Hello and welcome to Healthcare Magic. Thanks for your query.

You seem to be having a binge-drinking pattern of alcohol dependence. As regards, your gastric problems, you seem to be suffering from chronic acid peptic disease (APD) and reflux. This is caused due to stomach and duodenal irritation which leads excessive acid production and ulcer formation. This is the reason for the acid taste in your mouth, stomach discomfort and distension, etc. Rabicip, Rabium plus, etc. can help in decreasing the acid secretions, but it works only temporarily because your alcohol consumption keeps worsening it and prevents healing. So, along with treating this problem, it is very important to tackle your alcohol problems simultaneously.

Coming to the treatment part, firstly, I appreciate you for taking the initiative to seek help. This is half the road to success. Second half is that you should take treatment regularly and stay motivated.

Now, treatment for your alcohol problems will be in two phases. The first phase is called "de-toxification". In this phase, the aim is to get the body out of the effects of alcohol. This will include treatment of withdrawal symptoms (if any), improving your nutritional status and treating medical complications. The second phase is called "de-addiction". The main goal of this treatment is to prevent you from relapsing i.e. going back to your drinking. For this, there are medications called anti-craving agents like Acamprosate and Naltrexone. which can help reduce the urges or impulses to drink. There are other medication called detterent medication, like Disulfiram, which can also help you stay away from alcohol. Also, certain mood-stabilizing medication like Carbamazepine and Valproate can help in reducing your impulsivity and mood fluctuations, which may be causing you to have this kind of fluctuating drinking pattern.

Along with medication, counselling is also essential to improve your motivation and confidence levels. There are many forms of psychotherapy which can be used for de-addiction - like motivational enhancement therapy, aversion therapy, hypnotism, etc. A combination of medication plus psychotherapy has been found to yield the best results for de-addiction. So, please see a psychiatrist in person so that he can assess you in detail and plan which treatment option is appropriate for you.

Regarding your acid peptic disease, you can try a medication called 'Ulcikit'. It is a combination medication which is very useful especially in chronic and reccurrent cases. In addition, you can try a syrup called Sucrafyl-O, which serves as an antacid, anaesthetic as well as a ulcer-protective agent. You can also start on a thiamine supplement (Benthai Forte) and a hepato-protector (Silybon) for preventing further alcohol-related medical complications. The above medication can be taken safely with your anti-diabetic medication.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist

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Hello again,

Ulcikit (for chronic / recurrent acid peptic disease) comes as a set of three tablets - omeprazole 20 mg, amoxicillin 750 mg, tinidazole 500 mg. All three tablets have to be taken twice a day and have to be continued for a week at least.
Sucrafil-O syrup can be taken two spoons (before meals) three times a day.

As far as your alcohol problem, it is advisable to take:
Benthai Forte once a day (which is a Thiamine supplement) and
Silybon 70mg once a day (which is a hepato-protective agent for your liver)

As far as the de-addiction therapy is concerned, I would strongly recommed that you consult a psychiatrist in person because you first need a proper physical examination, a psychological assessment as well as some basic investigations, before planning further treatment options. Without doing these evaluations first, it may be unsafe to take the special de-addiction medication. Moreover, remember that medication is just one part of the therapy. Counselling, motivational enhancement and other psychological techniques are also absolutely essential to help you to stay motivated and get control over this habit.

Wish you all the best.
Dr. Jonas Sundarakumar
Consultant Psychiatrist

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