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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Indigestion,bloating And Epigastric Pain?

Hi there, I have been experiencing symptoms since last year June. It started with mild bloating and indigestion. Within 2 months it had developed into severe indigestion and an epigastric pain that felt identical to when I was diagnosed with gallstones, although I had my gallbladder removed in 2010. Then I developed extremely painful spasms just below my sternum if i sat down for anything longer than a few minutes which made it difficult for me to breath, even after I stood up, it would take a full minute before I could breath properly again and before the pain subsided. Pain was waking me at 4.30 every morning. When the spasms came, they were accompanied by a burst of sweat and a rush of adrenaline. I have yellow loose stools. It feel as though something i grossly swollen inside and is pressing against my diaphragm/stomach when I sit down, although the spasms are not as painful now and I can sit for twenty minutes or so before I get too much pain. Bras hurt where the under-wire touch me even if they are a couple sizes too big. I have a lot of gas. It feels like whatever is swollen inside is producing some kind of fluid as that area sticks together inside. It feels like there is something musculature going on as well as something digestive. I stopped taking a medication that caused me to have increased muscle tone and I wonder if whilst my muscles were returning to normal, I could have strained something? I have had a normal Ultrasound Scan; normal barium swallow; mild gastritis on endoscopy, normal un-enhanced CT, except largely distended stomach. Stool culture showed no parasites. After I had the barium swallow, the spasms spread to my intestines also, and I had diarrhoea for 2 weeks, but that has stopped now. PPI's and H2 inhibitors make the pain worse, I have been tried on Lanzoprazole, Omeprazole, Nexium and ranitidine. Also when I get the swollen feeling inside, I get numbness, like something is pressing on a nerve or cutting something's supply off. My Gastroenterologist is stumped as to what is wrong with me and I am petrified.
Thu, 21 Sep 2017
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Gastroenterologist 's  Response
Hi
Yes most likely its gastroenteritis,usually gastroenteritis is caused by viral infection(Nova virus) and is self limiting,Takes five to sevendays,But as you mentioned its already more then a weak so most likely you are having either bacterial or protozoal infection or a mixed infection.
I would suggest you to go for few tests
Ultra sound abdomen
Stool test under microscope
Complete blood count
Total and differential leucocyte count.

If stool test is positive for bacterial or protozoal infection.Start taking Zithromax(Azithromycin 500 mg once daily) and secnidazole 1 gram daily for 5 days.
Along with it take Fybrogel husk,It will increase the bulk of your stools.
Tab imodium 4mg stat folowed by 2 mg twice daily can be added to contriol frequency of motions
Eat light and easily digestible food.
Drink plenty of water and electrolytes to maintain rehydration.
Monitor puls and blood pressure twice daily
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What Causes Indigestion,bloating And Epigastric Pain?

Hi Yes most likely its gastroenteritis,usually gastroenteritis is caused by viral infection(Nova virus) and is self limiting,Takes five to sevendays,But as you mentioned its already more then a weak so most likely you are having either bacterial or protozoal infection or a mixed infection. I would suggest you to go for few tests Ultra sound abdomen Stool test under microscope Complete blood count Total and differential leucocyte count. If stool test is positive for bacterial or protozoal infection.Start taking Zithromax(Azithromycin 500 mg once daily) and secnidazole 1 gram daily for 5 days. Along with it take Fybrogel husk,It will increase the bulk of your stools. Tab imodium 4mg stat folowed by 2 mg twice daily can be added to contriol frequency of motions Eat light and easily digestible food. Drink plenty of water and electrolytes to maintain rehydration. Monitor puls and blood pressure twice daily