Brief Answer:
Stomach pains along with heartburn could quite possible be a gastric issue

Detailed Answer:
Hello ma'am and welcome.

Thank you for writing to us.

I have gone through your query with diligence and would like you to know that I am here to help. You have mentioned a couple of issues you are facing, all of which must be causing you frustration, but you have not really mentioned a question to which I can provide an answer for ma'am. So please bare with me if I do not answer any question you had in mind; if so, then please do state your question and I would be more than happy to help you.

The stomach pain and chest pain you have spoken about in most detail according to your description could be any of the following conditions:

+Acid reflux
+Hyperacidity (mainly stress related)
+Peptic ulcer disease
+Gastroesophageal reflux disease (GERD)
+Hiatus hernia
and a few others.

Some of the triggering factors in the form of suggestions have been listed below:

+Avoid smoking
+Avoid alcohol
+Avoid stress
+Avoid carbonated drinks
+Avoid tea and/or coffee
+Avoid long gaps between meals
+Avoid overeating
+Avoid spicy food
+Avoid oily food
+Avoid fatty food
+Avoid fried food
+If you are overweight then please try and lose some weight
+Drink at least 2-3 litres of water per day
+Have 5-6 smaller meals instead of 2-3 larger ones
+Have 1 tablet of 30 mg lansoprazole once every morning around 15 minutes before breakfast
+Avoid strenuous forms of exercise

I hope I have explained things in a manner best understood by you. Please do not hesitate to write back to me for any further clarifications, I am always here to help.

Best wishes.

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Brief Answer:
Menstrual irregularities causes stated; incontinence treatment approach

Detailed Answer:
Hello once again ma'am.

Thank you so much for the direction.

Let me start by telling you that menstrual irregularities such as yours can have many causes, and for your reference let me list as many as come to my mind right now:

+Medications: Many medication can cause irregularities in the menstrual cycle, but normalcy is achieved soon after discontinuing them
+Infection of the reproductive system (urinary tract infection, chlamydia, etc.)
+Abnormalities relating to the reproductive system (e.g. endometriosis, polycystic ovarian syndrome, etc.)
+General infections (anywhere in the body)
+Chronic conditions (e.g. diabetes, hypertension, peptic ulcer disease, insomnia, etc.)
+Stress: One of the major causes for menstrual irregularities
+Birth control
+Psychiatric conditions (E.g. anxiety, depression, etc.)
+Chronic pain conditions
and many other conditions as well.

So just so you understand, the period coming twice this month could have some underlying cause to it, which will have to be investigated and diagnosed, and accordingly treated, so speak to your gynaecologist about this who will run a few tests to find the cause ma'am.

Incontinence really requires a detailed examination to judge how exactly to treat it ma'am, but you will certainly require help in the form of:

+Muscle strengthening exercises
+Bladder control exercises
+Electrical stimulation
+Medication (e.g. alpha blockers, topical oestrogen, anticholinergics, etc.)
+Medical devices (e.g. pessary)
+Botox injections
+Surgery (e.g. sling procedure, prolapse surgery, etc.)

So please speak to an experienced urologist who will surely have the solution to your incontinence ma'am.

As for the sore around the vagina, could you please attach clear images of the region to our discussion for my examination or email them to me at:

YYYY@YYYY

and please do mention "ATTN: Dr. Shoaib Khan" in the subject line so the email can be easily directed to me.

I hope you find my response helpful and I look forward to hearing from you in order to help you further ma'am. Please do not hesitate to write to me for any further clarifications or information, I am always here to help.

Best wishes.

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