Suggest Remedy For Severe Burping And Gas Formation While On Thyronorm

Posted on Wed, 26 Aug 2015

Question: Hello,
I am a diabetic for last 12-13 years and am currently taking Invokana 100mg once and Galvus 50- twice daily and Actrapid Insulin 30-70 (16 units before breakfast and 14 units before dinner) I had some gas formation problem since long for which I used to take one Pantop 40 before breakfast. I had suffered from Semi acute thyroiditis last year after which now I am also having Thyroid problem for which I take Thyronorm 25mg daily.
I recently had a spine (D11) fracture 3-1/2 months back which forced me long bed rest for more than 2 months. Since the fracture happened I am having severe gas formation and burping and have been prescribed several medicines like Pantop 40, Ganaton, Gaviscon, Simfast etc. but nothing appears to be really working.
My endoscopy was also done 2-1/2 months back which showed a small hiatal hernia and the ultrasound was also normal.
I've just today been suggested Ganaton Total by my doctor but this also gave me some comfort in the morning but afternoon onwards I'm again having severe burping and gas formation.
I'm totally on simple diet and also doing some yoga exercises.
Please advise me.
Thanks and regards XXXXXXX

Answered by Dr. T Chandrakant (15 hours later)

Brief Answer:
Gastroparesis may be the reason, GI flora restoration

Detailed Answer:
Hi.
Thanks for your query and an elucidate history.
Diabetes needing so many medicines, thyroiditis needing Thyrox and fracture of D11 needing bedrest together affects the gastrointestinal system directly. All these affect by slowing the motility of the intestinal tract thereby allowing the imbalance of intestinal bacterial flora increasing the number of bad bacteria which produce gases in excess and cause burping.

I would advise you the following:-
First of all go for fresh investigations:
Blood- CBC, sugar fasting, pp and random, HbA1c, urea, creatinine, liver functions, thyroid functions for knowing any abnormality and adjust dosage of your medicines.
Stool and urine tests to see if any sub- clinical infection.
X-ray of abdomen in standing position.

All the tests help us to get a clinical evaluation.

The possible additional treatment are:
Continue Ganaton total as it has Mobility regulator
Pre and probiotics
5 day course of an antibiotic and metronidazole.
Activated charcoal like gasex or flatuna
Avoidance of foods and beverages which cause more gases.
Less or stress and anxiety.

All these medicines need a prescription and hence take help of your family doctor to get the medicines.

These help all my patients and will help you too.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Chandrakant (2 days later)

I've already ordered the blood tests as suggested by you and am expecting the reports by this evening or tomorrow morning. Please allow me time till then.

Thanks
XXXXXXX

Answered by Dr. T Chandrakant (5 minutes later)

Brief Answer:
sure...

Detailed Answer:
Sure,boss.
Awaiting for the reports .

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Chandrakant (18 hours later)

Hello Dr. Chandrakant,

I've just received my blood test reports which are attached for your kind perusal.

I'm currently taking Invokana-100mg. Tab before Breakfast and Galvus -50 after Breakfast and Dinner besides Humalog insulin 16 units before breakfast and 14 units before dinner. I'm also taking 25mg Thyronorm in morning.

For last 4-5 days I'm taking Ganaton Total - once daily before breakfast and Moza MPS Chewable Tab before Dinner. I'm on totally simple diet throughout the day.

The gas problem becomes unbearable towards the bedtime and this is disturbing a lot with almost continuous burps.

Please advise.

Thanks and regards
XXXXXXX

Answered by Dr. T Chandrakant (1 hour later)

Brief Answer:
As detailed.

Detailed Answer:
Thanks for your feedback.
Reports seen and show:
HbA1c- 8.1 unsatisfactory control.
ABG- 186 - Action suggested.
Iron on lower limits
Lipid profile - mild changes, expected in uncontrolled diabetes.
T4 just above normal- no treatment needed.

The salient feature suggest you need a better control of your diabetes and may need alteration of the Insulin dosages.
Regular blood sugar charting in the notebook.

For the gas problems:
Get a stool tests done for 3 consecutive days and start antibiotic, metronidazole, pre and probiotics, activated charcoal tablets like gasex, anti-oxidants (multivitamins) for 5 days and see the difference (you need a prescription of your local Doctor for some medicines).
increase the dosages of Insulin as per the blood glucose reports.
Avoid all the foods and beverages that you must have noticed to enhance your problems.
Control of anxiety and stress and avoiding the situations that cause anxiety and stress is a very important part of the whole treatment.

Rest of the medicines to be continued as advised by your Doctor.

I hope this answer helps you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Chandrakant (7 hours later)

Hello Doctor Chandrakant,

Thanks for your response. Can you please specify the stool test?

Thanks and regards
XXXXXXX

Answered by Dr. T Chandrakant (18 minutes later)

Brief Answer:
Routine, microscopy, occult blood.

Detailed Answer:
Hi.

Stool : routine, microscopy and occult blood.
on three different days.
(Doing three times sometimes helps)

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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar