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Suggest Treatment For Severe Diarrhea And Flatulence

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Posted on Mon, 22 May 2017
Question: I live at 7500 feet here in New Mexico. I have had 2 small bowel resections and a sigmoid colectomy doe CA. When I travel and return to SF from sea level, I experience tremendous increased diarrhea and gas. I already take 2-3 Imodium daily and up to 6 Welchol. Can you suggest any other treatment for this diarrhea? I am exhausted after these episodes.
Thank you.
doctor
Answered by Dr. Ramesh Kumar (2 hours later)
Brief Answer:
Try a combination of therapies.

Detailed Answer:
Hi,
Thanks for choosing HealthcareMagic for your query.

Due to resection of the gastrointestinal tract, the food passes through the intestines earlier without proper absorption of water hence causing recurrent and loose stools in your case.As digestive system is compromised a sudden change in atmospheric conditions leads to problems arising out of indigestion.

As per you history, you are on Imodium. Doses of Imodium can be increased up to 12 to 16mg in 24 hours in case you are not relieved by doses of 4 to 8 mg per day.

Another OTC medication is Bismuth sub-salicylate. It belongs to a class of medications called antacids and adsorbents marketed by name of Pepto Bismol. Doses up to 1gram can be taken daily to provide symptomatic relief from diarrhea.

Racecadotril is known as a prodrug. Once inside your body, it is broken down into an active ingredient called thiorphan. Thiorphan reduces the number of watery secretions that are produced by your intestines. This helps to reduce the amount of fluid that your body loses. In turn, this reduces the symptoms of diarrhea and helps reduce the risk of dehydration. Racecadotril can be taken in doses of 100mg thrice daily.


Cholestyramine is used to treat high cholesterol (hyperlipidemia) and itching caused by partial bile obstruction (when bile acids can’t easily move between the liver and gallbladder). The most common side effect of this drug is severe constipation.This side effect will help you.

Diphenoxylate and Atropine combination(Lomotil)-Atropine/diphenoxylate is an antidiarrheal and anticholinergic combination. It works by decreasing the motion of muscles in the intestines and prolonging the time it takes to move the contents through the body.

Codeine is often prescribed to relieve pain. When you take the drug as a tablet of codeine sulfate, it can help prevent diarrhea as again constipation as a side effect of codeine.

The above-mentioned medicines can be taken along with one another. Please discuss the options and doses with your Gastroenterologist.

To prevent your body from exhaustion and weakness arising out of diarrhea keep yourself hydrated. Take a lot of fluid especially juices rich in potassium and sodium salts.

Drink lots of coconut water and orange juices.
Hope I answered your query, In case you need more details please ask follow ups.

Regards!


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Ramesh Kumar (31 hours later)
Thank you for your reply. I am actually on Lomotil, as Immodium had been becoming less and less effective for me. My GI doc advised me not to use Peptobismol chronically. I tried cholestyramine, but had tremendous bloating and unending gas. Does that get better with continued use? I would love to try Racecadotril, but apparently it is unavailable in the US. Is there any way to order it online, and would those pharmacies be trustworthy? It sounds like a great drug.
Is there any eating pattern that you would suggest? How about the 5HT blockers, like zofran? Are the cox2 inhibitors like Celebrex helpful to decrease VIP? Or would that just inflame the gut. Do GI docs prescribe codeine for this, and wouldn't there be eventual loss of effectiveness? I'm worried that is happening with the Lomotil.
With a multi product use, is there any "schedule" you would recommend- when are intestinal secretions at there greatest volume in order to dose these things most effectively?
I appreciate your help, I am a retired anesthesiologist. I have a recurrent endometrial stromal sarcoma, which metastasized and was the reason for the 2 small bowel resections and sigmoid colectomy. I'm really interested in getting my hands on the racecadotril.
doctor
Answered by Dr. Ramesh Kumar (2 hours later)
Brief Answer:
Follow up.

Detailed Answer:
Hi again XXXX,

Racecadotryl is one of the safest and best drug i have ever used in my life but i dont know why it's not still used approved by FDA.
Racecadotryl is much safer then Imodium or Lomitil(As risk of paralytic ileus is always associated with their use).
I don't understand why FDA is not allowing them yet.
Food pattern recommended is-
Eat simple and natural home cooked food.
If possible try detox diet(Raw vegans) for atleast 3 month. Take normal food in lunch while in supper take uncooked raw natural form of food.This can play wonders.
Avoid taking excessive fibres.A total fiber intake of about 20-30 grram per day would be good for you.
No pizza,Burger,Red meat,and dairies for few weeks.
No alcohol or smoking.

Take natural food rich in probiotics like Yoghurt,Kimchi,etc.This doesnot mean that you have to take them as much as you can.Follow your body increase their uptake gradually.
Drink lots of juices and fresh water daily.
Avoid over spicy and heavy food.

If possible go for a detox diet but again don't force your body rather let your body adopt gradually to things.

Remenber-'Animals never have Gastritis or ulcers' and the only difference between them and us is that we take cooked and tasty food.Control your buds and follow nature.
So personally i believe in detox diet.
Though difficult to follow yet i can play wonders.

You can get Racecadotryl directly from any developing Asian nation without prescription.Yes pharmacies like Ranbaxy and Cipla are trustworthy.In case your friend is visiting asia ask him/her to get it directly for you.

Zofran (ondansetron) is an antiemetic and has nothing to do with you gas or bowel problem.
COX 2 will increase your problem by precipitating Gastritis.

As per the reistance is concerned the best way is don't stick to single drug shuffle the drugs every three months this will prevent developing of tolerence.For eg choose three drugs effective in you like Racecadotryl, Loperamide and Codein and change them every three months.

Codein is basically used for dry cough but as explained earlier we will use its side effect as an advantage in your case.
In case you have any further query feel free to ask.

Good luck XXX and Regards.

Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Ramesh Kumar (12 hours later)
Dr. XXXXXXX
Again, thank you for your reply. I will give the detox diet that you are describing a go, as best I can. I already avoid gluten, as I am intolerant. I take probiotic supplements as well. I also avoid the standard XXXXXXX diet, and eat organic as much as possible. I do not smoke, and only drink wine occasionally.
I have ordered the racecadotril from one online pharmacy in XXXXXXX but would like to order from another pharmacy in XXXXXXX Ranbaxy makes their drug. The first pharmacy did not require a prescription, but the second one does. Would you be able to email me a prescription? I would just have you send it to my email address, then attach it to the order form. My email is YYYY@YYYY . I would like to try the 100mg dose, TID, a 3 month supply, since it will take 2-4 weeks to receive the prescription.
Do I take the racecadotril every day, or PRN? If prn, do I take it before I eat, during or after a meal? The extreme gas and diarrhea I am experiencing have been worse at night recently.
I do not know if you have any Aruvedic medicine advice for me,but I would be interested in that if you have any to share with me. I am mostly a Pitta, I think. I am 5'6, and about 140 lbs. I used to have a great deal of energy, and like spicy foods. I tend to be warm, especially now that I am off estrogen completely.
I do take a lot of Curcumin (the BCM 95 type, about 3 grams a day) and use fresh turmeric root almost daily in a shake or on a salad, hopefully this is not too much of a bowel irritant.
Thank you for your help.
Sincerely, XXXXXXX Wilhite, MD DOB for Rx: 6/29/57 address: 1042 XXXXXXX del Norte, XXXXXXX Fe, New Mexico, USA,87501
doctor
Answered by Dr. Ramesh Kumar (11 hours later)
Brief Answer:
follow up.

Detailed Answer:
Hello again,

as far as Ayurveda is concerned yes I would suggest you to use-
Kutajghan vati-It helps in proper digestion and absorption of the food.
It helps in getting rid of loose and watery stools quickly. It helps to get rid of weakness by boosting up the body energy. It helps in balancing the salt and water balance in the body. It helps to retain water and salt contents by acting on the digestive system. It prevents recurrent attacks of loose stools by helping in proper digestion of the food.

Benifits of Kutajghan vati are-
It is a natural remedy for the treatment of chronic gastric problems. It helps by stimulating the functioning of all digestive organs.
It gives relief from recurrent attacks of infection of the digestive organs by harmful germs. It boosts up the immune system and prevents recurrent infection of the digestive system.
It gives quick relief from watery stools. It helps by balancing the acid base balance of the stomach.
It helps the digestive organs to secrete enzymes and other digestive juice for proper digestion of the food. It also helps in proper food absorption.
It also boosts up the energy of the body. People feel weak and tired due to loss of water and salts from the body.
It prevents the recurrent episodes of dysentery and it is a safe remedy for long term treatment. It may be taken by people of all ages for the treatment of digestive disorders.

Udaramrita vati-
It is recommended for all the digestive ailments. It helps to relieve indigestion, acidity, heartburn, etc. It helps to give quick relief from digestive disorders. It helps to stimulate normal functioning of the liver. It gives relief from constipation and diarrhea.

Udaramrita Vati helps in the treatment of stomach problems. It increases appetite and helps to cure abdominal pain.
Udaramrita Vati helps to cure abdominal pain. It is a very good remedy for diarrhea and constipation. Udaramrita Vati gives quick relief from flatulence, vomiting, nausea, indigestion, etc.
Udaramrita Vati is a wonderful natural remedy for giving relief from digestive disorders quickly.
Udaramrita Vati gives relief from acidity, heartburn and other digestive ailments.
Udaramrita Vati helps in increasing appetite, improves digestive functions, and liver disorders.


Agni tundi vati

Uses Of Agnitundi Vati
Agnitundi Vati is an excellent herbal remedy for weak intestines and gas formation.
Agnitundi Vati is excellent herbal remedy for gas, flatulence, colic pain due to gas and constipation.
Agnitundi vati improves digestion, improve intestinal movement and secretions.
Agnitundi vati is used to relieve intestinal colic, renal colic and all types of abdominal colics.
Agnitundi vati can also be used in nervous disorders. As most of the nervous disorders, pain are caused by imbalance of "Vata" (Air element) as per Ayurveda, therefore Agnitundi Vati is effective herbal remedy for Vata problems i.e. Nervous disorders.
Other Ayurvedic and herbal tips are-
Take 1/4 teaspoon of mustard seeds and add it to 1 tablespoon water. Soak it for 1 hour and then drink that water 2 or 3 times a day.(Very effective)
Lemon has high anti inflammatory properties which makes it very good for stopping loose stools.
Pomegranate seed is known for its benefits in stopping Loose stools.
You can either eat 2 pomegranates a day or prepare juice of it and have 1 glass 3 times a day for good result.
Add pomegranate leaves to water and bring this water to boil with the leaves in it. Drinking this water also helps in giving well formed stools.
Fenugreek seeds or methi have anti-bacterial and anti-fungal properties.
Blend 1 or 2 teaspoons of dried fenugreek seeds into fine powder. Mix this in 1 glass water and have it every morning empty stomach.
Take buttermilk with little salt or jeera powder or black pepper powder 2 or 3 times a day for relief from Loose motion.
Mint leaves or podina have anti-bacterial property and are very good for digestion.
Extract the juice of few fresh mint leaves to get 1 teaspoon of it. To this add 1 teaspoon each of honey and lime juice. Mix this well and have it 2 or 3 times a day.
Bottle gourd juice helps in maintaining water content in body and prevents from getting dehydrated during Loose motion.
Peel 1 fresh bottle gourd and blend it well to extract its juice. Have this juice 2 times a day.
Ginger has high anti bacterial and anti fungal properties. Also, it is very good for digestion and stomach pain.
Take 1/2 teaspoon dried ginger powder or you can also take a small piece of fresh ginger. Pound it and add it to buttermilk. Take this buttermilk 3-4 times a day. You can see considerable changes in 2 days.
Grate 1 raw papaya and add it to 3 cups of water. Boil it for 10 minutes and strain the water. Drink it warm 2 -3 times a day.
Prepare herbal tea and drink it 3 times a day. Take 1 teaspoon each of chamomile flower and fresh peppermint leaves in 1 glass water. Boil water and allow steeping for 15 minutes. Strain the water and drink it.
Try to avoid intake of milk products like cheese, milk, milk powder, coffee prepared with milk, etc.
Try to take bananas with little curd.
Try to drink lot of tender coconut.
Take 2 teaspoon lemon juice. To this add 1/2 teaspoon ginger paste and a little black pepper. Mix well and eat this 2 times a day.
Take 2 teaspoon each of cumin seeds and fenugreek seeds. Roast them and grind it to fine powder. Take 4 teaspoon of this powder and mix it with 1 cup yogurt. Mix it well and eat it 3 times a day.
Take 1 onion and slice it length wise into thin pieces. Fry this onion on a pan with 2-3 teaspoon ghee till golden brown. Eat plain rice with this fried onion. This helps to reduce pain in abdomen and frequency of passing stools.
Take few ripped bananas mash it with little salt. Eat this 2-3 times a day.
Take 1 teaspoon date or khajoor paste with little honey. Have this 3 times a day for regulating bowels. to taste. Drink this juice every hour.
Pomegranate is known for its benefits in stopping Loose motion.
You can either eat 2 pomegranates a day or prepare juice of it and have 1 glass 3 times a day for good result.
Add pomegranate leaves to water and bring this water to boil with the leaves in it. Drinking this water also helps in stopping Loose motion.
Fenugreek seeds or methi have anti-bacterial and anti-fungal properties.
Blend 1 or 2 teaspoons of dried fenugreek seeds into fine powder. Mix this in 1 glass water and have it every morning empty stomach.
Take buttermilk with little salt or jeera powder or black pepper powder 2 or 3 times a day for relief from Loose motion.
Mint leaves or podina have anti-bacterial property and are very good for digestion.
Extract the juice of few fresh mint leaves to get 1 teaspoon of it. To this add 1 teaspoon each of honey and lime juice. Mix this well and have it 2 or 3 times a day.
Bottle gourd juice helps in maintaining water content in body and prevents from getting dehydrated during Loose motion.
Peel 1 fresh bottle gourd and blend it well to extract its juice. Have this juice 2 times a day.
Ginger has high anti bacterial and anti fungal properties. Also, it is very good for digestion and stomach pain.
Take 1/2 teaspoon dried ginger powder or you can also take a small piece of fresh ginger. Pound it and add it to buttermilk. Take this buttermilk 3-4 times a day. You can see considerable changes in 2 days.
Grate 1 raw papaya and add it to 3 cups of water. Boil it for 10 minutes and strain the water. Drink it warm 2 -3 times a day.
Prepare herbal tea and drink it 3 times a day. Take 1 teaspoon each of chamomile flower and fresh peppermint leaves in 1 glass water. Boil water and allow steeping for 15 minutes. Strain the water and drink it.
Try to avoid intake of milk products like cheese, milk, milk powder, coffee prepared with milk, etc.
Try to take bananas with little curd.
Try to drink lot of tender coconut.
Take 2 teaspoon lemon juice. To this add 1/2 teaspoon ginger paste and a little black pepper. Mix well and eat this 2 times a day.
Take 2 teaspoon each of cumin seeds and fenugreek seeds. Roast them and grind it to fine powder. Take 4 teaspoon of this powder and mix it with 1 cup yogurt. Mix it well and eat it 3 times a day.
Take 1 onion and slice it length wise into thin pieces. Fry this onion on a pan with 2-3 teaspoon ghee till golden brown. Eat plain rice with this fried onion. This helps to reduce pain in abdomen and frequency of passing stools.
Take few ripped bananas mash it with little salt. Eat this 2-3 times a day.
Take 1 teaspoon date or khajoor paste with little honey. Have this 3 times a day for regulating bowel.

Personally I prefer to use kutajghan with Udaramrita vati(Ayurveda).


Racecadotryl should be taken initially for 14 days thrice daily before food.After that for 14 days twice daily followed by once daily for 14 days.After that again shift to loperamide for next 42 days then switch to codein and then again come back to Racecadotryl.

Racecadotryl can however also be taken on as and when required basis.

I am sorry doc but giving a prescription is not under the company policy of HealthcareMagic.
However you can contact customer care for the same.

Regards.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Ramesh Kumar (10 hours later)
Thank you for your excellent advice. What is the best source of the Aryvedic items you listed, and will instructions for use be included?
I understand about the Rx, I will contact customer service.
I really appreciate all you wisdom and help. XXXXX, M.D.


I have been having a most helpful consultation with on of your GI docs, Dr. Kamur. He suggested I try drug called Racecadotril 100mg, three times a day for my problem. The online pharmacy that I can order this drug from requires a prescription. He cannot write it for me, and suggested that I contact customer service. Will you be able to provide one for me, I am really very interested in trying this medication because I think it could really help me.
Thank you.
doctor
Answered by Dr. Ramesh Kumar (27 minutes later)
Brief Answer:
Follow up.

Detailed Answer:
Hi XXXXXXX
You can buy these ayurvedic products online.
Most trusted pharmacies are Dabur and XXXXXXX
Dosing i will text you once you start all medicines.As i have to look for the English medicines you are having along with Ayurvedic.
As you are interested in ayurved as a fellow Dr i would personally suggest you to try detox diet for 1month atleast.

Gor a prescription you have to write to customer care.I hope you can understand i need to abide by policies of HealthcareMagic.

Regards!

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ramesh Kumar (46 minutes later)
Dear Dr.Kamur,
Thank you again for your speedy reply. I completely understand and respect that you need to abide by the healthMagic rules. I am not surprised at all that you are unable to write a prescription for me, but I thought that I would ask. I am going to look online this morning for the kutajghan and Udaramrita vati. To be complete, I also take thyroid replacement, T3 compounded and T4 175micrograms q AM, and for the sarcoma treatment, at this point I am on Faslodex, an estrogen receptor blocker and Ibrance, which is a kinase inhibitor.
I did contact customer care as you suggested. I let them know that you have been most helpful, indeed more than any GI doc I have spoken with in this country.
How do I let you know when I've started the herbs? I will do a month long detox too.
Thank you again. XXXXXXX
doctor
Answered by Dr. Ramesh Kumar (48 minutes later)
Brief Answer:
Follow up.

Detailed Answer:
Hi dear,
Thank you so much!
You can start taking Kutajghanvati 1 tablet two times a day. XXXXXXX XXXXXXX vati once a day before going to bed.
Seperate them by atleast 30 minutes from your english medicines.
One more thing with ayurvedic you need to have patience.
The main objective of ayurvedic is to cure ailment from root.
This usually takes time infact in some cases months to show intial response.
So don't panic.
Remain calm.
Ayurvedic advocates use of "Shudh Saatvik" diet that means a pure diet.
So try to avoid oily spicy and nonvegetarian food when on ayurvedic medicines
You can keep me informed on HealthcareMagic you just need to write my name before question and they will intimate me.
Products of XXXXXXX pharmacy(Ayurvedic) are also available in USA .
Try to search it on XXXXXXX
Follow detox plus ayurveda plus allopathic(Taper them gradually).

In future if you wish to ask me you can do it through my direct link:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=72660

Hope you would be helped

I wish you great luck.
Regards.
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
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Dr. Ramesh Kumar

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Practicing since :1986

Answered : 2914 Questions

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Suggest Treatment For Severe Diarrhea And Flatulence

Brief Answer: Try a combination of therapies. Detailed Answer: Hi, Thanks for choosing HealthcareMagic for your query. Due to resection of the gastrointestinal tract, the food passes through the intestines earlier without proper absorption of water hence causing recurrent and loose stools in your case.As digestive system is compromised a sudden change in atmospheric conditions leads to problems arising out of indigestion. As per you history, you are on Imodium. Doses of Imodium can be increased up to 12 to 16mg in 24 hours in case you are not relieved by doses of 4 to 8 mg per day. Another OTC medication is Bismuth sub-salicylate. It belongs to a class of medications called antacids and adsorbents marketed by name of Pepto Bismol. Doses up to 1gram can be taken daily to provide symptomatic relief from diarrhea. Racecadotril is known as a prodrug. Once inside your body, it is broken down into an active ingredient called thiorphan. Thiorphan reduces the number of watery secretions that are produced by your intestines. This helps to reduce the amount of fluid that your body loses. In turn, this reduces the symptoms of diarrhea and helps reduce the risk of dehydration. Racecadotril can be taken in doses of 100mg thrice daily. Cholestyramine is used to treat high cholesterol (hyperlipidemia) and itching caused by partial bile obstruction (when bile acids can’t easily move between the liver and gallbladder). The most common side effect of this drug is severe constipation.This side effect will help you. Diphenoxylate and Atropine combination(Lomotil)-Atropine/diphenoxylate is an antidiarrheal and anticholinergic combination. It works by decreasing the motion of muscles in the intestines and prolonging the time it takes to move the contents through the body. Codeine is often prescribed to relieve pain. When you take the drug as a tablet of codeine sulfate, it can help prevent diarrhea as again constipation as a side effect of codeine. The above-mentioned medicines can be taken along with one another. Please discuss the options and doses with your Gastroenterologist. To prevent your body from exhaustion and weakness arising out of diarrhea keep yourself hydrated. Take a lot of fluid especially juices rich in potassium and sodium salts. Drink lots of coconut water and orange juices. Hope I answered your query, In case you need more details please ask follow ups. Regards!