
Hey Doctor, So Yesterday Morning I Woke Up With Really

So yesterday morning I woke up with really bad upper centre sided stomach pain in the epigastric region. The day before that I’m not sure if I had overdone it but in the morning I had a probiotic, for lunch I had my daily gut supplement which is this one https://www.australianvitamins.com/product/nutrition-care-gut-relief
And then for dinner I had a vitiams tablet which had vitiam c, zinc and echinacea because I was feeling a little sick that day. But the day after I just woke up with really bad stomach pain mainly consisiting of cramps in the epigastric region along with nausea too. Could I have maybe overdone it with those supplements? I’ve had them before in the past with no issues but I’m unsure? The other thing was that I had just come back from Bali in Indonesia and I’m from Australia 2 days ago could I have possibly caught a bug over there that didn’t show up until after I came back? I had never been before and I’ve heard of a lot people getting sick there but my pain is mainly just upper tummy related.

So yesterday morning I woke up with really bad upper centre sided stomach pain in the epigastric region. The day before that I’m not sure if I had overdone it but in the morning I had a probiotic, for lunch I had my daily gut supplement which is this one https://www.australianvitamins.com/product/nutrition-care-gut-relief
And then for dinner I had a vitiams tablet which had vitiam c, zinc and echinacea because I was feeling a little sick that day. But the day after I just woke up with really bad stomach pain mainly consisiting of cramps in the epigastric region along with nausea too. Could I have maybe overdone it with those supplements? I’ve had them before in the past with no issues but I’m unsure? The other thing was that I had just come back from Bali in Indonesia and I’m from Australia 2 days ago could I have possibly caught a bug over there that didn’t show up until after I came back? I had never been before and I’ve heard of a lot people getting sick there but my pain is mainly just upper tummy related.




Epigastric pain very likely acid peptic disorder or ulcers.
Detailed Answer:
Hello and Welcome to 'Ask A Doctor' service.
I have reviewed your query and here is my advice.
As per your complaint, it seems that you are suffering from intestinal ulcers.These are called peptic ulcers some times they are in intestine while some times they may be in stomach.
Soft drink contains hypophosphoric acid which irritates the gut hence causing pain.Same is with popcorn usually they are coated with spices again they irritate the exposed mucosa of ulcers and may cause pain.
It's not the popcorn or soft drink rather the increased acidity of gut which is the real culprit.
Smell in stools is suggestive of fact that bad bacteria's are growing in gut and are fermenting the food.This fermentation and putrification releases gases which are toxic and are smelly.
It has nothing to do with supplements.
It's neither the bug.
It's a clear cut case of gastritis or acid peptic disorder or ulcers.
A test called endoscopy should be done in which a tube with camera would be inserted inside your gut via mouth to see the condition of gut and upper intestines.
Till then,
I would suggest you not to worry too much.
Take a proton pump inhibitor like Omeprazole 40 mg twice daily. This will provide you symptomatic relief from symptoms.
Antacid like Pepto bismol can be taken for few days.Both are over the counter.
Follow up with reports of endoscopy.
Hope I was helpful.
Follow ups are welcome!

Epigastric pain very likely acid peptic disorder or ulcers.
Detailed Answer:
Hello and Welcome to 'Ask A Doctor' service.
I have reviewed your query and here is my advice.
As per your complaint, it seems that you are suffering from intestinal ulcers.These are called peptic ulcers some times they are in intestine while some times they may be in stomach.
Soft drink contains hypophosphoric acid which irritates the gut hence causing pain.Same is with popcorn usually they are coated with spices again they irritate the exposed mucosa of ulcers and may cause pain.
It's not the popcorn or soft drink rather the increased acidity of gut which is the real culprit.
Smell in stools is suggestive of fact that bad bacteria's are growing in gut and are fermenting the food.This fermentation and putrification releases gases which are toxic and are smelly.
It has nothing to do with supplements.
It's neither the bug.
It's a clear cut case of gastritis or acid peptic disorder or ulcers.
A test called endoscopy should be done in which a tube with camera would be inserted inside your gut via mouth to see the condition of gut and upper intestines.
Till then,
I would suggest you not to worry too much.
Take a proton pump inhibitor like Omeprazole 40 mg twice daily. This will provide you symptomatic relief from symptoms.
Antacid like Pepto bismol can be taken for few days.Both are over the counter.
Follow up with reports of endoscopy.
Hope I was helpful.
Follow ups are welcome!



Follow up.
Detailed Answer:
Hello again XXXXXXX
Before going for endoscopy last year do you have the same symptoms(frequency and intensity).
What PPI have you tried and doses?
Have you taken them empty stomach?
Please reply.
Waiting

Follow up.
Detailed Answer:
Hello again XXXXXXX
Before going for endoscopy last year do you have the same symptoms(frequency and intensity).
What PPI have you tried and doses?
Have you taken them empty stomach?
Please reply.
Waiting





Follow up.
Detailed Answer:
Hello again XXXXXXX
Sorry for asking more questions but I have few more doubts-
1)Last time when you had medium was the nature location and characteristic of pain same as what you are having now. I Mean before you had your endoscopy the nature of pain was same?
2)Have you taken any enzyme supplements for food digestion till date containing amylase lipase and papain etc?
3)Have you take any probiotics till DATE?
4)Did your primary doctor gave you information on gastritis in which there is inflammation in stomach wall but many times endoscopy misses it?
5)Your bowel habits any constipation loose motion etc?
6)What did your primary Gastroenterologist said about your symptoms?
7)Any relieving factor observed by you ?
Sorry for asking more queries but it's important in typical cases.
Waiting.

Follow up.
Detailed Answer:
Hello again XXXXXXX
Sorry for asking more questions but I have few more doubts-
1)Last time when you had medium was the nature location and characteristic of pain same as what you are having now. I Mean before you had your endoscopy the nature of pain was same?
2)Have you taken any enzyme supplements for food digestion till date containing amylase lipase and papain etc?
3)Have you take any probiotics till DATE?
4)Did your primary doctor gave you information on gastritis in which there is inflammation in stomach wall but many times endoscopy misses it?
5)Your bowel habits any constipation loose motion etc?
6)What did your primary Gastroenterologist said about your symptoms?
7)Any relieving factor observed by you ?
Sorry for asking more queries but it's important in typical cases.
Waiting.


A: The pain that I’ve had the last couple of days is more severe than what it usually is which is why I think something has triggered it off possibly something I ate or a bug from travelling to Bali? In terms of the location and type of pain it’s exactly the same as what I usually get just more way painful than normal.
2)Have you taken any enzyme supplements for food digestion till date containing amylase lipase and papain etc?
A: I haven’t had any enzyme supplements like that no only the gut relief that I linked earlier.
3)Have you take any probiotics till DATE?
A: I find probiotics for me in general seem to make things a lot worse. I find as soon as I start one symptoms seem to get worse for me and usually my acne flares up as well. Yakult is the only one that kind of dulled the stomach pain down a little but at the same time made the acne on my face worse. I recently tried this travel probiotic for when I travelled to Bali which I seemed to tolerate okay and it had “Saccharomyces Cerevisiae (Boulardii).5 billion CFU (Colony Forming Units)(Organisms).” in it.
4)Did your primary doctor gave you information on gastritis in which there is inflammation in stomach wall but many times endoscopy misses it?
A: They didn’t really mention that endoscopy can miss it but I do know a little about gastritis which was why I was taking that natural supplement to try ease it.
5)Your bowel habits any constipation loose motion etc?
A: Most of the time they are formed but I do see a lot of vegetables in my stool and undigested fragments and I do go quite often at least once a day but sometimes 2-3 times a day.
6)What did your primary Gastroenterologist said about your symptoms?
A: Her diagnosis was that because both the gastroscopy and colonoscopy where clear that I had IBS and there wasn’t really any treatment she gave me mainly that I just have to manage it.
7)Any relieving factor observed by you?
A: For some weird reason bananas seem to be the most soothing thing for me they are one of the only things that calm down my stomach pain a little.

A: The pain that I’ve had the last couple of days is more severe than what it usually is which is why I think something has triggered it off possibly something I ate or a bug from travelling to Bali? In terms of the location and type of pain it’s exactly the same as what I usually get just more way painful than normal.
2)Have you taken any enzyme supplements for food digestion till date containing amylase lipase and papain etc?
A: I haven’t had any enzyme supplements like that no only the gut relief that I linked earlier.
3)Have you take any probiotics till DATE?
A: I find probiotics for me in general seem to make things a lot worse. I find as soon as I start one symptoms seem to get worse for me and usually my acne flares up as well. Yakult is the only one that kind of dulled the stomach pain down a little but at the same time made the acne on my face worse. I recently tried this travel probiotic for when I travelled to Bali which I seemed to tolerate okay and it had “Saccharomyces Cerevisiae (Boulardii).5 billion CFU (Colony Forming Units)(Organisms).” in it.
4)Did your primary doctor gave you information on gastritis in which there is inflammation in stomach wall but many times endoscopy misses it?
A: They didn’t really mention that endoscopy can miss it but I do know a little about gastritis which was why I was taking that natural supplement to try ease it.
5)Your bowel habits any constipation loose motion etc?
A: Most of the time they are formed but I do see a lot of vegetables in my stool and undigested fragments and I do go quite often at least once a day but sometimes 2-3 times a day.
6)What did your primary Gastroenterologist said about your symptoms?
A: Her diagnosis was that because both the gastroscopy and colonoscopy where clear that I had IBS and there wasn’t really any treatment she gave me mainly that I just have to manage it.
7)Any relieving factor observed by you?
A: For some weird reason bananas seem to be the most soothing thing for me they are one of the only things that calm down my stomach pain a little.




follow up
Detailed Answer:
Hello again my dear patient,
As most of the tests done in gastroenterology are almost normal in your case and pain is confined to epigastric area.Secondly proton pump inhibitors/probiotics etc are not very helpful.I would suggest you to move toward other causes of epigastric pain the most common one is cardiac.
I would suggest you to get a Echo and stress test done to see if its not related to heart.Many times epigastric pain is also related to heart and is often missed by many doctor.
Follow up with reports!
As both endoscopy and colonoscopy are clear we have to make spectrum of investigation broad.
This may be a presentation of angina(heart pain) as it starts usually after heavy meals(post prandial angina) and is not relieved by antacids etc.
I would suggest you to go for above mentioned test and follow up with reports.
As far as infection in bali is concerned get a stool culture test done if there is a bacteria it would be reflected in that.
Pain mimicking heart burn is also seen in cardiac problem.

follow up
Detailed Answer:
Hello again my dear patient,
As most of the tests done in gastroenterology are almost normal in your case and pain is confined to epigastric area.Secondly proton pump inhibitors/probiotics etc are not very helpful.I would suggest you to move toward other causes of epigastric pain the most common one is cardiac.
I would suggest you to get a Echo and stress test done to see if its not related to heart.Many times epigastric pain is also related to heart and is often missed by many doctor.
Follow up with reports!
As both endoscopy and colonoscopy are clear we have to make spectrum of investigation broad.
This may be a presentation of angina(heart pain) as it starts usually after heavy meals(post prandial angina) and is not relieved by antacids etc.
I would suggest you to go for above mentioned test and follow up with reports.
As far as infection in bali is concerned get a stool culture test done if there is a bacteria it would be reflected in that.
Pain mimicking heart burn is also seen in cardiac problem.





Follow up.
Detailed Answer:
Hello XXXXXXX
Thank you for follow up,
Firstly I would like to comfort you by saying that your ecg reflects ventricular pre excitaion syndrome in which the lower chamber of heart is excited quiet early hence lower chamber does not get sufficient time to fill up.Though for your relief it's rarely serious and only one type called wolf Parkinson white(WPW) syndrome is dangerous which you don't have in your EKG.
However the serious point is bradycardia ie the slow heart rate.The normal heart rate should vary some what between 60 to100 beat/ min.In your case it's low.A holter test would be done in which a small machine would be attached to your waist to keep a record of your heart rate for 24 hours.This would reflect the minimum heart rate.If it dips below 30 then cardiologist may implant a Pace maker.
As there is shortness of breath also a complete cardiac triology should be done
Stress test
2d echo
The above two would reflect any blockage in artery supplying blood to heart.
Holter 24 hour for heart rate and rythm.
Yes mucoid stool can be a sign of infection.
Please take a course of ciprofloxacin and metronidazole for 5 days(Prescription needed).
For any further query regarding Heart or Gastro do follow up.
I would be happy to provide you with professional advice..
Thanks and may God bless you!

Follow up.
Detailed Answer:
Hello XXXXXXX
Thank you for follow up,
Firstly I would like to comfort you by saying that your ecg reflects ventricular pre excitaion syndrome in which the lower chamber of heart is excited quiet early hence lower chamber does not get sufficient time to fill up.Though for your relief it's rarely serious and only one type called wolf Parkinson white(WPW) syndrome is dangerous which you don't have in your EKG.
However the serious point is bradycardia ie the slow heart rate.The normal heart rate should vary some what between 60 to100 beat/ min.In your case it's low.A holter test would be done in which a small machine would be attached to your waist to keep a record of your heart rate for 24 hours.This would reflect the minimum heart rate.If it dips below 30 then cardiologist may implant a Pace maker.
As there is shortness of breath also a complete cardiac triology should be done
Stress test
2d echo
The above two would reflect any blockage in artery supplying blood to heart.
Holter 24 hour for heart rate and rythm.
Yes mucoid stool can be a sign of infection.
Please take a course of ciprofloxacin and metronidazole for 5 days(Prescription needed).
For any further query regarding Heart or Gastro do follow up.
I would be happy to provide you with professional advice..
Thanks and may God bless you!





Follow up
Detailed Answer:
Hello my dear,
Go for stool test and culture.
fecal calprotectin(to rule out inflammation in intestine)
As of now take antispasmodic dicyclomine 10 mg twice to relieve pain.
Follow up with reports.

Follow up
Detailed Answer:
Hello my dear,
Go for stool test and culture.
fecal calprotectin(to rule out inflammation in intestine)
As of now take antispasmodic dicyclomine 10 mg twice to relieve pain.
Follow up with reports.

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