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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can zinc and iron deficiency cause stomachaches, chest pain, acid reflux and nausea?

Answered by
Dr. Ramesh Kumar


Practicing since :1986

Answered : 1590 Questions

Posted on Mon, 14 May 2018 in Digestion and Bowels
Question: Hey doctor,

I am a 20 year old male and for the last year now I have been having stomach pains and digestion problems. The main symptoms I have been having are:

- Stomach pain right in the center and abdominal pains on the lower left side where pointed in the image.
- Painful chest pains
- Occasional acid reflux and heartburn
- Nausea
- Loss of weight I have lost about 6kg in the last 6 months for no reason down from 58kg to 52kg currently.
- Alternation between diarrhea and normal stools.
- Sometimes greasy and foul-smelling stools.
- Bad acne flareups
- Have developed bad anxiety because of all of this

I have been through numerous blood tests along with an ultrasound and endoscopy/colonoscopy and they have come up with nothing major but I did notice looking through them that my zinc and iron where on the very low end of the acceptable range

Another thing that I also recently I have noticed when I have alcohol only one small 600ml can like the other day for example that ever since then I have had this dull painful ache under my left ribs and I have attached an image pointing to exactly where is there any way I can alleviate this pain a little? What organ is located here and what could be the source of my pain could it maybe pancreas related? I have also been reading up about this disease called SIBO and how it is caused by low stomach acid and I have tried to cut out gluten, dairy, wheat and soy the last couple of weeks to see if that will help but the loss of weight is the biggest concern for me and a lot of people seem to notice it as well.

Medications I have tried are Zantac, Nexium, antacids which all make my symptoms a lot worse I have also tried antispasmodic which made me feel sick as well.

About 2 years ago I had this bad ear infection that didn't go away and I was on 5-6 antibiotics and I feel that is where all of this started and my mother and her father have the exact same symptoms and problems.

My diet growing up was never really the best either with a lot of processed and junk food which I feel contributed to this problem as well.

Would you have any recommendations of foods, diet, and supplements to try to based on all of this and maybe something to alleviate the pain under my ribs that goes around my back as well?

In terms of that stomach pain I get in the middle there are certain foods that trigger it and they are

Fatty foods
Wheat Bread

And that pain I get on the lower left side with the image I have attached seems to always be triggered by alchool.

I always seem to be running on adrenaline as well always sort of pumped up because I don't really feel like I get my energy from when I eat foods.

IMG_4567.JPG where I am pointing I have noticed that when I do a deep breath in it hurts there along with if I do a fake cough that it hurts in that spot. I also forgot to mention that I struggle to eat larger meals I feel as if the food just sits in my stomach especially meat.
Answered by Dr. Ramesh Kumar 1 hour later
Brief Answer:
Would like to treaty you on guidelines of IBS with overlapping gastritis.
Read the expaination patiently.
Take a print out consult your gastroenterologist.
Ask him for a prescription.
It won't help you in a day or two it would take time and life style change but i assure you that you can lead a normal life if you follow things properly.
IBS is not curable but fully controllable.

Detailed Answer:
Thank you for choosing HealthcareMagic for your query.
I've gone through your details all attachements reports and photos.
I am Dr Kumar and would be addressing your concerns.
As per your queries answer is see most of your symptoms their durations and not responding to medications are all suggestive of Irritable bowel syndrome.Let me give you a small briefing about it before progressing to your individual queries.
First and foremost point which suits your complete history is that IBS is a diagnosis of exclusion as there is no test to confirm you have IBS,It means that when you have nothing or all your investigations are normal you are labelled as having IBS.As per your reports your colonoscopy endoscopy biopsy(mild gastritis} USG Blood tests etc etc are all normal.Only investigation left is a MRI scan (though not required yet if its also normal,would clear pancreatic etc pathology) then you are having Irritable bowel syndrome overlapping with gastritis and aciod peptic disorder(image 4599 and biopsy reports are clearly suggestive that you are having chronic gastritis which irritates the layer of mucosa in your gut causing inflammation.This inflammation is the cause of pain as pain is inflammatory in nature and is involving gut and not intestines antispasmodics are of no use).

IBS is a very common disorder affecting the large intestine(image 4567). Abdominal pain, bloating, gas constipation unformed stools and diarrhoea are some of the signs and symptoms of IBS. Foods, stress and other diseases can trigger the problem.They vary from person to person.Frankly speaking the exact cause of irritable bowel syndrome is not yet known but studies suggest that a lot of factors play a major role. The intestinal walls are lined with a layer of muscle which contracts and relaxes in a rhythm when they move to your rectum through your intestinal tract. If you acquire irritable bowel syndrome, the contractions can get stronger and last much longer than usual. This causes diarrhea, bloating and gas. In some cases, the opposite can also occur, this can be characterized by weak intestinal contractions, which slows food passage resulting to dry and hard stools.Some patients presents with constipation while other have loose stools.Some have both.Anxiety stimulates the autonomous nervous system and further adds to problem.
What i mean to say is that Every patient with IBS is different with varying symptoms.
In a lay mans language in IBS there is some problem in the functional ability of the gastro intestinal tract that leads to the symptoms of irritable bowel syndrome. The structure of the intestines is normal, only functional abnormality occurs in this condition.So frankly speaking (IBS) represents a functional disorder of gastrointestinal tract without the presence of an anatomic defect.Therefore all tests would turn up normal as organ is not functioning properly but is normal anatomically and pathologically SO in lay mans language till date we are not sure whats the exact cause of this problem.

Now the million dollar question is how to repair a system when you don't know which part of it is faulty(Some says it can be brain other says it can be hormone anxiety age etc etc hundreds of hypothesis are there but till date its aarea of grey zone for researchers ).

Good news is that though every medicine is not helpful for every patient yet every patient usually responds to a particular medicine.Which one?
That we have to find out by taking small trials and observing results.

If you were my patient i would have started you on a combination of
Tab cibis 8mg thrice daily(contains Chlordiazepoxide, Clidinium Bromide, and Dicyclomine) consult your local pharmacy for this salt combination.

Why cibis?
Dicyclomine is an anticholinergic drug.An anticholinergic agent is a substance that blocks the neurotransmitter acetylcholine in the central and the peripheral nervous system. Anticholinergics inhibit parasympathetic nerve impulses by selectively blocking the binding of the neurotransmitter acetylcholine to its receptor in nerve cells.

Clidinium bromide is an anticholinergic (specifically a muscarinic antagonist) drug.

Chlordiazepoxide works by increasing the action of GABA, a chemical messenger which suppresses the abnormal and excessive activity of the nerve cells in the brain.
So by one tablet we can cover hormonal hypothesis with intestinal functional abnormality hypothesis).

For bloating and gas take Tab Dimethicone thrice a day it is used in the treatment of bloating and abdominal pain.
Along with it take a probiotic(vsl#3)twice daily with food as proper digestion of food will prevent excess gas formation.When food is not properly digested large amount of gases are produced inside due to incomplete fermentation of food.Hence if digestion improves overall symptoms will also improve.

Along with it take two tablets of Vegaenzymes(search online) digestive enzyme supplements twice 30 minutes before having meals.
An anti anxiety tablet like Etizolam 0.5 mg initially for a week(non habit forming).
Itopride 1 tablet a day in combination with rabeprazole.
You would need a prescription for them.
Better idea is get a print out of this answer and discuss this with your treating doctor and ask him to provide you with these medications.
If he does not then you should ask him for a explaination.

Now lets come to the part on which 70% cure depends yes food and nutrition.
Food pattern recommended is-
Eat simple and natural home cooked food.
If possible try detox diet (Raw vegans) for at least 1 month. Take normal food in lunch while in supper take uncooked raw (low fiber) natural form of food. This can play wonders.
Avoid taking excessive fibres. A total fiber intake of about 20-25 gram per day would be good for you.
No pizza,Burger, Red meat, non veg and dairies for few weeks.
No alcohol or smoking.

Take natural food rich in probiotics like Yoghurt, Kimchi,etc.This doesn't mean that you have to take them as much as you can.Follow your body increase their uptake gradually.
Drink lots of juices and fresh water daily. Drink cleaner water, it will help a lot.
Avoid spicy and heavy food.

If possible go for a detox diet but again don't force your body rather let your body adopt gradually to things.

follow up after a week.
Its nothing like pancreas etc.However just to get clearance and to label you as IBS get a MRI abdomen done.

In case you need any other help feel free to ask.I would be happy to help you.

Above answer was peer-reviewed by : Dr. Kampana
Follow up: Dr. Ramesh Kumar 1 hour later
Thank you for the very detailed reply it definitely helps clear a few things up but just a couple of things I wanted to clarify that you didn't cover. What about things like SIBO (Small intestine bacterial overgrowth), candida/yeast/bacteria/fungal/parasites overgrowth in the gut, and low stomach acid as well can they be contributing factors or causes of my symptoms? Would it do me any harm trialing Betadine HCL tablets with the digestive enzymes to see if they improve some of my upper GI symptoms and if they don't work just stop them?

I have tried one digestion enzyme so far called Brom Enzyme when I have meat and that seems to help quite a lot.

In terms of the diet that you recommend, I am very interested in this detox diet is there anywhere online that has more info on it? The only diet I have been recommending to try is the low fodmap diet for 4 weeks with also cutting out gluten, dairy, wheat and soy as they cause inflammation in your gut?

I really want to avoid any pharmaceutical drugs at this point as any I have tried have only made things worse for me and I would like to try a diet and more natural approaches first before adding those on if needed but my issue is I haven't really had a good sense of direction and procedure with these diets?

What about gaining weight back as well what would be the best way about that, how much water should I be having a day for someone like me skinny 52kg, 175cm in height?

In this raw vegan diet would it be ok to still have simple home cooked meats?

I have also listed below a list of medications that my doctor wanted me to trial individually for short periods of time and I wanted to know what you think of them as opposed to yours as and if I do trial them what is the correct way to take them? She has a more functional/natural approach as a doctor than a lot of others have.

- Nutrition Care Gut Relief:
- Brom Enzymes then Enbiotic
- HCL with pepsin caps with meals
- Olive leaf extract
- Pau D'Arco

Why avoid fiber as well I thought that it was good for your digestive system? I also notice a lot of undigested food and what looks like white pieces of flecks in my stools that float around in the water along with when I urinate that same thing comes out thus why I suspect candida/yeast/bacteria/fungal/parasites overgrowth in some form?
Answered by Dr. Ramesh Kumar 1 hour later
Brief Answer:
Follow up.

Detailed Answer:
Thanks for follow up,
Answers are as follows-
Why avoid fiber as well I thought that it was good for your digestive system?-20-25 grams per day is enough for you.Including too much fibers in your diet would increase bloating and production of gas in patient with IBS.

I also .... some form?-Easy way out take a stool and morning urine sample for stool routine and microscopy and urine routine microscopy followed by culture and sensitivity test.Things would be clear in a day.

What about gaining weight back-How do we gain weight or grow?
Simple logic sir we take food metabolize it and absorb it use the good part and throw out the part not needed.Food is broken down into fat protein and carbohydrate .When digestive system is not working properly when food is not absorbed(you can yourself see undigested food in your stools).How would body gain weigh infact slowly and slowly you would land up into malnutrition if things are not treated properly.Rather you are having low body mass index at present only.

If any of the below mentioned process s not functioning well;Breakdown-metabolism-absorbtion and excretion your body won't gain weight.

In this raw vegan diet would it be ok to still have simple home cooked meats?-Try to avid meat for few weeks as its hard for digestive system to digest lean and heavy proteins.

Diet plan-
8 am wake up -Have 1 apple
1 banana
50 grams oat
5 ml honey

10 a.m-Two egg whites boiled

1 scoop pre-digested veg protein shake
2Loafs of brown bread
Fat free milk 200 ml.
ON fitness fiber 5gram
30 gram chick peas

4 pm
1 tsf peanut butter
1 pear
Half orange.

Veg salad one plate
30 gram boiled cooked kidney beans

1 scoob casein powder.

- Nutrition Care Gut Relief:
- Brom Enzymes then Enbiotic
- HCL with pepsin caps with meals
- Olive leaf extract
- Pau D'Arco

All of them are basically supplements so you can try them together.They are either natural supplements.They are not medical salts except HCL and Pepsin(protein digestion).
So have them for 4 weeks minimum and see result(though i i don't feel it would make much difference but you never know,lets give it a try).

For detox diet you can post a query to dietician on this forum.Thay exclusively deal with diets only.

As per SIBO is concerned a simple breath test is enough to rule that out.This test is named hydrogen breath test secondly as suggested above stool test would reflect overgrowth of bacteria's.You have already tried FODMAP Diet clinically if it was SIBO you would have responded really well to it.

For query regarding low stomach acid-
-Mix 1/4 teaspoon of baking soda in 4-6 ounces of cold water empty stomach and drink it.
take a stop watch and note time you take to belch it takes you to belch. Time up to five minutes means normal acid production if its more then that then you would be checked for hypochlorhydraia.

You can try these things but as per me its IBS.

Hope i was helpful.
Above answer was peer-reviewed by : Dr. Yogesh D
Follow up: Dr. Ramesh Kumar 23 hours later
So trying these diet tips and fixing the underlying digestive problems would correct the weight loss issue and stop it from getting even worse is what you are saying in terms of that? Would eating maybe smaller meals more often be of help to get in more calories would it be worth seeing a dietitian to help on this?

Another thing that I wanted to further touch on is that I feel that I have some form of adrenaline fatigue that is enhancing my digestive problems. I always feel as if I am running on adrenaline all day long and I feel that is effecting my digestive health. Along with I have also had some form of addiction to masturbating and I have had pains in my prostate/pelvic region but I did an renal ultrasound and urine test and that came out fine but that maybe the over masturbating is why my zinc levels are low? I have read that over masturbating and sexual exhaustion can lead to these things and also cause some of the digestive/tiredness and acne symptoms I am having is that true I was reading this post;


I forgot to mention my doctor also had Zinc and Iron supplements on that list too but I have read that you have to be careful when taking them because you can overdose and make your problems worse what would be the best way about taking those if I do try them?
Answered by Dr. Ramesh Kumar 1 hour later
Brief Answer:
folow up.

Detailed Answer:
These are all sham article.Masturbating is a natural and healthy process.2 times a day is well tolerated by body.Keep searching and you would see that madturbating is a diseases it can cause weakness bla bla...Please refer to article given on NCBI or join sites like magic genie for articles.

Zinc supplements are available any where you can take a natural multivitamin.As explained earlier there are hundreeds of mineral micro maxro nutrient ions vitamins etc .Ecery thi g could not be perfect at a time.We can’t have all parameters normal alwasys.So you can just poo a natural multivitamin daily.
If you are supplementing iron measure hemoglobin and ferritin every 3 month.
For adrenaline anxiety induces secretion of catecholamines get a blood level checked up.
Follow mayo,NCBI and magic genie.
Rest all any one can write ant thing.
I have to sell my product i would write any thi g.Billion dolars market sir.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
Follow up: Dr. Ramesh Kumar 2 hours later
Righto good to clear that up with a doctor ahah! One last thing though with the gastroscopy that I had those stomach pains specifically on the left side began kind of after I had gone through the procedure so my question is can having a gastroscopy in some situations causes bruising or damage and if so would it heal over time as my gut does? I read online a lot of other people having pains after having theirs as well referring to this as an example would there be much I could do about that if it some how did cause damage?
Answered by Dr. Ramesh Kumar 24 hours later
Brief Answer:
If you feel its due to endoscopy take tylenol or any anti inflammatory for 3 days if pain settles down its due to it.However the collections of symptoms you are having are not due to endoscopy etc as a matter of fact.
Your age 20 is usually when IBS
Detailed Answer:
Hello again my dear patient,
Endoscope is a very sophisticated instrument designed after years of researches.Yes mild rupture of mucosa layer of esophagus or gut is possible while doing endoscopy but it usually heals itself in 3 to 7 days.If not a mild anti inflammatory like tylenol heals it.
Very rarely does a doctor do it so badly that it perforates gut or esophagus(absolute rookie) and in that case severe bleeding vomiting and pain is there but they are 1 in million or more case.
If you would read internet there would be hundreds of possibility.Do you know patient can have migraine without headache?But they are rarest of rare cases and most of the times you can find these rare scenario patient only complaining and predicting things on internet on various forums because those who are cured(majority)never surfs these topics in details.Only a person suffering and not relieved by standard treatment can understand the pain and suffering he/she is going through.
Basically my dear patient you are are a case of IBS with gastritis and as you are not ready to take medicines right now you are having problems.Things in this century are very difficult to be controlled only naturally.

So my sincere advice is consider my initial suggestion if still not convinced discuss with other gastroenterologist my answer(Dr Shehu or Dr Kinni etc there are a number of gastroenterologist(from various parts of world) ) available on this forum and as said by elders two heads are better then one head or discuss my answer with your treating doctor.
For me its IBS with gastritis managed improperly.

Hope i was helpful,
Feel free to follow up and warm regards!
Do rate the answers when this thread is closed and any suggestions about making quality of answers better would be appreciated my dear.

Above answer was peer-reviewed by : Dr. Raju A.T

The User accepted the expert's answer

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