday I still experienced squeezing/ cramping pain at left upper quadrant of abdomen as you explained as Splenic Flexure. I experience the pain intensity increasing proportionately I start to sleep lieing down on bed and could not resist from sitting. And whole night I am awake till I release the gas. Also I feel some sort of uncomfortableness at the same location (left upper quadrant of abdomen) during day time.
Could you confirm me if this is because of Splenic Flexure or Vitamin D deficiency or if both are related?
Also suggest me if more medication has to been taken along with Shelcal HD?
doctor
Answered by Dr. Charles S Narasi (2 hours later)
Hello XXXXXX,
Your Vit.D levels are still on the low normal range. For
a healthy adult that should be at least 50 +.
Try to lay on your stomach flat for 15-30 mins. before
you go to bed. Also drink a glass of warm water.
Vit-D deficiency should not give you the kind of pain
you are experiencing. As I mentioned to you before,
you need to get X-ray studies of your small and large
intestine to rule out any structural problems.
You can ask your doctor to prescribe some anti-spasmodic
medication that you can take before bed time.
Wish you well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Charles S Narasi (9 days later)
Sir,

I am taking Shelcal HD after dinner and after breakfast.

After I consume food I have some kind of irritation at Left upper quadrant of Abdomen with which I could not resist myself from keeping finger at that location.

Hepatic calcification is seen in Right lobe of Liver in CT-KUB, could the Shelcal HD which contains calcium impedes Liver functioning and cause some kind of irritation at Left upper quadrant of Abdomen.
doctor
Answered by Dr. Charles S Narasi (41 minutes later)
Hello, XXXXXX,
Calcium supplements that you take does not cause abnormal
liver function and also does not cause calcium spots in the liver.
Usually the calcifications that are seen in the liver are due to old
parasitic infection (Not active) or they are called granulomas
which are not harmful to you.
The left upper quadrant pain sometimes is related to trapped
gas in the part of the large intestine under the left rib cage
called "Splenic Flexure" since it is close to the spleen.
Gently rubbing the stomach (Abdomen) starting from the right
side and across the top and down the left side when you are
lying down or standing up few times may help relieve this.
You can also try applying something like "Amrutanjan" cream
to that area where you get the pain three times a day.
I hope you are also asking your doctor to do the x-ray studies
that I had mentioned earlier to find out what is causing the
Vit-D deficiency.
Good luck and good health.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Charles S Narasi (22 minutes later)
Sir,

Could you prescribe me the medicine (Anti-Spasmodics), so that I can take from tomorrow?

Could you provide me names of X-ray tests of large and small intestines?
doctor
Answered by Dr. Charles S Narasi (4 hours later)
Hello, XXXXXX,
I can give you the names of the antispsmodics, but I
cannot prescribe due to regulations.You have to have
your druggist or doctor can prescribe.One is dicyclomine
and the other is hyocyamine.(I am giving you generic names)
Brand names will be different in India.
As for x-rays, you need upper G.I.series and small bowel
X-rays.
Hope this gives you enough to work with.
Wish you well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Charles S Narasi (6 days later)
Sir,

After stopping Shelcal-HD, I have experienced acidity in abdomen
I have taken ENO and I feel very much releaved.

I still feel bit acidic in abdomen.

Could you confirm that it is acidity also can you suggest me
medication for complete recovery?
doctor
Answered by Dr. Charles S Narasi (2 hours later)
Hello, XXXXXX,
It is nice to hear from you. If XXXXXXX is giving you
relief, I think you will do very well if you take
a PPI drug, vailable over the counter such as
Omeprazole, Pantoprazole,Esomeprazole, Lansoprazole,
any of these once or twice a day.
I am still hoping that your doctor is still looking to
find out what is causing the Vit-D deficiency.
Good luck to you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Charles S Narasi (8 hours later)
Sir,

Can you suggest me dosage of Pantoprazole?
When the drug Pantoprazole to be taken i.e., after/before food?



doctor
Answered by Dr. Charles S Narasi (4 hours later)
Hello, XXXXXX,
Pantoprazole over the counter probably comes in
20 mg. tablet. If that is the case, you need to take
one tablet twice a day about one hour before you
eat , before breakfast and before the evening meal.
Syay on that for about 4 weeks and that should heal
any inflammation or even small ulcers in the stomach.
Wish you well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Charles S Narasi (31 hours later)
Sir,

I will continue taking Pantoprazole.

Could you let me know if this problem is related to Vitamin D deficiency?
Also could you let me know the health problems from Vitamin D deficiency.
I would also take Upper G.I. series, small bowel x-rays.
I would also take Celiac tests.

Could you let me know if any tests can show any inflammation or even
small ulcers in stomach for further diagnosis?
doctor
Answered by Dr. Charles S Narasi (2 hours later)
Hello XXXXXXX,
This problem is not related to Vit-D deficiency.
Problem is what is causing the deficiency. Vit-D is
very essential for bone health , to make our bones strong.
I am sure you have heard of Rickets due to Vt-D deficiency.
Bones become very brittle and they can crack causing mutiple
fractures, collapse of the vertebral column or the spine etc,etc.
X-rays will pick up significant ulcers in the stomach, not very
small ones ,but they can show if you have small bowel disease
such as Crohn's. Go ahead and get the tests that I have suggested
and let me know.
Wish you well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Charles S Narasi (9 hours later)
Sir,

I am experiencing Loss of hungryness to eat.

Could you suggest me medication for hungryness?
doctor
Answered by Dr. Charles S Narasi (3 hours later)
Hello, XXXXXX,
If you start taking Super B-Complex with C, vitamin
tablet once a day, that will improve your appetite.
Ginger cookies also will give you a little boost.
Try these .
Good luck and wish you the very best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Charles S Narasi (6 hours later)
Sir,

I also have dry cough for the past 2 days very few times followed by Sputum, Could you prescribe me medication for the cough?
doctor
Answered by Dr. Charles S Narasi (20 hours later)
Hello,XXXXXX,
I am not able to prescribe any controlled medications for
you from XXXXXXX However you can go to any nearby
drugstore and ask the pharmacist for some over the counter
cough medicine that contains dextromethorphone.
They will tell you which one.
Good luck.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Charles S Narasi (52 minutes later)
Sir,

Can you explain me if hungryness is related to digestion?
I take food regularly thrice a day. Can we say if the feases
are normal the food is digested? Or even if there could be some
reason even if food is digested proper nutrients/ vitamins are not
absorbed and that could lead to loss of weight?
doctor
Answered by Dr. Charles S Narasi (48 hours later)
Dear XXXXXX,
I think you worry too much. You should learn to relax and not
always think about what is happening to you. When you have
vitamin deficiency of one vitamin, you can also have low levels
of minerals like calcium, that is the reason to be on the calcium
supplement. I am glad you are working on getting the x-ray
studies and the blood tests we discussed before. Eventhough
you may be eating enough calories , if your intestines are not
fully absorbing the nutrients, you can lose wait.
Wait till you get everything done and you can let me know
what the local doctors told you.
Good luck.
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Charles S Narasi

Gastroenterologist

Practicing since :1962

Answered : 693 Questions

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Suffering From Abdominal Cramps And Loss Of Appetite. Diagnosed With Vitamin D Deficiency. Concerned

Hello, XXXXXX,
Glad to receive a question from my favorite place in India.
May Lord Srinivasa bless you with good health. You are a
young gentleman and a very long life ahead of you.
On your left side of the upper abdomen there are a few organs
that we would be concerned with. The spleen is on that side and
for any reason , that is enlarged or bruised ,that can give you pain.
Calcifications that are seen in the liver may indicate old burnt out
parasitic infection. Sometimes granulomatous conditions such as
sarcoidosis, rarely Tuberculosis can cause calcium scars.
Again, these are harless except if the disease is active.
Another organ that is on the left side is the left part of the colon
or large bowel called the transverse colon, the part is called
"Splenic flexure". Sometimes gas gets trapped in that part of the
colon and gives intense pain which is relieved after passing gas.
You tell me they have found you are Vit-D deficient. You also have
had loss of weight and changes of your stool consistency. I will
be concerned about "Malabsorption Syndrome". Something that
you have has affected the digestive process. You are losing
nutrients. I would recommend that you get tested for Celiac Sprue.
Blood tests can rule that out.
The calcium supplement that you are taking is O.K. But as I mentioned
you have to find out what is causing the deficiency. I don't know how
your consumption of dairy products that contain calcium.
You may ask your doctor to arrange for X-rays of your small intestine.
This can show changes if you have small bowel disorder.
Please follow through .
Wish you well.