HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

I Am Looking For A 2nd Opinion Before I Start

default
Posted on Sun, 10 May 2020
Question: I am looking for a 2nd opinion before I start on the medication.
I have had the following symptoms for some time.
1. Stomach bloating. like always filled up gas hard
2. Pain (feeling) in the stomach
3. Some times, lose motion.
4. Anxiety and headache
I used to treat the above with tablets like zantac, or pentazole and with one or two does, i gets healed
This happened like once or twice a year.
This year, it happened 3 days ago and this time I went to see my doctor. Who took my blood sample and H.Pylori came Positive.
He prescribed the following medications for 7 days:
Hyposec capsules 2 x twice a day (before meal)
Penamox 500 - 2 capsules twice a day (morning/evening) after meal
Clarimac 500 - 2 tab - one morning and another evening (after meal)
gaviscon syrup (not sure before or after mean)
I have yet to start the above medication. I have done some google and found the following:
This bacteria some times gets in childhood and remain there in 60% of population. Cause of alarm when it is accompanied
with m symptoms.
Now I have a strong feeling that I can again take precautions and take zantac or pentazole for few days and eats diet like oats etc and i will be back to normal. Because am afraid of taking 3000 mg antibiotics daily for 7 days (just a fear of side effects).
Therefore I am asking your opinion? what should I do?
If you ask me to proceed wit antibiotics, what food should i take to avoid antibiotics side effect because doc told me to stay away from milk (was thinking of taking milk to reduce antibiotic side effect)
Thank you.
default
Follow up: Dr. Prof. Kunal Saha (0 minute later)
I am looking for a 2nd opinion before I start on the medication.
I have had the following symptoms for some time.
1. Stomach bloating. like always filled up gas hard
2. Pain (feeling) in the stomach
3. Some times, lose motion.
4. Anxiety and headache
I used to treat the above with tablets like zantac, or pentazole and with one or two does, i gets healed
This happened like once or twice a year.
This year, it happened 3 days ago and this time I went to see my doctor. Who took my blood sample and H.Pylori came Positive.
He prescribed the following medications for 7 days:
Hyposec capsules 2 x twice a day (before meal)
Penamox 500 - 2 capsules twice a day (morning/evening) after meal
Clarimac 500 - 2 tab - one morning and another evening (after meal)
gaviscon syrup (not sure before or after mean)
I have yet to start the above medication. I have done some google and found the following:
This bacteria some times gets in childhood and remain there in 60% of population. Cause of alarm when it is accompanied
with m symptoms.
Now I have a strong feeling that I can again take precautions and take zantac or pentazole for few days and eats diet like oats etc and i will be back to normal. Because am afraid of taking 3000 mg antibiotics daily for 7 days (just a fear of side effects).
Therefore I am asking your opinion? what should I do?
If you ask me to proceed wit antibiotics, what food should i take to avoid antibiotics side effect because doc told me to stay away from milk (was thinking of taking milk to reduce antibiotic side effect)
Thank you.
doctor
Answered by Dr. Prof. Kunal Saha (6 hours later)
Brief Answer:
Fiber intake is important

Detailed Answer:
Thanks for using the Ask a Doctor service.

I have gone very carefully through your query. Your problem seems to be due to gastritis or gastroesophageal reflux. Our gastrointestinal tract has a forward propulsive movement (peristalsis) that moves the food material forward as it is digested, absorbed and finally expelled as feces. If somehow this movement gets hampered, food along with the digestive juices would stagnate, stomach acid will reflux into the food pipe and on the other hand the bowel habits would not be proper this leading to constipation. Degradation of undigested food in the intestines by the intestinal bacteria would lead to the excess gas formation. On the other hand constipation alternates with diarrhea. Antibiotics are unlikely to solve your problem.

In order to relieve yourself, you need to do the following:
* Avoid spicy food. Take small but frequent meals. Avoid long gaps between meals.
* Avoid alcohol intake (if it a part of your habit).
* Take Prilosec (omeprazole) once daily before breakfast.
* Take plenty of green leafy vegetables as well as other sources of dietary fibers. Take fiber supplements like isabgol/psyllium husk or senna. I would insist you to increase your dietary fiber intake.
* Regular morning walk and exercise to keep the bowel movements proper.
* If I had a patient like you I would perhaps have suggested Prodep (fluoxetine) 20 mg tablet (long term anxiolytic and a prescription drug) once daily for at least 2 months (it may take time for the action to set in). Discuss about this with your treating physician.
* Take curd or yogurt on daily basis. It contains beneficial bacteria and should help.
* Stress reduction has a very important role to play. Yoga and meditation should help.

Fiber rich food items include:
* Apples, pears, parsnip, berries, raspberries, kumquats, guavas, squash, oranges, passion fuit, avocado, blackberries, pomogranate, currants, persimmons, kiwi fruits, figs, bananas, blueberries, cherries, apricots, strawberries, tangerines, papaya, mangoes, pineapple, plums, litchi, grapes, watermelon
* Broccoli, cauliflower, cabbage, lettuce, brussels sprout, carrots, leafy vegetables and spinach, amaranth, artichokes, green peas, collard greens, XXXXXXX sweet potato, okra, fennel, eggplant/brinjal, sweetcorn, beets, turnip, asparagus, onions
* Legumes, beans, lentils, chickpeas, celery, soybean, navy beans, cranberry beans, french beans
* Whole grains, quinoa, brown rice, millets and oats, squash and pumpkin seeds, seasame seeds, dried coconut, almonds,
* Mushrooms
* Flax seeds, chia seeds, corn XXXXXXX

Hopefully that should help.

Let me know if I could help further.

Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Prof. Kunal Saha (0 minute later)
Brief Answer:
Fiber intake is important

Detailed Answer:
Thanks for using the Ask a Doctor service.

I have gone very carefully through your query. Your problem seems to be due to gastritis or gastroesophageal reflux. Our gastrointestinal tract has a forward propulsive movement (peristalsis) that moves the food material forward as it is digested, absorbed and finally expelled as feces. If somehow this movement gets hampered, food along with the digestive juices would stagnate, stomach acid will reflux into the food pipe and on the other hand the bowel habits would not be proper this leading to constipation. Degradation of undigested food in the intestines by the intestinal bacteria would lead to the excess gas formation. On the other hand constipation alternates with diarrhea. Antibiotics are unlikely to solve your problem.

In order to relieve yourself, you need to do the following:
* Avoid spicy food. Take small but frequent meals. Avoid long gaps between meals.
* Avoid alcohol intake (if it a part of your habit).
* Take Prilosec (omeprazole) once daily before breakfast.
* Take plenty of green leafy vegetables as well as other sources of dietary fibers. Take fiber supplements like isabgol/psyllium husk or senna. I would insist you to increase your dietary fiber intake.
* Regular morning walk and exercise to keep the bowel movements proper.
* If I had a patient like you I would perhaps have suggested Prodep (fluoxetine) 20 mg tablet (long term anxiolytic and a prescription drug) once daily for at least 2 months (it may take time for the action to set in). Discuss about this with your treating physician.
* Take curd or yogurt on daily basis. It contains beneficial bacteria and should help.
* Stress reduction has a very important role to play. Yoga and meditation should help.

Fiber rich food items include:
* Apples, pears, parsnip, berries, raspberries, kumquats, guavas, squash, oranges, passion fuit, avocado, blackberries, pomogranate, currants, persimmons, kiwi fruits, figs, bananas, blueberries, cherries, apricots, strawberries, tangerines, papaya, mangoes, pineapple, plums, litchi, grapes, watermelon
* Broccoli, cauliflower, cabbage, lettuce, brussels sprout, carrots, leafy vegetables and spinach, amaranth, artichokes, green peas, collard greens, XXXXXXX sweet potato, okra, fennel, eggplant/brinjal, sweetcorn, beets, turnip, asparagus, onions
* Legumes, beans, lentils, chickpeas, celery, soybean, navy beans, cranberry beans, french beans
* Whole grains, quinoa, brown rice, millets and oats, squash and pumpkin seeds, seasame seeds, dried coconut, almonds,
* Mushrooms
* Flax seeds, chia seeds, corn XXXXXXX

Hopefully that should help.

Let me know if I could help further.

Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
default
Follow up: Dr. Prof. Kunal Saha (6 hours later)
Thank you doctor for your detailed reply and what you said really makes sense, and I will definitely implement all of what you said in my life.
One question, though, I have already started one dose of the medications provided to me (2 sets of antibiotics +Hyposec).
What should I do now, should I discontinue or complete the 7 days course. Please advice/reconfirm to me and I will stop the antibiotics and reply on only the medicines you prescribed.
Another part of the same question is that what about that H.Pyroli +ve test which appeared in the blood test report? How do I take that into account with your first reply? please explain.
Thanks for such a wonderful reply and expecting a followup reply soon please.

default
Follow up: Dr. Prof. Kunal Saha (0 minute later)
Thank you doctor for your detailed reply and what you said really makes sense, and I will definitely implement all of what you said in my life.
One question, though, I have already started one dose of the medications provided to me (2 sets of antibiotics +Hyposec).
What should I do now, should I discontinue or complete the 7 days course. Please advice/reconfirm to me and I will stop the antibiotics and reply on only the medicines you prescribed.
Another part of the same question is that what about that H.Pyroli +ve test which appeared in the blood test report? How do I take that into account with your first reply? please explain.
Thanks for such a wonderful reply and expecting a followup reply soon please.

default
Follow up: Dr. Prof. Kunal Saha (8 hours later)
Just to add on top of above.

https://www.healthline.com/health/exercise-fitness/diarrhea-after-working-out#prevention

https://www.everydayhealth.com/gerd/best-exercises-to-beat-heartburn.aspx

As a matter of fact because of my weight, I have started home exercise. not too much. but in include stomach crunchs and lying down face up and legs cycle in air. Also side plank.
And I have strong instinct that these things worsen my condition of gases.

Hence I have stopped. these. Can you suggest if exercising plainly on elliptical (notmal walking) is OK? These days due to corona cant walk outside .

Pls please also answer my prev question of taking antibiotics (now have taken two does). Shall I stop antoibiotics and only take one Nexium morning as you suggested?

Thanks

default
Follow up: Dr. Prof. Kunal Saha (0 minute later)
Just to add on top of above.

https://www.healthline.com/health/exercise-fitness/diarrhea-after-working-out#prevention

https://www.everydayhealth.com/gerd/best-exercises-to-beat-heartburn.aspx

As a matter of fact because of my weight, I have started home exercise. not too much. but in include stomach crunchs and lying down face up and legs cycle in air. Also side plank.
And I have strong instinct that these things worsen my condition of gases.

Hence I have stopped. these. Can you suggest if exercising plainly on elliptical (notmal walking) is OK? These days due to corona cant walk outside .

Pls please also answer my prev question of taking antibiotics (now have taken two does). Shall I stop antoibiotics and only take one Nexium morning as you suggested?

Thanks

doctor
Answered by Dr. Prof. Kunal Saha (21 minutes later)
Brief Answer:
Suitable antibiotic regimen needed

Detailed Answer:
H.pylori needs prolonged treatment with specific antibiotics. There are various regimens. Get it prescribed by your treating physician and follow that course.

The exercises are essential and would help in increasing your gastrointestinal issues and would not make it worse. Please continue.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Prof. Kunal Saha (0 minute later)
Brief Answer:
Suitable antibiotic regimen needed

Detailed Answer:
H.pylori needs prolonged treatment with specific antibiotics. There are various regimens. Get it prescribed by your treating physician and follow that course.

The exercises are essential and would help in increasing your gastrointestinal issues and would not make it worse. Please continue.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
default
Follow up: Dr. Prof. Kunal Saha (1 hour later)
You wrote
"The exercises are essential and would help in increasing your gastrointestinal issues and would not make it worse. Please continue."

Did you mean decreasing your gast.. issues?

I can not go to my doctor and ask for change of antibiotics to ones you mentioned, he would be offended because he already prescribed antibiotics of his own.

Nevertheless, I will have to complete my current doc's antibiotics, only then I can go to him and discuss further.

Thanks
default
Follow up: Dr. Prof. Kunal Saha (0 minute later)
You wrote
"The exercises are essential and would help in increasing your gastrointestinal issues and would not make it worse. Please continue."

Did you mean decreasing your gast.. issues?

I can not go to my doctor and ask for change of antibiotics to ones you mentioned, he would be offended because he already prescribed antibiotics of his own.

Nevertheless, I will have to complete my current doc's antibiotics, only then I can go to him and discuss further.

Thanks
default
Follow up: Dr. Prof. Kunal Saha (1 hour later)
I believe doctor you missed my earlier comment where doc has already provided antibiotics for the H-Pylori eradication. Please see the screenshot which I attached.
default
Follow up: Dr. Prof. Kunal Saha (0 minute later)
I believe doctor you missed my earlier comment where doc has already provided antibiotics for the H-Pylori eradication. Please see the screenshot which I attached.
doctor
Answered by Dr. Prof. Kunal Saha (11 hours later)
Brief Answer:
Treatment on correct lines

Detailed Answer:
I am sorry that the autocorrect has changed 'improving' to 'increasing'. I meant that these interventions will improve the situation. Apologies for missing the attachment. Please complete your treating physician's antibiotics and discuss about his further plans with respect to H pylori treatment.
Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. Prof. Kunal Saha (0 minute later)
Brief Answer:
Treatment on correct lines

Detailed Answer:
I am sorry that the autocorrect has changed 'improving' to 'increasing'. I meant that these interventions will improve the situation. Apologies for missing the attachment. Please complete your treating physician's antibiotics and discuss about his further plans with respect to H pylori treatment.
Above answer was peer-reviewed by : Dr. Kampana
doctor
default
Follow up: Dr. Prof. Kunal Saha (2 hours later)
That's ok doctor. I was under the impression that when a patient fills out the details and attachments, it should have been reviewed because no offence you mentioned to me in your reply that you have gone thru my care carefully.

I think I have enough information from you, definitely I will consult with my doctor after the treatment, the purpose to join your website is to get a second opinion and "to ask freely the sort of questions which one does not or cant ask during doc visit".

I just have one more last query please.

Today is the 3rd day of taking the triple therapy and I must say that heavy antibiotics is really making my mouth taste so bad plus I have also pain feeling in the stomach (not the pain I had told before but the pain which you usually have when you are on normal antiniotics, only this time its much more ). I am taking good diet.

1. could you advise any food or etc to reduce this effect?
2. if I cant bear the treatment say for another day or two, I will need to stop the treatment. so could I reduce the dosage to 2g per day instead of 3g now.

Thanks you and may god bless you

default
Follow up: Dr. Prof. Kunal Saha (0 minute later)
That's ok doctor. I was under the impression that when a patient fills out the details and attachments, it should have been reviewed because no offence you mentioned to me in your reply that you have gone thru my care carefully.

I think I have enough information from you, definitely I will consult with my doctor after the treatment, the purpose to join your website is to get a second opinion and "to ask freely the sort of questions which one does not or cant ask during doc visit".

I just have one more last query please.

Today is the 3rd day of taking the triple therapy and I must say that heavy antibiotics is really making my mouth taste so bad plus I have also pain feeling in the stomach (not the pain I had told before but the pain which you usually have when you are on normal antiniotics, only this time its much more ). I am taking good diet.

1. could you advise any food or etc to reduce this effect?
2. if I cant bear the treatment say for another day or two, I will need to stop the treatment. so could I reduce the dosage to 2g per day instead of 3g now.

Thanks you and may god bless you

doctor
Answered by Dr. Prof. Kunal Saha (19 hours later)
Brief Answer:
The regimen needs to be modified

Detailed Answer:
Thanks for writing back.

Unfortunately these are very strong antibiotics and do cause a number of problems including affecting taste. There are various regimens ranging from two days (very strong) to 14 days or more (moderately strong) which are given as per tolerability. i would not suggest reducing the dose own your own. Rather, reapproach your doctor and he will modify the regimen suitably. Till then any change in diet will not really help.

Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Prof. Kunal Saha (0 minute later)
Brief Answer:
The regimen needs to be modified

Detailed Answer:
Thanks for writing back.

Unfortunately these are very strong antibiotics and do cause a number of problems including affecting taste. There are various regimens ranging from two days (very strong) to 14 days or more (moderately strong) which are given as per tolerability. i would not suggest reducing the dose own your own. Rather, reapproach your doctor and he will modify the regimen suitably. Till then any change in diet will not really help.

Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Prof. Kunal Saha (5 hours later)
Brief Answer:
Wish you good health

Detailed Answer:
I am glad that you feel better. I am sure that your body will adjust and you will be fine. The query will automatically be closed off in due time and I hope that you will be fine soon.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Prof. Kunal Saha (0 minute later)
Brief Answer:
Wish you good health

Detailed Answer:
I am glad that you feel better. I am sure that your body will adjust and you will be fine. The query will automatically be closed off in due time and I hope that you will be fine soon.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
default
Follow up: Dr. Prof. Kunal Saha (1 minute later)
From today I feel better, I did not reduce the dose. seems my body is adjusting to the antibiotic effect.
Remaining 3.5 days more.

I am just worried about the overall side effects of antibiotics, if one reads the leaflet , very scary like kidney issue etc.

Anyway thanks doc, for your support, you may close this ticket now.
cheers
default
Follow up: Dr. Prof. Kunal Saha (0 minute later)
From today I feel better, I did not reduce the dose. seems my body is adjusting to the antibiotic effect.
Remaining 3.5 days more.

I am just worried about the overall side effects of antibiotics, if one reads the leaflet , very scary like kidney issue etc.

Anyway thanks doc, for your support, you may close this ticket now.
cheers
default
Follow up: Dr. Prof. Kunal Saha (2 days later)
One quick question doc please.
Today is the 6h day.
Some how the dose which am supposed to take at 12 pm. I forgot and realized at 5 pm. I immediately took it.

So now
1. do I have to take the 2nd dose at usual time or wait 12 hrs and take the next one at 5 am?
3. will this slip of 5 hrs delay cause me to retake the whole course?
cheers to reply quickly pls
default
Follow up: Dr. Prof. Kunal Saha (0 minute later)
One quick question doc please.
Today is the 6h day.
Some how the dose which am supposed to take at 12 pm. I forgot and realized at 5 pm. I immediately took it.

So now
1. do I have to take the 2nd dose at usual time or wait 12 hrs and take the next one at 5 am?
3. will this slip of 5 hrs delay cause me to retake the whole course?
cheers to reply quickly pls
default
Follow up: Dr. Prof. Kunal Saha (6 hours later)
Last question, after completion of the antibiotics.
Should I take one Nexium daily morning before breakfast for how many days?? and what mg.
cheers
default
Follow up: Dr. Prof. Kunal Saha (0 minute later)
Last question, after completion of the antibiotics.
Should I take one Nexium daily morning before breakfast for how many days?? and what mg.
cheers
doctor
Answered by Dr. Prof. Kunal Saha (15 hours later)
Brief Answer:
Nexium for at least 6 weeks

Detailed Answer:
You need to take the doses at usual times but a delay in.a dose would not make it necessary for you to retake the entire course. You need to take Nexium for at least 6 weeks. 20mg is the standard dose but sometimes doctors recommend a higher dose. Please discuss with your treating physician.

Regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Prof. Kunal Saha (0 minute later)
Brief Answer:
Nexium for at least 6 weeks

Detailed Answer:
You need to take the doses at usual times but a delay in.a dose would not make it necessary for you to retake the entire course. You need to take Nexium for at least 6 weeks. 20mg is the standard dose but sometimes doctors recommend a higher dose. Please discuss with your treating physician.

Regards
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Prof. Kunal Saha

General & Family Physician

Practicing since :1954

Answered : 4467 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
I Am Looking For A 2nd Opinion Before I Start

I am looking for a 2nd opinion before I start on the medication. I have had the following symptoms for some time. 1. Stomach bloating. like always filled up gas hard 2. Pain (feeling) in the stomach 3. Some times, lose motion. 4. Anxiety and headache I used to treat the above with tablets like zantac, or pentazole and with one or two does, i gets healed This happened like once or twice a year. This year, it happened 3 days ago and this time I went to see my doctor. Who took my blood sample and H.Pylori came Positive. He prescribed the following medications for 7 days: Hyposec capsules 2 x twice a day (before meal) Penamox 500 - 2 capsules twice a day (morning/evening) after meal Clarimac 500 - 2 tab - one morning and another evening (after meal) gaviscon syrup (not sure before or after mean) I have yet to start the above medication. I have done some google and found the following: This bacteria some times gets in childhood and remain there in 60% of population. Cause of alarm when it is accompanied with m symptoms. Now I have a strong feeling that I can again take precautions and take zantac or pentazole for few days and eats diet like oats etc and i will be back to normal. Because am afraid of taking 3000 mg antibiotics daily for 7 days (just a fear of side effects). Therefore I am asking your opinion? what should I do? If you ask me to proceed wit antibiotics, what food should i take to avoid antibiotics side effect because doc told me to stay away from milk (was thinking of taking milk to reduce antibiotic side effect) Thank you.