Brief Answer:
Life style changes & consult your Gastroenterologist..

Detailed Answer:
Hi XXXXXXX
Thanks for the query through health care magic virtual clinic. I understand your concern.
*The possible causes of the shoulder pain you have can be-
- It's good that you could manage IBS symptoms with Laxido, Fybegel,Colpermin all these years,but as the age advances, the intestinal movements get sluggish, causing stagnant food in GI tract & this results in aggravation of IBS symptoms by causing more acidity signs ( gastro esophageal reflux ), more bloating of abdomen , the gas collects under diaphragm.. . & this gives a referred pain & heaviness in right shoulder.
* In my view, Lanparazol is good medicine to control acidity but it's over use can cause bacterial over growth to aggravate regurgitation & acidity. So you should consult with your doctor about duration of it's use..You can add Fibegel if you have associated constipation.
* pathological test to exclude / diagnose bowel infection with bacteria/ amoebae followed by it's needful specific treatment according to your gastroenterologist's advise would be ideal at this stage.
* changes in life style would help a better relief-
- Have small & multiple servings of food.
-Avoid fatty, oily & high carbohydrates ( which cause more fermentation ) & spicy diet.
- have sufficient fibers in diet along with 10-12 glasses of water / day. This facilitates bowel movements.
- Regular exercises & regular bowel habits help .
- Stress management & sound sleep play major role in good digestion.
** In short, I would advise for consultation of your Gastroenterologist to reassess your IBS & exclude infection of bowels & few life style changes would help you.
I hope, you find the answer both informative & useful. Any follow up query is welcome.
Thanks.

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Brief Answer:
prevent infection,anxiety/ lifestyle changes / gastroenterologist's care.

Detailed Answer:
HI XXXXXXX
Thanks for the follow up query.
* Yes, Anxiety does play a role in dyspepsia.
It affects by two ways.
- In anxiety the food or water are eaten in hurry.. leading to excessive air swallowing.. leading to distension of abdomen as well as difficult food digestion.
- Anxiety or any type of psychological stress affect the nerve stimulation to gut.. thus causing slow gut movements, delayed emptying of gut which becomes cause of fermentation of food & difficult digestion/ dyspepsia,
- This is why I had added Stress management in life style to control IBS./ dyspepsia.
- Management of stress can be -
- with help of a counselor.
- Naturally by mind concentration techniques.
* Yes you are correct. Probiotics are responsible for good health of bowels by-
- increasing bowel resistance / preventing infection/ infestation of bowels.& thereby helping normal bowel activity..
- Lactobacilli produce vitamin B complex in gut.. there by offering general good health.
- Probiotics also prevent of cholesterol from gut... thus prevents raised cholesterol and health issues following it ,like blood pressure.
So taking probiotic is daily meals is very good Specially natural probiotic in form of curd/ butter milk is good.
* Management of dyspepsia depends on balancing between causative factors( infection, psychological stress,management of lactose intolerance - if nay)& supplementing it with healthy life style & taking medicines advised by your doctor regularly.
The balancing is some times difficult.which makes dyspepsia difficult to shift. But determined efforts taken persistently over a long period.. definitely succeeds in shifting dyspepsia..and I guess ( from your approach to the problem )You can make it !
I hope that answers your query well. Any follow up query is welcome.
Please grade the answer, in case you are satisfied with it.
Thanks.

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