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What Could Be The Cause Of Gas Problem With Normal Endoscopy And USG ?

Posted on Fri, 18 May 2012

Question: Hello doctor, I am 39 Year Male, I have been suffering for Gas problem since last 4 months. Doctor asked to do endoscopy two weeks back but found nothing. USG is also normal. Doctor Prescribed Rabcip (rabeprazole sodium) and VSL#3 for 10 days. Gas problem seems to be increased now and in middle of the night and even during day I am getting terrible hungry feel and feel very heavy after taking food. I have stopped taking the medicines now. Any help? Thanks in advance.

Answered by Dr. Pragnesh Vachharajani (29 minutes later)

Dear XXXXXXX thanks for posting your query.

In today`s era of fast life and stress this kind of problems are on rise.The treatment given by your doctor is right.The good part is that the endoscopy is normal and you do not have ulcers which are the most common cause of this kind of problem.

Whether you had gone for an ultrasound of abdomen or not ? If not, please go for ultrasound of abdomen on empty stomach.This can provide vital information for diagnosis in such kind of cases at times.Please also go for basic blood test like blood counts,stool test which might help to clinch the diagnosis and help in treatment.

Please continue taking Rabcip as prescribed.This will definitely give relief in your case.One more thing that you have pointed is that you are getting stressed very easily.

In the stomach and digestive systems problems this plays a very big role.In fact it has got a direct relation between them.Means when you are stressed your problem will increase and vice a verse.

Please take following precautions:

1.Avoid skipping meal or having heavy meal.
2.Do not take any pain killer drugs for long time without advise.
3.Divide your meals in four major parts.
4.Have meals at regular intervals.
5.Avoid taking alcohol,soft drinks,tobacco in any form.
6.Try to avoid stress.Try yoga,pranayam etc.to relieve mental stress and increase mental strength.
7.Do not sleep up to 2 hours after food.
8.Avoid fast foods and eating heavy foods XXXXXXX in oil.
9.Take medicines regularly.
10.If needed do not hesitate to ask your doctor for help regarding medicines for anxiety and stress.

I hope I have answered your query,still if you something more to ask ,I will be available for follow up.Bye and take care.

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

Follow up: Dr. Pragnesh Vachharajani (1 hour later)

Doctor,

Thanks for answering in details. Response to few your questions and more questions

Whether you had gone for an ultrasound of abdomen or not ?
- USG was done a month back for abdomen, I have a non obstructive kidney stone (there for last 2 years and gradually reducing size, current size in 5.4mm). Other than this no abnormality was found in the report.

Please also go for basic blood test like blood counts,stool test which might help to clinch the diagnosis and help in treatment.
- Same was done 1 month back as part of Master checkup and report was normal.

Please continue taking Rabcip as prescribed. - Doctor, I thought Rabcip created the new problem as described earlier. Middle of the night I am getting a feel of empty stomach and both upward and downward gas movements. This symptom was not there earlier. Even during day time 4/5 hours after taking meal I am getting this irritating sensitivity. If I take couple of biscuits then immediate that hungry/starving feeling goes away. Today before dinner I took a OMEZ and feeling little better now. Also 1 thing I forgot to tell you , I get occasional kick in the lower rib cage area , just above stomach.

Please take following precautions:

1.Avoid skipping meal or having heavy meal. - OK
2.Do not take any pain killer drugs for long time without advise. - Never take
3.Divide your meals in four major parts. - OK
4.Have meals at regular intervals. - I do
5.Avoid taking alcohol,soft drinks,tobacco in any form. - OK dont have any havit except 2/3 cigarette per day
6.Try to avoid stress.Try yoga,pranayam etc.to relieve mental stress and increase mental strength. - I regularly do Yoga and lot of exercise for last 2 years without skipping any day
7.Do not sleep up to 2 hours after food. - OK
8.Avoid fast foods and eating heavy foods XXXXXXX in oil. - I dont
9.Take medicines regularly. - which medicine?
10.If needed do not hesitate to ask your doctor for help regarding medicines for anxiety and stress. - OK

I shall definitely see my doctor in this week end but wanted to check with you if there is alternate medicine you recommend? Can I continue taking OMEZ or you want me to take RABCIP instead? This is sometime so disturbing that I am unable to concentrate on work.

Thanks again Doctor.

Answered by Dr. Pragnesh Vachharajani (8 hours later)

Dear XXXXXXX

Good to see you back.You are patient that every doctor will love to treat.Very clear in ideas and to the point.I really appreciate that.

Any way come to your query,it is good that ultrasound and blood reports are normal.It seems that you are having acid peptic disease or GERD,some times known as.

Omez and rabcip practically are same drug class of proton pump inhibitor.There mode of action is similar and after day 5 of starting they are same.You can take either of them as per your convenience.

Stop smoking cigarettes.Any number in not allowed.Have snacks in between meals like fruits,salads,soups,juices etc.Avoid things like biscuits all the time as they are difficult to digest.

Please continue this tablets for minimum six weeks,in order to have proper benefits.

It is good that you are doing regular exercise and also doing yoga.Just learn to stay cool and calm.Plan things properly so last minute haste does not lead to anxiety and stress.

While sleep at night ,if you are uncomfortable,please raise head end your bed.You can either place blocks under it or place pillows below your mattress.This will help a lot.

And as advised please be touch with your doctor.Bye and take care.

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

Follow up: Dr. Pragnesh Vachharajani (59 minutes later)

Thanks a ton Doctor, really appreciate. One last question - How many OMEZ per day I need to take for 6 weeks? Shall I take this before or after food? I was advised to take RABCIP 1 tablet after food at bed time.

Thanks again. It seems the new method of collecting advise online, working well for me and I am going to propagate this in my network.

Answered by Dr. Pragnesh Vachharajani (9 minutes later)

Dear XXXXXXX

Thanks for Quick response.

The normal dose of omeprazole(omez) for an adult is 20mg once daily on empty stomach. Ideally this should be taken as first thing in a day after brushing your teeth,even before tea/coffee/milk.

This drugs works better when taken on empty stomach. Though an over the counter medicine I would suggest you to call up your doctor before starting this drug. He is the person who is going to treat you.

I hope things are clear now.

Wishing you good health all the time.

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