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    Suggest treatment for bloating, acidity and burning sensation in the stomach

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Posted on Tue, 4 Jul 2017 in Digestion and Bowels
Question: Hi Doctor,
I am XXXXXXX 27 Years old and would like to describe the events to you. Please share you expertise on the below incident.
I have always had this Gastric problem coming and going - Bloated, acidity, burning sensation in stomach, acid regression as my life style is of software engineer and no Physical activity.
15 XXXXXXX 2017 - I had my first sex encounter and protected sex with CSW for a less than half minute and I got so scared and depressed with this. Read google a lot and lots of time reading the HIV and STD forums, symptoms and relating to my body. Was in lot of stress and mental torture after this incident dint go for work took leaves and stopped taking to people. Then I saw health magic website asked many doctors (HIV Specialist) about my case as told me I am safe and 100 % fine but I was so depressed and thought my life to end had lot of stress and psychological issues.
10 March – As per Doc’s advice I took my 4th Gen Vidas AG/AB DUO's and it was negative. (On 8th week) and when asked a HIV specialist he told me I am 100% safe. So I was happy
Now - I last had my Non veg on 1 XXXXXXX 2017 and was not been having non veg and alcohol for 4 months till 20 May
20 May - I had Chicken in a regular Dhaba I visit and 1 Strong Beer (felt some gastric and fullness in stomach already) and bloating.
21 May - I had more chicken and more beer and whisky at same place.
22 may - I had some gastric again and was passing fouls smelling gas and the stool was shiny and soft with light Yellow with some smell
23 May - Now I had mucus in my stools and it increased a little more next days - No loose motion. But I use to Pass gas and stool both at a time and I saw the stool very closely it was having a little pink I think it was blood and got panicked also started to had cramps in both sides of stomach hip region and sometime pains in center of stomach coming and going.
26 may - I had lots of stomach bloating as I was not having food on times I was not hungry it built more gastric but I had more beer and smoked more with skipping meals- I had a heavy stomach and vomiting sensation – on this day had 2 strong beers and 1 glass whisky
Morg when I saw very closely stools was loose and saw a light red / pink and I am sure it was blood again I had cramps in side of stomach and centre and below right ribs and some times in left ribs also (sensation and cramps in sides of stomach) and burning sensation in anus and feeling of sum thing coming out after passing stools and randomly it use to come if I sit
27 May - I went to DOC General Physician and told him all these - he told I have IBS and gave me prePo IBS for 6 days and then i was taking it and mucus stopped by stools also were hard.
30 may - I was not feeling hungry and had the same feeling of pains under rib and sides of stomach went to same doc he advised me to take TAXMIM 1-0-1 OZ - 5 days with PrePro IBS tab as I had some infection he told. And my urine is all fine and no yellow. please help me
Please help me relax my anxiety as I am fearing Hepatitis because I had sex with CSW and read on google it can come through sex its nearing 5 Months after exposure about am totally scared and depressed about the hepatitis though and reading google – request you to help me SIR.

I am so worried and tensed.


doctor
Answered by Dr. Ramesh Kumar 4 hours later
Brief Answer:
Dyspepsia with gastritis and hemorrhoid.

Detailed Answer:
Hi,
Thanks for choosing HealthcareMagic for your query.
Have gone through all your details and i appreciate your concerns.
As per you query answers are
HIV AIDS is one of the most overhyped disease of this century.
Trials have shown that even if unpreotected sex is done with a patient of AIDS in full viremia(Last stage) chances if transmission is as low as 0.1% and this is about high viremia phase.
As all your tests till date are normal i dont think worrying about HIV is required.Just forget that and move on.

As per your query regarding Hepatitis.Go to the nearest path lab and get a test named HBsAg.If the test is negative you don't have hepatitis.

Now lets come to problems of Gastroenterology.
Firstly Irritable bowel syndrome is a diagnosis of exclusion.So without performing baseline tests like Endoscopy or Colonoscopy its not in protocol to label patient as IBS.

More over your symptoms are clearly suggestive of severe gastritis and dyspepsia.Smoking and alcohol irritates the lining of stomach and causes parietal cells in stomach to secrete lots of acid.This acid refluxes back into esophagus causing pain inflammation and heaviness with heartburn.
Our gut consists of million of good bacteria which are responsible for proper digestion of food specially carbohydrates.
Excessive smoking alcohol and poor food habits destroys this good flora hence causing indigestion.The carbohydrate is incompletely fermented causing release of large amount of gases in gut.
Suggestion are-
Start taking syrup Mucaine gel 2 table spoon thrice daily before lunch breakfast and dinner.
Tab Rablet l to be taken once daily 7 am
They are going to take care of your dyspepsia acid reflux bloating and gastritis
Take a good quality probiotic like Econorm twice daily for few weeks.It will help to replete the disturbed G.I flora.


Blood in stool and sensation in anus are mist likely due to hemorrhoids.Go to a surgeon and ge will perform digital rectal examination along with proctoscopic examination to rule out the possibility of hemorrhoid.
Once confirmed-
start using Prepration H (or Ruticool a combination containing contains Calcium Dobesilate, Hydrocortisone, Lignocaine, and Zinc.) locally over hemorrhoids.

Ask your gastroenterologist to prescribe you with oral Calcium Dobesilate-Doxium therapy for 3 months. Initially twice daily for 21 days followed by once daily for 10 weeks. Trials have shown that 3-month therapy can cause shrinkage of Hemorrhoids in almost 60% cases.It was demonstrated that calcium dobesilate decreased capillary permeability, inhibited platelet aggregation and improved blood viscosity; thus resulting in reduction of tissue edema.

Add Metamucil/Fybrogel to your regimen. It's a natural laxative containing husk. It absorbs water from the intestine and swells up making passage of stool easy and add bulk to stool.Take it 2 tsf twice daily with half cup of XXXXXXX warm milk.



Suggestion-

Avoid alcohol and smoking.
Drink 2 cups of cold milk daily.
Proper food habits are very essential to control excessive flatulence.
Avoid-
Dairy products, which contain sugar lactose that causes gas.
Vegetables, including onions, radishes, cabbage, celery, carrots, brussel sprouts, broccoli, cauliflower and legumes.
Fruit sugar, which is especially high in prunes, raisins, bananas, apples, apricots and fruit juices from prunes, grapes and apples
Fiber.
Fatty foods and carbonated drinks.

Eating more fermented foods. These are rich in both good bacteria and enzymes you can try raw natto kefir or cultured veggies. This is probably one of the most important first steps.
Taking a high-quality probiotic.
Exercising, to help keep food moving through your system.
Using spices that may help to prevent flatulence. These include turmeric, coriander, peppermint, fennel, sage, chamomile and ginger.

Dont drink juices they cause acidity.
Anxiety stimulates vagus nerve causing secretion of large amount of acid in stomach.So try to control your anxiety levels otherwise consider taking Anxiolytics like Lorazepam once daily for few days.

Suggestions-
A planned endoscopy should be done to rule out possibility of peptic ulcers.

Follow what ever i suggested and you will feel better in 2-4 weeks.



Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Ramesh Kumar 2 hours later
Hi XXXXXXX Sir,

Thank you for the detailed answer appreciate your approach and patience.

I have few more points which i need you help and diagnosis.

1. Are these symptoms related to Hepatitis which i have got share your opinion as you are so experienced and distinguished doctor ? I have read lots on google and confused and worried about Hep. a lot as its a very dangerous and not curable deceases. Help me

2 .Doctor told IBS and stomach pain and gave me 5 days antibiotic dose as he told their is stomach infection Even after taken Taxim oz for 5 days and cyfolac ( daily 2 tab) ( today was last dose ) still i get pains coming and going in center of stomach and under diaphragm and below right and left ribs bout not as before the taking tablet ( i read these are first symptoms of hepatitis? please help.

3. Today when passed the stool i saw the stools was normal first with and after that it was in Fluffy pieces with ragged edges as if i had not digested the food well and after hours i suddenly i felt my anus is itching sometimes and pain near anus ( some time) now the burring sensation has come down

4. I am really scared because after the exposure on 15 XXXXXXX i have being getting
red raised bumps ( Red rash like i dint know exactly )and itchy coming and going. sudden rash and then it takes some days and goes off. also i have been getting kinda non itchy red patch kind of thing on my hands and legs - so i am thinking is it related to HIV or Hepatitis infection. i am very disturbed and my family too of this.

doctor
Answered by Dr. Ramesh Kumar 1 hour later
Brief Answer:
Follow up suggestions.

Detailed Answer:
Hi again Dear Patient,

Answers are-

1)Frankly speaking no its not Hepatitis. presenting complaint of patient with Hepatitis(B,C Sexually transmitted) is severe jaundice(yellowing of eyes) with nausea,vomiting,Malaise fatigue and extreme letharge. Hepatitis means inflammation of liver cells.When liver cells are inflammed they become permeable to enzymes stored inside them hence Liver function test including bilirubin are grossly deranged in hepatitis.This bilirubin accumulates in cornea of eye causing yellowing of cornea.
2) I have read lots on google and confused and worried about Hep. a lot as its a very dangerous and not curable deceases-Hepatitis B and C is well controllable and patient can lead a normal life -Don't google too much its helpful when you know the basics.

2)Antibiotics have no role in treatment of IBS.

-Even after taken Taxim oz for 5 days and cyfolac ( daily 2 tab) ( today was last dose ) still i get pains coming and going in center of stomach and under diaphragm and below right and left ribs bout not as before the taking tablet ( i read these are first symptoms of hepatitis?

No They are not classical signs of hepatitis rather they are tell tale sign of Gastritis heartburn and GERD.

Though i have explained all symptoms above but if your mind is still not satisfied see symptoms on reliable sites like Mayo.

Suggestion are-
Start taking syrup Mucaine gel 2 table spoon thrice daily before lunch breakfast and dinner.
Tab Rablet l to be taken once daily 7 am
Pain would be much better in few days.

3) Due to excessive smoking and liquor and having unhealthy food mucosa layer covering you gut is inflammed.This inflammation in stomach area is described as Gastritis or GERD while in anal area is termed as hemorrhoid(initial stage).

Your digestive system is crippled right now and complete treatment is required as suggested by me ion previous answer.

4) so i am thinking is it related to HIV or Hepatitis infection-You have already been investigated thoroughly for HIV( possibility is 0%).
For hepatitis get a Serology test done.

I think anxiety is causing obsession.It would be better to take anti anxiety meds for few days as adviced by me earlier.

Feel free to follow up.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ramesh Kumar 16 hours later
Hi Sir,

Thank you so much for you Kindness and your thought have helped me relax.

Still i have some more questions to ask you - Sorry!

1.please tel me if i am safe from Hepatitis as its 4 month passed sexually exposure and can you tel me the Time line or Sero - conversion for the symptoms to occur for Hepatitis infection to show up in a person after exposure. as per your experience?

2. Can i know the reason for changes in stools structure and texture very offten

From the day of this problem i have had many changes in bowel moments and stools color odor and softness - please advise.

from the day this started - felt like constipation, loose stool and color and smell and the bowel movement is not normal and stomach also - felling fullness and not hungry
Example :
4, 5 Jun - Felt like normal stool with yellow color and some time I was feeling as i am not getting stools but got it after some time.

yesterday - I had dark hard stools in the mrg and then after some time 5 hrs later i had dark yellow stools and it was like soft small pieces of stool spread all over

Today - Morning i had hard pieces of stool in dark color and now when i went it was like full yellow stool and i could see blood ( i am not sure) and dont know how to look for blood in stool with some bad smell and i could see some food particals left in them ( kind of pieces of food) - please advise





doctor
Answered by Dr. Ramesh Kumar 3 hours later
Brief Answer:
Follow up answer.

Detailed Answer:
Hello again.
Its a pleasure to answer you feel free to ask whatever you want.
1) HBsAg will be detected in an infected person's blood an average of 4 weeks (range: 2–10weeks) after exposure to the virus.
The window period is time between potential exposure to Hepatitis infection and the point when the test will give an accurate result.

2) Poor food habit and extremely unhealthy life style. I have explained this already and have also suggested you how to improve things.Please go through my initial reply.Just follow what ever i suggested and you will start feeling better in few weeks.let me give you a brief idea about what is intestinal flora.
Our body has its own enviroment called gut flora.Gut flora is the complex community of microorganisms that live in the digestive tracts of humans. The intestinal microflora is a complex ecosystem containing over 400 bacterial species. The flora is sparse in the stomach and upper intestine, but luxuriant in the lower bowel.Long term use of these antibiotics smoking alcohol eating spicy unhygenic food destroys this flora and can lead to various problems with digestive system like indigestion,constipation loose stools , bloating change in stool texture and increased gas formation.These symptoms may vary from person to person..I would suggest you to start good quality probiotics for a few days. Probiotic mechanisms of action include enhancement of the epithelial barrier, increased adhesion to intestinal mucosa, and concomitant inhibition of pathogen adhesion production of anti-microorganism substances and modulation of the immune system.In LAY MANS language it contain a lot of bacteria's which forms a part of normal gut flora.


Kindly go back through my initial and follow up reply i have already adviced you everything.

Even after that if you have some doubt feel free to ask.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Ramesh Kumar 3 days later
Hi Doc,
Thank you for the detailed information.

My apologies Sir but please help me clear my mind of fear of Hepatitis Sir. i am so tensed and worried i read on google when i searched my systoms it was like when its pain under Right side rib and burning sensation in right its Hep or Liver infection. please request to you give Ur expert advise in context to my sexually exposure 4 months back.

1. Today from 2 days i have being getting pains ( some time pains and cramps i dont know what is happening at a stretch ) below my right ribs and lot of burning sensation i am feeling now also in the right side of of right abdomen and extends to entire back bad front stomach region with pricking sensation in outer stomach some times . please help me understand.

2. I have got a lot of burning sensation in my right leg (back of keen) and its reduced now - any thing u can relate to connect to this to.

3. i have also being getting itching and pricking sensation (After stool or in mrg before going to stool or just sitting in seat) some times and pains in anus )

this will be my last question please help me. i so distributed for Hep
doctor
Answered by Dr. Ramesh Kumar 1 hour later
Brief Answer:
None of the symptoms is suggestive of hepatitis.

Detailed Answer:
Hi again XXXXXXX
Thanks for follow up.

Initially, before answering your question let me give you a briefing,

Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over. In your case obsession is your fear of hepatitis B and compulsion is your mind thinking again and again about that, despite repeated clearance from various specialties...


Some features of OCD are-
Not able to control his or her thoughts or behaviors, even when those thoughts or behaviors are recognized as excessive

Spends at least 1 hour a day on these thoughts or behaviors,
Experiences significant problems in their daily life due to these thoughts or behaviors,

So my first suggestion would be to suppress your obsession about Hepatitis;

Start paroxetine at low doses to be increased every 14 days to maximum doses (to be prescribed by a psychiatrist)- This is the mainstay of therapy.

Request him/her to add tab Clonazepam or Lorazepam ( benzodiazepines), to lessen your anxiety levels.
These drugs should be discussed with your psychiatrist before use.

Try to take 8 hours sleep, try strenuous exercises 45 minutes a day, yoga can be done to relieve your mind.

Follow these advices for 3 months, and you should be fine.

Now lets come to your query dear,

1) Today from 2 days i have being getting pains ( some time pains and cramps I don't know what is happening at a stretch ) below my right ribs and lot of burning sensation I am feeling now also in the right side of-of right abdomen and extends to entire back bad front stomach region with pricking sensation in outer stomach sometimes

Answer-Severe gastritis. Retrosternal chest pain involving ribs is a common feature of reflux disorder.As the acid from the stomach is refluxed back into esophagus it damages the esophageal mucosa and causes heartburn. This heartburn is felt as pain in throat and ribs. When left untreated it migrates to abdomen also.There is a possibility that these are peptic ulcers(strong history of alcohol and smoking).

A planned endoscopy should be one.
This is not at all a symptom of a patient presenting with hepatitis. As these symptoms are classical of Gastritis or ulcers.

2) Most likely a sprain or cramping due to electrolyte imbalance. It has nothing to do with hepatitis or any other sexually contracted disease.

3)Most likely its hemorrhoid dear but you need to get examined by a general surgeon for that.

Please feel free to follow up.
You are my patient and for me, it's really a pleasure to help you further.

Take home suggestion-
None of your symptoms are suggestive of hepatitis rather you are getting obsessive about your symptoms which are basically due to gastritis and dyspepsia.

Take my words XXXXXXX it's not hepatitis.
Fell free to follow up I would be glad to provide you with other details.

Thanks.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Ramesh Kumar 2 days later
Hi Sir,

Good Evening.

Thank you for detailed explanations and time sent on my question.

I really apologizes for asking you so many question. I am having the guilt of my act and also i am under immense pressure mentally thinking on my old parents, my future life and my career. As i was getting all this symptoms and reading on google and comparing it to Hepatitis and HIV, i keep asking and teling you about the symptoms i never had any thing to disturb you with my lame questions.

With you permission, can i ask you couple of follow up questions. As per your advice i am planning to meet Psychiatrist this Saturday.

I really need some information from you on the below - Please, I apologies again if i am repeating the questions.

1. From this episode - 20 May - i had been to Doc - ENT and he told IBS and chance of Hemorrhoid in anus - He told me to take 20 Tab of PreProIBS Tablets and 5 days Taxmin OZ as Antibiotics as he told you might have some infection in stomach and he told me to take Maxi Enzyme Syrup 5ml - 0 - 5ml for 1 week as it will help digestion - Sir should i continue this and do you need me take your tablet told by you in the previous answers - I am confused. please tel me the tables i will take only those

At present I have lot of stomach Bloating,Not hungry at all, nausea, constipation/ no normal bowel moments, some times burps come while eating food. I am worried its been 3 weeks and still my stomach has problems.

2. With regard to the Pain and burning sensation under right ribs and telling you under my right ribs - Today at office i felt pain in center of stomach, needle pricking around stomach and felt below ribs and burning sensation coming and going on right below ribs and also pains come chest and left side of body also and some times i feel pains come and go on my chest or same place in left side with out burning - My doc here is telling it could be a liver infection or Hepatic - Please provide your thoughts the doc here tels i have indigestion, pains and burning is because of liver infection


3. as you have always assured me i don't have Hepatitis can you please provide me the ans as to why and on what points you think so . as per Google i searched many websites days back before meeting you on health care.com as Symptoms of Hep can show only after 3 months of exposure to 6 months now its 4th months so i getting worried ? but you told 2 - 14 weeks and 4 being averaged which is correct ? Have you seen hepatitis positive and people getting symptoms after 4 months of sexually exposured i was shocked to read as per United states CDC .com website - Hep symptoms occur only after 3 months and till 6 month - you answer for this. share you real time experience on Hepatis systems and timeline to show the symptoms after Protected SEX.


doctor
Answered by Dr. Ramesh Kumar 16 hours later
Brief Answer:
Follow up suggestions.

Detailed Answer:
Hello again Dear,
Firstly sex is a demand of human body so don't feel bad.

1) Take the tablets as prescribed by me.

To pen down-
Cap Rablet L once daily 7 a.m(acid and bloating)
Tb XZofran 4 mg twice daily(nausea)
Cap Vizylac twice daily.(probiotic)
Syrup Mucaine gel 2 TSF thrice daily.

If after taking them for 5 days you feel constipated then add syrup looz/duphalac 15 ml once daily.

2)Your doctor i don't know who he is but try to see another doctor.This is not hepatitis its Gastritis and acid reflux disorder.

For hepatitis most essential thing is elevated levels of bilirubin and deranged liver function tests.

3) told 2 - 14 weeks and 4 being averaged which is correct -I was not taking about symptoms it as about [positive blood test.Blood test would be positive in 14 weeks.

"HBsAg will be detected in an infected person's blood an average of 4 weeks (range: 2–10weeks) after exposure to the virus."

As test is negative in your case there is no reason to doubt hepatitis however if you want repeat HbsAg test again.

If test is negative symptoms have no value.

Read about hepatitis on NCBI and Mayo official site.

Feel free to ask your queries.

Thanks.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Ramesh Kumar 57 minutes later
Hi Sir,

Thank you for the response.

I will follow the tablets you just mentioned.

You have mentioned as - "As test is negative in your case there is no reason to doubt hepatitis however if you want repeat HbsAg test again"

To correct you i have not taken any hepatitis test so far and its now 4.3 Months.
Do you think i need this test? i am nervous now
doctor
Answered by Dr. Ramesh Kumar 5 minutes later
Brief Answer:
go for it.

Detailed Answer:
Hello XXXXXXX
Yes obviously yes dear.
Get the test named HBsAg done(will cost you hardly 4-5 dollars).
And things would be clear in next 24 hours.

Go for the test and follow up with reports.
Thanks.
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Ramesh Kumar 1 hour later
Hi Doc..

I have fixed a appointment with clinic for Hep blood check and now an am feeling so dam tensed.. after u teing me to go for a Check up... do you think my report will be negative...
doctor
Answered by Dr. Ramesh Kumar 5 minutes later
Brief Answer:
Follow up answer.

Detailed Answer:
Hi again Dear,
Take my words report would be negative.
If your eyes are not yellow your urine is not yellow its not hepatitis.
Thanks.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ramesh Kumar 20 hours later
Hi Doc,

Please help me.

I have taken the LFT and some enzyme test - i am tensed with report. is it normal? i see nor normal range in bilirubin - please help me

Attached complete report.
doctor
Answered by Dr. Ramesh Kumar 20 minutes later
Brief Answer:
Follow up.

Detailed Answer:
Hey,
Have hone through your reports.
They are perfectly normal.
Mild elevation of bilirubin has no clinical significance.Bilirubin more then 3gram/dl is clinically significant.
Other liver function tests should be atleast 3 times the normal value to have any significance.

I can't see reports of HbsAg antigen( Done for hepatitis).

Thanks!
Above answer was peer-reviewed by : Dr. Remy Koshy
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Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2436 Questions

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