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For The Past Couple Weeks I’ve Suffered Nausea And Mild

Posted on Tue, 19 May 2020

Question: For the past couple weeks I’ve suffered nausea and mild heartburn. Can’t get an endoscopy due to coronavirus, but chest X-ray, blood samples normal, kidneys ok, etc. Was prescribed takecab, rebamipide, metoclopramide. Ate pasta with cheese and nuts for supper, took two tums (calcium). Now nausea worse than ever and pain in stomach middle abdomen. What could it be and how can I treat it? Endoscopy impossible.

Answered by Dr. Ramesh Kumar (1 hour later)

Brief Answer:
Drastic change in food habits required.

Detailed Answer:
Hi there,
Thanks for asking query on HealthcareMagic,
Have seen your details,
First and the foremost thing is to change your eating habits.
Unless you would start eating a diet which is home cooked and bland in nature gastritis attacks won't get relieved.
So before medicine first suggestion is for few weeks(till covid crisis) starts taking a simple vegetarian home cooked diet which should have minimum spices and and chillies and low in fat.
Stop taking foods like pasta cheese chocolates cream etc.
Now let's move to medicinal part as off now start taking rabemide twice daily.
Take Domperidon 10 mg three times a day.
Metochlorpromide can be taken as and when required for nausea and vomiting.

In short take 2 tablets of Rabemide now.
If you can manage get Domperidon tablets
Take metochlorpromide for nausea and vomiting.

Drink chilled milk in morning and evening.
Avoid any citric fruit and it's juice like lemon,Orange etc.
Take a diet consisting of complex carbohydrates easily digestible veg proteins like lentils soy and fat( less ).
Avoid going to hospitals or any procedures as of now.
Follow up after taking two doses.
Thank you!

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ramesh Kumar (6 hours later)

I woke up and took rebamitide. Feel better but still worse than usual. Will try to get Domperidone.

Will Domperidone help more than rabeprazole or takecab? How is it different? I have both in house and have not tried the rabeprazole yet.

Do you think I could have an ulcer that requires antibiotics?

Answered by Dr. Ramesh Kumar (5 hours later)

Brief Answer:
Follow up.

Detailed Answer:
Hi again,
Both have different actions while Rabeprazole prevent the baseline as well as excessive secretion of acid.
Domperidon prevent it's accumulation and reflux.
So they together have a much better and additive effective.
Dose of Domperidon is 10 mg thrice/30 mg slow release once daily.
Even if you have ulcers you would be relieved temporarily by using this combination plus proper food.
See right now going to hospitals is not a good idea so a treatment which can keep you functional for few weeks should be treatment of choice.
Lastly antibiotics are used in very heavy doses to treat ulcers caused by bacterium which can further increase you Gastritis to next level.
However if you can get Sucralfate you can take it 1 gram a day to soothe your ulcers(umbrella treatment).
However taking Rabeprazole twice and Domperidon 30 once would make things much better in 2-3 days.
Thank you

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Ramesh Kumar (24 hours later)

Thank you. I got Domperidon and Sucralfate. Took them two hours ago with food but if anything my nausea is worse now. Will try to get an endoscopy as soon as possible, but it could be a very long time before clinics are operating normally again.

Do you have any idea what else my problem could be? The only real symptom is nausea. The heartburn is very mild, and I don’t seem to have stomach pain localized to a specific area. Only the nausea feels serious. Could it be due to stress?

Answered by Dr. Ramesh Kumar (38 minutes later)

Brief Answer:
Gastritis itself is a common cause of nausea.

Detailed Answer:
Hi again,
Gastritis itself is a common cause of nausea.
I would suggest you to take Zofran 4 mg thrice daily(ondensetron) in place of Metochlorpromide this would help you with nausea.
Don't haste for endoscopy wait for the COVID episode to shut down.
Thanks.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Ramesh Kumar (9 days later)

Thanks for the previous advice. A few days ago I didn't take my PPI for one day to ease constipation. Later that day I developed a cramp just below my ribcage on my right. At first it was occasional, but today I feel it all the time.

I don't know if it is a real sign of a gastrointestinal problem, or simply a muscle cramp or "irritable bowel syndrome" from stress, which are also possible given my stress levels. Is there a way I can tell the difference? I can book an endoscopy, but if possible would like to find a way to tell the difference first.

Answered by Dr. Ramesh Kumar (40 hours later)

Brief Answer:
Follow up.

Detailed Answer:
Hi there,
Thanks for follow up,
Irritable bowel syndrome is diagnosis of exclusion which means when all tests are normal and problem still persists.
Tests to be done are-
Fecal calprotectin
Colonoscopy
Endoscopy.
However right sides upper quadrant pain is because of Gastritis.
Take proton pump inhibitor continuously and your problem would be in control.
Thanks.

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Above answer was peer-reviewed by : Dr. Yogesh D