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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest antispasmodic for chronic tightness above the umbilicus

I have a combination of upper GI problems. After severe stress last year, I had a flare up of oesophagitis and antum gastritis, for which I have been on Esomeprazole 40mg and Domperidone 10mg 3 x daily fit the last 11 weeks. I am not suffering heartburn or regurgitation. However I have constant tightness, presumably spasm above the umbilicus. I know this is part of the autonomic nervous system, which I have no control over. I have found no benefit from Colofac, ie Merbeverine. My Gastroenterologist suggested trying Colpermin, but my GP said it would cause heartburn, so prescribed Dicycloverine instead. Ive since read on the internet that this relaxes the LES and shouldn t be taken by someone with a hiatus hernia like myself.I am completely confused by these different opinions about the best antispasmodic to use. I feel that my chronic tightness is due to visceral hypersensitivity from stress. Can you please advise which is the best antispasmodic in my circumstances. Thank you, your advice is appreciated.
Tue, 26 Mar 2019
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General & Family Physician 's  Response
Hi,

Continue esomeprazole plus domperidone. Dicycloverine may be added. Do lifestyle modifications, avoid tea, coffee, spicy and fatty foods. Sleep early and with the head a bit propped up(in view of hiatus hernia). Avoid long fastings and take dinner early

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. AJEET SINGH, General & Family Physician
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