Suggest treatment for acid peptic disease and chronic diarrhea

Posted on Mon, 12 May 2014 in Abdominal Pain
Question: Hi doctor, I have gone through Upper GI Endoscopy, RUT,Colonoscopy, Biopsy tests. Below are the findings ----------------------------------------Endoscopy---------------------------------------------------------------- Indication :- Acid Peptic disease Oesophogus :- Lax lower EsophagealSphincter Stomach :- Antral Non Erosive Gastrities Rapid Urease Testfor HpyloriNegative Duoedenum-Cap :- Normal 2nd part :- Normal ----------------------------------Colonoscopy Report---------------------------------------------------------- Indication:- Chronic Diarrhea Illeum :- Terminal Illeal Erosions- Biopsy taken to look for Infective/Inflamatory bowel disease Caecum :- Normal Ascending colon :- Normal Transvers colon :- Normal Descending colon :- Normal Sigmoid colon :- Normal Rectum :- Grade I Internoexternal Haemorrhoids with healed fissure in Ano -------------------------------- Biopsy Report------------------------------------------------------------------ Brief Clinical History :- ?Inflammatory bowel disease Specimen :- Ileal biopsy Macroscopic Description :- Received 4 grey white mucosal bits ranging in size from 0.2 to 0.3 cms. Entire tissue processed. Microscopic Description:- Illeal biopsy shows normal villi with crypts showing occasional foci of muchi depletion. The lamina propria is unremarkable.There are no granulomas. Diagnosis/Comments:- Illeal biopsy is within normal limits -------------------------------------------------------------------------------------------------------------------------Now please suggest me the following 1) I have used tablet Nexpro 40mg for about 2 months before breakfast and could not find any relief 2) Treatment for the all the above findings in Endoscopy/Colonoscopy/Biopsy Test. 3) Must avoidable diet and required changes in life style. 4)How much time it will take to get rid of all these problems if i take proper medicines and appropriate changes in life style. Waiting for your advice. Thanks & Regards XXXX
Answered by Dr. T Chandrakant 48 minutes later
Brief Answer: as Advised Detailed Answer: Hi XXXXXXX Thank you so much for an elucidate history. Gone through the reports thoroughly. I wonder to see the indication of Upper GI as acid peptic disease and that for Colonoscopy as Chronic diarrhea. Ileal Biopsy is normal irrespective of the finding of erosions. And Upper GI - Oesophogus:Lax lower Esophageal Sphincter and Stomach: Antral Non Erosive Gastritis and Rapid Urease Test for Hpylori Negative I would suggest the following: *Tablet Ranitidine 150- 12 hourly ( twice daily and spacing of 12 hours strictly) *Tablet Motilium-M (Domperidone) 10 mg 8 hourly - a 1 each at 6am- 2 pm - 10 pm. No relation with the food. * Liquid Happicid or Mucaine get 3 tsf exactly 3 hourly preferably when you are empty stomach. * Tablet Equirex ( may need a prescription) only if you have pain , tenesmus (pain and feeling of going for a motion) or loose motion. * Diet= The simple rule is - the patient has to find himself on permutations and combinations and old experiences whichever foods and beverages do not suit you . Stop all of them altogether. I hope this mixture of medicines would give you relief within a few hours to a few days only. Continue for a minimum of 1 month. Please feel free if you have further queries or clarifications.
Above answer was peer-reviewed by : Dr. Shanthi.E
Follow up: Dr. T Chandrakant 16 minutes later
Thanks a lot for your response doctor. Please clarify the following 1) I do not have any pain/burning sensations as of now but weekly twice i will have a feel of going for motion for the 2nd time. 2)Will all the problems get resolved 100% if i take medicines for 1 month 3) Why you are wondered to see Acidic peptic disease and chronic diarrhea? Is that a rear combination?
Answered by Dr. T Chandrakant 6 minutes later
Brief Answer: You will . Detailed Answer: Thanks XXXXXXX IT is this time that you take Equirex- when you get the feeling of going twice or more times. All the patients with the problems like you have got well , so you too are going to be well and healthy. Only see that any change in the diet, stress level, particularly when you have to do anything against your will and wish all can cause a recurrence. You have to avoid them at any cost. Take this as a recurrent problem- the best part is this is treatable , manageable and avoidable. I wondered for the the different indications the Doctors have written on both the endoscopies... Which are of the same patients. They should have mentioned both the problems at both the reports ( a part of the practical medical humor/ joke- nothing to do with the treatment)
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
Follow up: Dr. T Chandrakant 13 minutes later
That's fine doctor 1) I have consulted my family doctor as per his opinion he says need not use the medicines just take proper diet 5 times a day in little quantities (i,e.. the amount of diet that i take 3 times he just asked to make it 5 times without changing the quantity) 2)But i doubt how come all the problems found in those reports will cure without any medicines? I am in dilemma whether to use medicines/not? 3)If i have to meet you personally for consultation please let me know your hospital name and address. Can you please answer to my above 3 quries indvidually
Answered by Dr. T Chandrakant 3 hours later
Brief Answer: please go through Detailed Answer: Sure... but in a different order. 2) The medicines I have prescribed will never harm and if at all, are going to help you. I have specifically used the word a ''mixture''. So start taking them and se the better part of life. Faith is very important. 1) Everyone develops with his medicine mixtures. These is not going to do any harm. And I am not sure how much your Family Physician is exposed to such problems. Dividing and taking meals into 5 parts and taking them from time to time is practically very difficult, although this too is what I prescribe ; but over years have not a single patient who can really follow this. Yet you can try. 3) I really do not the procedures of people at HCM. I am in Bhopal and you may please contact HCM pals to get the phone number and other details. Where are you stationed at ?
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Dr. T Chandrakant

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