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Suggest Treatment For Abdominal Pain And Bloating, Nausea And Chronic Constipation

Posted on Mon, 2 Nov 2015

Question: My wife is suffering from abdominal pain. (bloating, nausea, chronic constipation). She has had these issues since the 3rd week of July 2015. (which was about 2 weeks after we took a trip to the bahamas). At first, the thought was that it was worms and she took albenza 400 and 2 doses of nitazoxanida 500mg, but these treatments were not effective. She's submitted 2 stool samples and has had a CT scan, endoscopy and colonoscopy. All results are "good" (i.e. no cancer, no problems that can be identified). She's put herself on a no dairy, no meat diet, mostly vegetable and no sugar diet. The diet seems to control her symptoms somewhat. She feels a dull pain in her stomach along with very strong hunger pangs. We are concerned and don't know what to do.

Answered by Dr. Dr.P.Ratnakar Kini (7 hours later)

Brief Answer:
Dyspepsia and constipation

Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.

It looks like she is having dyspepsia and constipation. Since all the test results are "good", these symptoms could probably be functional.

But since all these started after a trip to the Bahamas, infection should be ruled out.
A course of Rifaximin may provide relief.
She needs to take probiotic supplements also.
For relief from bloating, either Levosulpiride or Reglan may be taken.

For relief from constipation she needs to take high fiber diet, enough fluids and miralax.

I hope that answers your question.
Let me know if you have any more questions.
Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (2 hours later)

Hello Doctor.

Thank you very much for your reply.

If you don't mind, I have a couple of follow up questions.

1. Could you please explain what you mean in your reply by "since all these started after a trip to the Bahamas, infection should be ruled out"? Do you mean that a "bacterial infection should be ruled out?

Also, could you review the image that I uploaded called "martha-pink-spots.jpg". This image was taken during an October 2nd colonoscopy. You will notice pink spots on her colon. My wife also had a colonoscopy 18 months ago and these spots were not present. Do you have any idea what these spots might be? Her Gastroenterologist is not sure what they are.

I sincerely appreciate your help.
XXXXXXX

Answered by Dr. Dr.P.Ratnakar Kini (20 hours later)

Brief Answer:
Answer given below

Detailed Answer:
Hi,
Thanks for getting back to me with more questions.

1. Yes bacterial infection should be ruled out.
2. These spots appear benign. A biopsy should be done to find the cause.

Regards,
Dr.R.K.

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Above answer was peer-reviewed by : Dr. Vinay Bhardwaj