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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for acid reflux post an angiogram while on Ecosprin and Storvas

Answered by
Dr.
Dr. Priyank Mody

Cardiologist

Practicing since :2009

Answered : 910 Questions

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Posted on Mon, 6 Jun 2016 in Hypertension and Heart Disease
Question: Done angiogram,having tablets of ecosprin 150mg,storvas 40mg,deplatt,betaloc 25 mg,orfer-xt,restyl 0.5 mg.Taking pan40 mg for gas .Some days he feels better but some times he looks very tired and restless and tells he had some pain the stomach.Can you suggest any other syrup/tab for gas.He is not able to go for free motion and if he goes also the motion is in black color.Is it anything to worry.Can he take ulgel tonic for easy digestion along with the medicines mentioned above.
doctor
Answered by Dr. Priyank Mody 1 hour later
Brief Answer:
Stop Orofer XT . Stool for occult blood after 7 days .

Detailed Answer:
Hello ,
The black colour of stools can be because of Tab Orofer XT, 2 high is an iron supplement or because of small amount of blood loss due to Ecosprin and deplatt which are blood thinners .
Also Orofer XT can cause constipation and abdominal pain .
I would strongly suggest that you stop Orofer XT for a week and if the back coloured stool is still persistent Do stool for occult blood as investigation.
All other medications are necessary for heart and should be continued .
For constipation. Liquid duphalac 30 ml at night would be helpful.
Also increase tab Pan 40 mg twice a day
Lastly yes you can take ulgel for relief however ni cardiac medication withen 2 hours of taking ulgel as it interfere with absorption .
Hoping this will help .
Regards Dr Priyank Mody
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Priyank Mody 2 hours later
I didn't understand the last answer that can I take ulgel.I need to take ulgel before 2hrs of my medicines right.orofer was given since there is blood loss when angioplast was performed which reduced hemoglobin levels.so is it recommended to stop this.he also gets finger pains,neck pain,wrist pains also.is it due to these medicines.if he has gas what all fruits he can take
doctor
Answered by Dr. Priyank Mody 17 hours later
Brief Answer:
Do rate for others reference

Detailed Answer:
Hello ,
Ulgel works by coating the stomach . This coating may prevent absorption of most medicines . So a time difference of 2 hours is good to balance .

I understand that Orofer XT was given for increasing hemoglobin, but at the same time if it's causing stomach erosion , he will lose more blood than what will form .
So I told to stop is for 1 week and see the difference. If the side effects were because of iron they should decrease considerably, also stopping iron for 1 week will not harm him
Because oral iron is nit the only way to increase hemoglobin, if your father is not tolerating oral iron , we can supplement iron iron once in 6 months till hemoglobin normalise .
All the other medication are extremely important , and if we have to stop them even for a day, the chances of stent closing is high , so we have to protect the stomach and all unnecessary e tea medication should be reduced to decrease the side effects is my thought.
Any clarification you can even call me through HCM .
Hoping I could help resolve your doubts.
Do rate for others reference.
Regards Dr Priyank Mody
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Priyank Mody 2 days later
I have attached my dad's angiogram reports. Already 2 blckas have been cleared with stents and Can you check and let me know if there are other major/minor blocks which can cayuse the attack.If the tablets prescribed are good and will dissolve the minor blocks.
doctor
Answered by Dr. Priyank Mody 41 hours later
Brief Answer:
Yes .the medicine is appropriate and will take care of minor blocks

Detailed Answer:
Hello ,
I have gone through all the reports you have attached . In the angiogram there is evidence of only 2 blockages in LCX and LAD , both of with which they have stented it seems as both were critical . The final result and if any problem I would be only able to comment if I see the CD recording which they must have given to you .
Otherwise you need not worry as the medication is appropriate and as per available papers there are no residual minor blockages.
However do continue the medication as prescribed by the doctor without any breaks and keep regular 3 monthly follow up with your doctor .
Regards Dr Priyank Mody
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Priyank Mody 1 hour later
Can u share me ur gmail id I can share u in google drive bcz f the huge file size or let me know how I can share the video
doctor
Answered by Dr. Priyank Mody 22 hours later
Brief Answer:
Do physically mail to CD copy for review

Detailed Answer:
Hello Sir , My previous experience with Google drive hasn't been good . Any further review.
You may physically mail the CD copy to
Dr. Priyank Mody,
Lilavati Hospital and research center,
Bandra West , XXXXXXX
I would review the same and send you my comments here.
Regards,
Dr Priyank Mody

Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Priyank Mody 13 hours later
Today the doctor has changed my dad's tablets.He asked us to discontinue Orofer and changed the gas tablet pan 40 mg to pan-d 40 mg and changed betaloc12.5 mg to metxl 12.5 mg since he is feeling restless and getting gas problem.Are these god medicines.Should metxl be taken twice or once daily
doctor
Answered by Dr. Priyank Mody 11 hours later
Brief Answer:
Yes all medications are appropriate, met xl once daily is enough

Detailed Answer:
Hello ,
As we previously discussed, Orofer XT can cause gas trouble and should be stopped , it's justified in doing so . Also pan d is appropriate upgrade .
Met xl as the name suggests is long acting metoprolol as compared to betaloc so one daily dose would be enough. If needed he can keep on increasing the dosage according to the need, keeping the blood pressure and pulse into view .

All modification is in line of our previous discussions and yes they are good for your father .
Lastly you have to trust the treating doctor as he on personal front would always wish best for the patient .
Regards Dr Priyank Mody
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Priyank Mody 3 days later
Can you try once with the google drive download.Just download the file,extract and then view it.Please let me know if you can do this.With the new medication also he is having the same symptoms like gastric problem,shivering,head ache,neck pain and some times stomach pain.I suspect if he is having any stomach infection.can he take digene syrup which was written by the doctor but i have not preferred buying it since he is already taking pan d tablet or is it better he takes digene/ any other syrup.With the new medication also he is having the same symptoms like gastric problem,shivering,head ache,neck pain and some times stomach pain.I suspect if he is having any stomach infection.can he take digene syrup which was written by the doctor but i have not preferred buying it since he is already taking pan d tablet or is it better he takes digene/ any other syrup.
doctor
Answered by Dr. Priyank Mody 30 hours later
Brief Answer:
Do go through the detailed information

Detailed Answer:
Hello .
1) The mechanism of action of digene and pan d is different , though of two pan d is more effective.
Digene lies the stomach surface not allowing food and other particles to touch the inflamed stomach membrane decreasing pain . Mucaine syrup is an alternative.
Pantorazole decreases secretion of stomach acid . So taking both togather may be more effective .
Also other precaution like no spicy food , tea coffee , chocolates , aerated drinks and no smoking should be strictly adhered to
If the symptoms persists may consider decreasing Ecosprin to 75 mg after consultation with your doctor
2) Yes restyl is sleeping pill and should be avoided in long run as it can be habit forming .However because of recent heart problem , good sleep is more essential.
So if he is getting good sleep without restyl may consider stopping restyl or after 3 months slowly tapering down the dose and stopping ro prevent rebound
3) If the symptoms persists rule out anything related to the heart or other symptoms as it's not wise to consider gastritis as the only cause of the symptoms, thought it's the most common one
4) you may contact me through HCM , If not available may mail me at YYYY@YYYY or call on 0 0000

Above answer was peer-reviewed by : Dr. Naveen Kumar
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