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Dr. Andrew Rynne

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Suggest treatment for anxiety and IBS

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Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1414 Questions

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Posted on Thu, 28 Aug 2014 in IBS(Irritable Bowel Syndrome)
Question: Hi, I had acid reflux problems three years ago up to the level where it wakes me up in the middle of the night. I used to try to overcome it with home remedies and didn't take it serious until one day (18 months ago) I had an orange juice and felt all my stomach burning. I was so terrified that I have a serious problem. The next day I had constipation which lasted for a while and sometimes I had diarrhoea but I was constipated most of the time. My father died of liver cancer and a close friend was fighting stomach cancer in the same time I had those symptoms which created a great fear inside me. I went to the doctor (16 months ago) and he asked for blood, urine, and stool tests. He also told me that gastroscopy is needed even though all my tests were fine. After that I've been diagnosed with IBS and GERD. The doctor prescribed the following medications for me:
Paret 20mg one time a day for a month
duspatalin 200 for a month
and cipralex 10 for three months

he prescribed cipralex after few visits and many questions because I was asking him if I needed colonoscopy but he said I don't need it.

I was better after the medications but the anxiety didn't completely cured. My friend who had stomach cancer died of it and since then I can say I was hypochondriac. I started to monitor every single change in my body and get worry about it. Sometimes I would feel like I'm under real danger and get the fight or flight response. My life was very difficult and in many times I used to feel separated from everything around me. I took cipralex 20 for three months and my situation was slightly better after it. The entire situation created a great fear inside me and I was thinking of death and how my family will live after me. Those thoughts were invading me and I tried to fight them back but I couldn't get rid of them completely all I could do in the best case is to give them very small time of thinking in my day.

Since I was diagnosed with IBS I have constipation most of the time but the level of constipation vary from time to time. Constipation in my case is begin able to defecate daily but the stool would be dry in the best case and hard small formed in the worst case. Couple of weeks ago constipation came back and this time was very hard to pass. In the same time the acid reflux start to strike hard and cause pain in the chest. I also have mild pain in my upper left abdominal and bloating most of the time. This caused a huge stress and my anxiety level got so bad and I felt that I have a serious problem. I drank 60 ml of castor oil (for the first time in my life) and I was able to clean my stomach. I felt much better by at least 70% but I still have the mild burning pain in the chest and the mild pain in my upper left abdominal sometimes during my day. I don't have medical insurance and many times I would avoid going to the doctor only because I afford the tests doctors usually ask for.

Can you please tell me all the useful information about my situation?

More information about me:
I'm 33 years old
hight: 178 cm
wight: 78 kg
Married and have one daughter.
I was diagnosed with type two diabetes 8 months ago
I also have Insomnia these days


Thanks
doctor
Answered by Dr. Binu Parameswaran Pillai 2 hours later
Brief Answer:
thyroid function and blood calcium

Detailed Answer:
Hello
Good day.
Noted your issues. Mind has a strong relationship with out Intestine and stomach functions. After analysing your symptoms and after noting that you had a normal gastroscopy and blood tests, I have concluded that you do not have major physical illnesses. These symptoms are mostly related to your mind and your thoughts.

You should try to meet a psychiatrist and a clinical psychologist and seek help. You may need a combination of counselling and medications.

However , it is always worth getting a colonialist done. Have you got a thyroid function and blood calcium levels done?
Binu








Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai 3 hours later
Hi,

Yes thyroid function and blood calcium levels were done as part of full checkup one year ago and it was fine. However, vitamin d level was low and the doctor gave me vitamin d drops but I never checked vitamin d level after I took the drops.

So what cause the mild burning pain in the chest and upper abdominal? I feel it in the middle of the chest and in the upper abdominal horizontally from the right to the left but most of the time in the left. I have this pain mostly when I wake up or when I'm at work but it really comes anytime during the day and very frequently.

I know that I had gastroscopy done but sometimes I think this was more than one year ago maybe I need to do it again? Is there a timeframe for those things?

doctor
Answered by Dr. Binu Parameswaran Pillai 5 hours later
Brief Answer:
Hi

Detailed Answer:
Hi,
Gastroscopy being normal, the burning sensation in chest is called as non ulcer dyspepsia. This is common in obese people and in persons who are very anxious.

Take a light dinner and do not lie down soon after eating food. Try to lift the head end of your bed by around 15 cm. Do not smoke and limit alcohol intake ( if you have these habits).

Sorry for the typing errors earlier ( typed from smart phone). I was indicating that you may need a colonoscopy, just to rule out any other disorders like inflammatory bowel disease. If you are concerned, getting a repeat gastroscopy is worthwhile.
Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai 14 hours later
Hi,

I made an appointment with the doctor but it will take sometime to see him and do all necessary checks.

As I mentioned earlier I'm hypochondriac and for the last few days my life like hell because of it. Please tell me are my symptoms related to cancer in my age I can't sleep well, I can't smile, and I even can't rest my mind.

current symptoms are:

1- Constant bloating
2- nausea after eating or drinking sometimes (No vomiting and it last for few seconds)
3- Change in my bowl movement. I feel my colon lazy and giving me hard time to defecate. Not because the stool is hard only but also I feel my bowl move stool slowly.
4- Cold feet or numbness when I lie on my back.

the bloating giving me a lot of bad thoughts. I feel bad about myself now and I only hope I get my health back
doctor
Answered by Dr. Binu Parameswaran Pillai 9 hours later
Brief Answer:
Hi

Detailed Answer:
Hi dear,
I seriously feel sorry about you. All the symptoms which you mentioned can occur in anxiety disorders. I agree that these symptoms may occur in some cancers. You are very young and previous investiatins have been normal.Hence i do not think Cancer is a cause of your problems.

You need counselling and psychiatrist's help


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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