Brief Answer:
Irritable bowel syndrome with dyspepsia

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.
It seems that it could be Irritable bowel syndrome (IBS), which can give rise to constellation of symptoms like increased belching or flatulence, stomach bloating with sounds and alteration in bowel habits like loose stools/motion.

In patients with concurrent symptoms of dyspepsia, esophago-gastro-duodenoscopy may reveal evidence of lax LES/Hiatus hernia which is unlikely to cause loose motions as you are having.

Some patients with IBS-D (diarrhoea) may have undiagnosed celiac sprue. Serum antibodies—IgA antigliadin, IgA antiendomysial, and IgA anti-tTG antibodies are the serological tests for celiac sprue.

Commonest cause however is intestinal infestation with Giardia lamblia or other parasites which may cause similar symptoms.

I feel you should undergo stool for routine examination, if not done already.

Kindly consult your Gastro-enterologist again as your symptoms persist for 2 months now.

Dr. T.K. Biswas M.D. XXXXXXX

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Brief Answer:
Follow-up query

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.

As a therapeutic trial, one should avoid any foodstuffs that appear to produce symptoms but at the same time one should avoid nutritionally depleted diet(only white rice).

Nutritional supplement like multivitamins should be taken if you are not taking fresh fruits or green vegetables or dairy products.

Modulation of Gut Flora:-Antibiotic treatment benefits a subset of IBS patient. Rifaximin(standard dose -400 mg three times daily) is the only antibiotic with demonstrated sustained benefit.
Probiotics to naturally alter the flora. Bifidobacterium infantis has shown significant improvement in the composite score for abdominal pain, bloating/distention, and/or bowel movement in two placebo-controlled trials.

Doctor, yes if available infectious disease specialist will be able to tell you better.
Yoga may be effective for some IBS patients, especially poses which exercise the lower abdomen.
Relaxation techniques such as meditation also helps.

Regards

Dr. T.K. Biswas M.D. XXXXXXX

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Brief Answer:
Gastroesophageal reflux disease (GERD)

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.
Your problem is partly due to LAX LES/Hiatus hernia.
The major esophageal symptoms are heartburn, regurgitation, chest pain, dysphagia, odynophagia, and globus sensation.
Air sounds in stomach and air entering in upper stomach is due to aerophagia.
Avoid sipping fluids during meals and aerated drinks.








Regards

Dr. T.K. Biswas M.D. XXXXXXX

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Brief Answer:
Drinking liquids too quickly..etc with hiatus hernia

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.

You should drink water slowly. It's not good to drink so fast that you can hear and feel it sloshing around in your belly.

Lax LES/Hiatus hernia allows fluid to regurgitate into the lower esophagus and too fast drinking will only aggravate symptoms ,as the stomach may not have relaxed enough to accommodate the fluid;similar effects occur with too fast eating also.

Palpitations can occur due to cardiac compression by the hernial sac filled with fluids. Sudden physical exertion like fast walking,can also cause increased pressure in the abdomen resulting in hiatal hernia.


Regards

Dr. T.K. Biswas M.D. XXXXXXX

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