Brief Answer:
Biliary Dyspepsia with Bile Sludge / Under Assessment of treatment

Detailed Answer:
Hi Dear !! Thanks for your query to HCM at My Virutal Clinic.
Dear, I read and reviewed your query in context to your health concerns of current painful attack of right upper abdominal pain.

My Impression-
Based on latest USG findings and your current and last painful attack,Biliary Dyspepsia,from bile sludge, with partial and recurring blockage of the bile duct flow-off and on.
Drug induced gastritit(from theophylline in Gravol) is adding to biliary dyspepsia and aggravating painful attacks with more nausea.

Remedy Suggested NOW-
I feel concerned about this attack and would suggest you to take following steps-Now-
-Just Take Tab-Tylenol-3 -stat- ONLY-to relive the right upper abdominal pain attack.
-Tab pantoprazole + ondansetron to control- accompanied acidity and resultant nausea
-Avoid Gravol-(as it contains theophylline as it is adding up to drug induced gastritis along with caffein and acetaminophen.)
-Take yellow tea 2-3 times a day x for a day ONLY- to control accompanied gastric dystonia.
-Increase fluid intake-3-4 liters / day.
-Take lime juice with warm water,to relive dyspepsia and would help in long run by reducing blood cholesterol.
-Take Black paper with sugar -to stimulate biliary flow and relieve the bile duct partial blockage.
-Coconut water x 2 times a day
-Totally Avoid fat and oily diet.
-No spicy/fried/non-veg diet.
-Be on high carbo-diet
-Be on Rice-soups with no spices.
The above tips would relieve the current attack and would reduce number of incoming attacks,due to the stoppage of Gravol and addition of Panto-D.

-Update the lipid profile -if done/ or get it done and report it to ME.

Tylenol medication won't harm you.

Hope this would relieve your current problem and would guide you in managing biliary dyspepsia, due to bile sludge, which would need some more investigations and special treatments, in time to come.

But for these special treatment, please update me your blood reports and lipid profile test reports as soon as possible.

So keep Me updated by direct question to Me via following HCM link-
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=7022.

Hope this reply would reduce your anxiety and would help you to resolve the health issues with help of doctors attending on you there.

If need be, update any health issue 24 x 7 by a direct question to ME in time to come.

Dear, if satisfied ,Don't forget to close this query with YOUR pleasing feedback comments(like last time) to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at HCM services.

If you want to update more details and ask more update queries ,
You are most Welcome herewith !!

Good Day!!

Wishing Good Healthy Life in time to come!!

Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS

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Brief Answer:
Biliary Dyspepsia with Bile Sludge / Under Assessment of treatment

Detailed Answer:
1. Is Tab pantoprazole + ondansetron only available by prescription?
Ans. You need to opt for Pantoprazole /or omeprazole (prilosec-OTC) now as its the main drug suggested. Prilosec (omeprazole) is available as over the counter. Pantoprazole may need a prescription.
You can have Domeperidone / ondansetron-for its prokinetic-LES -motility regulator effect and would controls the dystonia accompanied with biliary dyspepsia added up with drug induced gastritis-as explained above. This is not available over the counter.

2.You are suggesting a high carbohydrate diet? what kind of foods.
Ans. Rice floor soup with salt and sugar -in low quantities-at a time-
and Decoted tea- with more water in it-would keep you away from-

3. what is yellow tea?
Ans. Adding more water to -Black tea. It would help you to control the food hunger and accompanied biliary dyspepsia with more eating.

4. How do I update my lipid profile? through blood tests?
Ans. Yes, this is tested with a blood sample. You can ask your doctor to order if you haven't done it earlier. This test would assess the fat contents in your blood, which if high- would need to be reduced in time to come.
If this test has been done earlier, you can upload the reports here.

5. You said I would need some more investigations and special treatments-what are these?
Ans.Yes, it would be needed in the due course of time after regular follow ups. I suggest more tests only after looking at the response of your body to these treatments, so as to keep un-necessary cost from it
But get lipid profile done and update on your body weight and height,so as to suggest more on reducing obesity.

6. oh and I am only taking ginger pills now; not gravol.
Ans. I will preferably avoid taking it in strong doses, as it would also induce-gastritis in high doses.

Hope this would relieve your current problem and would guide you in managing biliary dyspepsia, due to bile sludge.

If you want to update more details and ask more update queries ,
You are most Welcome herewith !!

Good Day!!

Wishing Good Healthy Life in time to come!!

Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS

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