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Suggest Treatment For Gas, Severe Abdominal Pain And Alternating Diarrhea And Constipation

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Posted on Fri, 15 Sep 2017
Question: Hey doctor,

For the last 2 months I have been having a wide variety of digestive issues. I pass a lot of gas, have abdominal pain on both left and right sides of my lower abdomen and sometimes a mix of constipation/diarrhoea but only mild and not that often. Prior to that I had acid reflux problems on and off for about a year which was solved mostly with a month and half Nexium which I have now been off for about a 3 weeks now. Most of my symptoms aren't severe but the collection of them decreases my quality of life a lot and I am struggling to get through uni and work. I'm only 19 years old and have been through numerous tests already including an upper endoscopy down the throat, blood tests, ultrasounds, stood tests, urine tests, and h.pylori test which came up all clear yet I am still experiencing these gastro symptoms every single day? The next test the doctor recommended was a colonoscopy but I am unsure if it will even turn up anything. Could this possibly be some sort of gut problem or in balance with the gut? I also have acne just to add to that. What do you think it could be any ideas SIBO or IBS possibly? I have tried Buscopan but it didn't do a huge amount although I didn't give it a long shot only for a couple of days. I sometimes feel foods sit in my stomach especially fatty foods or ice cream and the gas increases quite a lot. What other tests could I try and maybe diets that I can go on and try? My current diet isn't the best but over the last couple of months it's changed quite a bit I used to eat a lot more processed junk food and alcohol and whilst I have completely cut alcohol out for the last 6 months I still have a bit of junk food here and there but I have added a large variety of fruit, vegetables and raw foods to my diet along with a probiotic and only drinking water. I do have a bit of anxiety especially about my health but even when I am happy I still have the symptons regardless. Thank you for your help in advance any other ideas would be much appreciated.

Kind Regards,
XXXX

A couple of things to add I weigh 56kg at the moment so on the lower end of the weight side, exercise regularly and some additional symptoms I have had off and on are nausea and loss of appetite sometimes being the opposite with being super hungry it's just completely random.
doctor
Answered by Dr. Prof. Kunal Saha (2 hours later)
Brief Answer:
Possibly due to slowing of gastrointestinal movements

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone very carefully through your query. Your problems seem to originate from one single aspect and that is the slowing of gastrointestinal movements. 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 leading to gastritis or gastroesophageal reflux, and on the other hand the bowel habits would not be proper. Degradation of undigested food in the intestines by the intestinal bacteria would lead to the excess gas formation.

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) or Nexium (esomeprazole) 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.
* 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.
* If that does not help, you might benefit from taking 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 prior to attempting such medicines.

Hopefully that should help.

Let me know if I could help further.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prof. Kunal Saha (22 minutes later)
I already do the majority of things that you have listed, but in terms of fibre intake what foods are good sources of fibre and would benefibre supplment be helpful I have attached a picture of it and its ingrientents? For yogurt as well is there ones that I should avoid and ones that I should have? I have stopped Nexium as I no longer need it with my acid reflux symptons no longer there only abdominal discomforts during the day. Is there any other tests that you recommend that I do as well?
doctor
Answered by Dr. Prof. Kunal Saha (37 minutes later)
Brief Answer:
Can be taken

Detailed Answer:
Thanks for writing back. You can take Benefiber, the images of which you have uploaded.

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

I do not think that further tests are needed.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prof. Kunal Saha (15 hours later)
One other thing to add I have noticed that I have been having abnormally large stools when I go to the toilet. Its not happened every day but over the last week I have been getting it more often and I never feel fully relieved after passing the stools either.
doctor
Answered by Dr. Prof. Kunal Saha (16 minutes later)
Brief Answer:
Soluble fibers should help.

Detailed Answer:
Thanks for writing back. The large stools are nothing concerning and you need not worry about them. However, among fibers, I would insist you to take soluble fibers in particular. Soluble fiber is found in oat XXXXXXX barley, nuts, seeds, beans, lentils, peas, and some fruits and vegetables. It is also found in psyllium, a common fiber supplement. I am certain that they will help you feel relieved after your bowel movements. However, do not expect immediate action. You would need to give some time.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prof. Kunal Saha (9 hours later)
Thanks for that doctor I will definitely try that and see how it goes, just an update though from last night and tonight. I was up until the early hours of the morning with a painful stitch type of pain on the left side of my abdomen along with a general discomfort below my belly button and gas prior to that which I have both attached pictures exactly where the sharp pain is only on the upper left side in the first picture. Is there anything I can do to relieve the pain in the meantime before I see my doctor it seems to get quite painful at night time.
doctor
Answered by Dr. Prof. Kunal Saha (2 hours later)
Brief Answer:
Due to stagnation of stool

Detailed Answer:
Thanks for writing back. I have checked the attached images. The pain overlies the junction of the transverse colon and descending colon. The pain is therefore likely to be related to stagnation of stool. As of now you can take some antispasmodic like Decolic tablet. But ultimate getting the stool cleared is what would provide relief.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Prof. Kunal Saha (46 hours later)
Hey doctor, Just something a little unrelated but my mum has been complaining of a pain in her throat when she eats. She says that everytime she swallows and just before the food enters the stomach she feels a pain there. She says shes had it for quite a while now possibly 6 months and shes aged 50 what could the possible causes be? Would an endoscopy be warranted?
doctor
Answered by Dr. Prof. Kunal Saha (43 minutes later)
Brief Answer:
Gurgling with lukewarm water can help.

Detailed Answer:
Thanks for writing back. It could be due to some allergic component. I would insist to you ask her to gurgle with lukewarm water. Also ask her to take take some antiallergic like cetirizine once daily for the next few days. I hope that would suffice. If not, it would be good to get her clinically evaluated by an ENT doctor. It is only in more complicated scenarios that endoscopy might be needed.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prof. Kunal Saha (1 hour later)
She also has acid reflux problems like me do you think it may be related to that more so rather than an allergy componet to it? She said Zantac had helped her but since its been going so long wouldn't tests be warranted due to possible damage or cancer?
doctor
Answered by Dr. Prof. Kunal Saha (9 minutes later)
Brief Answer:
Worrying precipitates acid reflux.

Detailed Answer:
Thanks again for writing back. I have already suggested the steps in my first communication in this thread. Cow milk allergy could be a contributory factor but otherwise allergy is unlikely. I would insist her to continue Zantac without worrying about cancer or any damage to the stomach. It is a frequently used medicine and is tolerated well. Moreover, it is more important to resolve the symptoms first. Worrying will only make matters worse.

Regards
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Prof. Kunal Saha

General & Family Physician

Practicing since :1954

Answered : 4467 Questions

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Suggest Treatment For Gas, Severe Abdominal Pain And Alternating Diarrhea And Constipation

Brief Answer: Possibly due to slowing of gastrointestinal movements Detailed Answer: Thanks for asking on HealthcareMagic. I have gone very carefully through your query. Your problems seem to originate from one single aspect and that is the slowing of gastrointestinal movements. 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 leading to gastritis or gastroesophageal reflux, and on the other hand the bowel habits would not be proper. Degradation of undigested food in the intestines by the intestinal bacteria would lead to the excess gas formation. 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) or Nexium (esomeprazole) 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. * 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. * If that does not help, you might benefit from taking 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 prior to attempting such medicines. Hopefully that should help. Let me know if I could help further. Regards