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Having acidity, constipation and severe concentration problem. Suggest the treatment?

Nov 2013
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Answered by

Practicing since : 1994
Answered : 5574 Questions
Hi Doctor,

I have been facing the following symptoms for quite a long time now:

Acidity - Burning sensation in the stomach. Generally severe during the evening time.
Constipation - Feeling of incomplete bowel evacuation.
Severe concentration problem - Cannot concentrate while I am reading, or someone is talking to me, or even when I am watching a movie. Cannot process information efficiently and this is the part which worries me the most. This part is effecting me at work.
Whenever I the acidity and concentration symptoms aggravate, I also experience severe nasal congestion feeling and stiffness in the head.

I do not know whether acidity is the root cause or there is a neurological problem (like dopamine or serotonin imbalance or some kind of infection) which is causing other symptoms. I had earlier reported the symptoms on this website and Dr XXXXXXX (Neurologist) had suggested me Piracetam for one month. The doctor was very considerate and understanding, but I think I probably did not explain all my symptoms clearly earlier. Also, recently around 4-5 days ago, I had severe nausea one day and also ended up vomiting during the evening.

My Gastroenterology reports (endoscopy, colonoscopy, sigmoidoscopy) are all normal, MRI scan without contrast is normal.

Please let me know if you need any additional information which could help in diagnosis of my symptoms.


Would like to add one more thing. Everyday, by evening, I experience severe bloating of stomach (not necessarily due to gas though, as there is not a proportionate amount of gas discharge). There is also loss of appetite in general. Not enough desire to eat food.
Posted Wed, 2 Oct 2013 in Brain and Spine
Answered by Dr. Sudhir Kumar 2 days later
Brief Answer:
Detailed answers are below

Detailed Answer:

Thank you for posting your query.

I am willing to answer your query again, I purposely left it unanswered for 2 days, so that you can get opinion of another neurologist, but it did not happen so far. If you are willing, please let me know, then, I can answer.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Above answer was peer-reviewed by
Follow-up: Having acidity, constipation and severe concentration problem. Suggest the treatment? 22 minutes later
Hello Doctor,

I believe that the doctor knows more than me. I would be more than happy to take your opinion on this, and as you have already diagnosed earlier, I believe you would be the best person to answer my query.

Thanks a lot for your help!

Answered by Dr. Sudhir Kumar 14 minutes later
Brief Answer:
Please see the answer below.

Detailed Answer:
Thank you,

I am glad to review your case again.

It is good to know that your detailed gastroenterological evaluation and MRI of brain were normal. This rules out any serious problems with the gut and brain, such as tumors, severe infections, etc.

You have two separate problems, one related to the gut and the second related to the gut. One does not cause the another, which means that the brain problem is not due to the gut problem, and vice versa.

However, it is possible that the underlying causes for both are the same. The most likely diagnosis for your gut problem could be functional bowel disease, also referred sometimes, as neurotransmitter imbalance, as your MRI is absolutely normal.

It could be related to serotonin imbalance , as that could cause both gut and brain problem.

One medicine that could help in both is Dothiepin, commonly sold in the name Prothiaden. I usually give it at a dose of 25 mg once daily at night, and increase if needed after one month to 50 or 75 mg.

Also, the dose of piracetam can be increased to 1200 mg twice daily.

Taking vitamin B12 supplements would also help.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
Follow-up: Having acidity, constipation and severe concentration problem. Suggest the treatment? 10 hours later
Hello Doctor,

Thanks for your suggestion. I have a few questions I would like to clarify:

1. Do you think it is a good idea to increase Piracetam dose to 1200mg first, and then if the symptoms do not subside, then go for Dothiepin also? Or should I immediately start to take both Piracetam 1200 mg and Dothiepin at the same time?

2. For how long should I continue Piracetam and/or Dothiepin?

3. Do I need to be aware of any specific side effects of Dothiepin, and should I be taking any precautions for the same?

Thanks for your patience in answering all my questions!

Answered by Dr. Sudhir Kumar 4 hours later
Brief Answer:
My answers are below

Detailed Answer:
Thank you for getting back.

My answers are below:

1. You can increase piracetam to 1200 mg and take dothiepin at the same time.

2. You should take them for at least one month to see any improvement.

3. Dothiepin may cause drowsiness in the initial few days.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
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