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Taking razo for GERD. Having loose motion, lower abdominal pain. Endoscopy normal. Any advice?

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Practicing since : 2001
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My wife aged 37 and mother of child 10 yrs old.She has gerd and on razo 20 for the past 5 years.Recently for last 3 months she is having loose motion with lower abdominal ache.We went to her doc again and he now gave sompraz 40 with equirex 3 times but no change over last 1 month.Way back 2 yrs before she was tested negative both for endoscopy anf colonoscopy.Pls advise what to do next ? I stay in kolkata.I also want to add that she is patient of depression but now completely ok with ongoing medicine arip mt and fludac 20,she hss to continue this in any case as per the pshychiatrist.Her weight is 70 kg light obese diet is normal without any sedantry life style and housewife.Otherwise we r a hsppy family.Kindly advise.
Posted Sat, 11 May 2013 in Digestion and Bowels
Answered by Dr. Abhijit Deshmukh 3 hours later
Thank you for the query.

Possibly, she has some odd intestinal infection or an irritable bowel. It is worthwhile getting her thyroid (TSH) and a stool routine examined for infection like giardia etc.

If they are normal and still she has diarrhea then she may need a repeat colonoscopy and if required an upper gastrointestinal endoscopy to look for any obvious bowel inflammation and diseases like celiac (gluten sensitivity).

Rarely patients on long-term acid suppressants may also develop carcinoids causing diarrhea, which are likely to be picked up on endoscopy.

If all this is normal, the likely it is irritable bowel, which can be managed with medication. A bit change of anti depressants, which in addition have some constipating effects, will help her.

Hope this answers your query.

Wish her an speedy recovery.
Above answer was peer-reviewed by
Follow-up: Taking razo for GERD. Having loose motion, lower abdominal pain. Endoscopy normal. Any advice? 9 hours later
Dear Doctor,

Thanks for the reply. I got her colonoscopy done here by doc XXXXXXX Goenka an eminent gastroenterologist in Kolkata who is the same doc treating her for last 5 years. The report will be given on 19/04 evening and I will share/upload the update accordingly apart from the below help required.

The medicines like arip mt and fludac anti depressants are a must for her else she looses a mental balance and back to depression. She is on the same medication for the same period as well. In between for 3 months it was kept off but symptoms came back and she became violent. Now over a year she is under the medication and very much better from the psychiatric side.

Further again today she complained of mild lower abdominal pain, may be due to colonoscopy effect. Currently her pulse is normal. Bp and blood sugar is normal without any temperature.

My next doctor face to face consultation will be next week. In the mean time can you suggest some medicine ? Should I stop the sompraz and equirex ? Please give me some for the time being medication if possible. My goal is to get her bowels back to normal and to the place where it was 4 months back. Also suggest if anything specific in diet to stabilise this naturally.
Answered by Dr. Abhijit Deshmukh 2 hours later

Thanks for writing back.

If Dr Goenka is treating her then she is in good hands, need not worry.
Well if evaluation as mentioned by me in previous answer is normal, then we can try changing her anti depressants especially fludac a tricylic group of anti depressants after consulting Dr Goenka and your psychiatrist.

Mild pain could be due to colonoscopy which would settle in a day or two.
She can take a mild anti diarrheal like rececadotril 100 mg twice a day and a pro biotic to control her symptoms for time being.

Do not stop any of her previous medications.

Can take more curd and butter milk in diet and avoid other milk products till time being and see how she is feeling.

Hope this answers your query.

Wish her a speedy recovery.


Above answer was peer-reviewed by
Follow-up: Taking razo for GERD. Having loose motion, lower abdominal pain. Endoscopy normal. Any advice? 21 hours later
Dear Doctor,

I got her colonoscopy results , and doctor said there is no problem ( also mentioned in report) and nothing to worry and nothing was found. But I said for continuous loose motion what is the solution , which is happening in phases over the last 4 months and in the last month being more frequent, he said no further tests required. He has given "LOMOTIL" for every alternate day and asked to visit after one month. Since he is a XXXXXXX doctor I did not argue much but is this a resolution by a doctor ?

Now coming back to your medical forum please guide me the road map of treatment. Lomotil cannot be a continuous medicine , I need to understand this properly and looks to be a temporary arrangement and I have read about it on the web. How can I cure her IBS , at least control it , even if I assume she has developed this. She was doing fine for the last 5 years. There should some medication to stabilise this. Also what should her diet be ? as she takes normal home cooked food with less spice/oil , please specify clearly. I am mentally worried. I work in a high profile in a fortune 10 company and we are a happy family. Waiting for your update.
Answered by Dr. Abhijit Deshmukh 14 minutes later
Hi again,

Possibly she has an irritable bowel.

However it is worthwhile getting her thyroid (TSH), stool routine examined for infection like Giardia and get her workup for celiac disease antibody testing (TTG IG A ) done etc. Worthwhile treating her empirically for Giardia too.

Also, as I had mentioned earlier you need to visit a psychiatrist and suggest him to change the anti depressant which additionally will reduce her diarrhea too.

There is no cure for irritable bowel even if you can control it; it may remit on its own in many patients over years. As I had said there is no diet restriction unless she feels something worsens her diarrhea then need to avoid it. No spice oil restriction.

Hope this answers your query.

Wish her a healthy life ahead.
Above answer was peer-reviewed by
Follow-up: Taking razo for GERD. Having loose motion, lower abdominal pain. Endoscopy normal. Any advice? 7 hours later
Dear Doctor,

Ok understsnd.But proactively can you suggest giardia or XXXXXXX related medicine with duration so that I can go ahead logically.If the symptoms go away fine else I will go ahead for other advise as mentioned by you.

Kindly revert.
Answered by Dr. Abhijit Deshmukh 5 hours later
Thank you for the query.

Well, it would be unethical and inappropriate to prescribe you scheduled drugs without doing a proper examination.

You can check it with your GP or Dr Goenka or get her stools examined for the same from a standard laboratory.

Do get back if you have any other query.

Above answer was peer-reviewed by
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