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Suggest Treatment For Persistent Chronic Pancreatitis
Question: Hi, I am patient of recurrent chronic pancreatitis (diagnosed in 2013) with frequent bouts of pain leading to hospitalization. In between these episodes, the major issue that I often face are random and frequent( 2-3 times weekly) episodes of sour eructations which invariably lead to nausea/vomiting and diarrhea. I have been prescribed Zinetac(Ranitidine) and Esofag-D (Esomeprazole+Domperidone) over different periods of time, but neither seem to help. Redotil(Racecadotril) does stop the diarrhea but only until the next episode of sour-eructations, and thus the cycle continues. The other minor issue is occasional bile-reflux after a meal(mostly dinner). I take Panlipase(Pancreatin 25000) with lunch & dinner, Esofag-D in the morning. Duloxetine 30MG BD (for anxiety), Antoxid BD. Please recommend appropriate drug(s) for sour-eructations+diarrhea.
Brief Answer:
Likely to be due to GERD
Detailed Answer:
Thanks for asking on HealthcareMagic.
I have gone carefully through your query. Although you have recurrent pancreatitis, you concurrently have acid reflux. The stomach acids are meant to assist in digestion. 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 and even bile refluxes into the food pipe.
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 Esofag D once daily before breakfast. Take the other medicines as directed.
* 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 20 mg tablet once daily for at least 2 months (it may take time for the action to set in).
* Take curd or yogurt on daily basis. It contains beneficial bacteria and should help.
* Yoga and meditation should help.
Hope that helps.
Let me know if I could help further.
Regards
Likely to be due to GERD
Detailed Answer:
Thanks for asking on HealthcareMagic.
I have gone carefully through your query. Although you have recurrent pancreatitis, you concurrently have acid reflux. The stomach acids are meant to assist in digestion. 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 and even bile refluxes into the food pipe.
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 Esofag D once daily before breakfast. Take the other medicines as directed.
* 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 20 mg tablet once daily for at least 2 months (it may take time for the action to set in).
* Take curd or yogurt on daily basis. It contains beneficial bacteria and should help.
* Yoga and meditation should help.
Hope that helps.
Let me know if I could help further.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have been following a strict fat-free, non-spicy diet with frequent small meals, for past 3 years. I don't consume alcohol or tobacco. I go for a brisk 30' walk every morning and evening.
The problem of sour-eructations with diarrhea has worsened over the last six months while following the same strict diet. I was also recently diagnosed with post-pancreatitis diabetes and the diet has become even more stricter now with addition of insulin twice a day, but the sour-eructations have only worsened and become more frequent.
I have consumed a PPI(Proton-pump Inhibitor) tablet/capsule for every single day since 2013. Since it has obviously not helped, I was wondering if any other medicine might. The most recent endoscopy (a month back) suggested LAX XXXXXXX but the presiding doctor dismissed it as inconsequential.
Regards
The problem of sour-eructations with diarrhea has worsened over the last six months while following the same strict diet. I was also recently diagnosed with post-pancreatitis diabetes and the diet has become even more stricter now with addition of insulin twice a day, but the sour-eructations have only worsened and become more frequent.
I have consumed a PPI(Proton-pump Inhibitor) tablet/capsule for every single day since 2013. Since it has obviously not helped, I was wondering if any other medicine might. The most recent endoscopy (a month back) suggested LAX XXXXXXX but the presiding doctor dismissed it as inconsequential.
Regards
Brief Answer:
Lifestyle modification and stress reduction techniques would help.
Detailed Answer:
The laxity of the lower esophageal sphincter is what is allowing the reflux (sour regurgitations) to occur. However, there is hardly anything that can be done about it. Discuss with your doctor about Prodep. It is a long term anxiolytic and could lead to reduction of the symptoms. A healthy lifestyle backed with regular exercise and morning walk is important.
Regards
Lifestyle modification and stress reduction techniques would help.
Detailed Answer:
The laxity of the lower esophageal sphincter is what is allowing the reflux (sour regurgitations) to occur. However, there is hardly anything that can be done about it. Discuss with your doctor about Prodep. It is a long term anxiolytic and could lead to reduction of the symptoms. A healthy lifestyle backed with regular exercise and morning walk is important.
Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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