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What Causes Inflammatory Polyp With Hiatus Hernia?

Posted on Mon, 5 May 2014

Question: Hi, I am 29 year old and taking Rabekind-plus (Rabeprazole + Levosulpiride) tablet from last 6 weeks for gastric problem, but still i am suffering from gastric (After eating small amount of food stomach feels full, Vomiting sensation, sometime I can hear sound and gas bubble sensation inside the stomach, Tiredness (unable to work), numbness in hand, Recently I have given B12 vitamin injection. No pain or burning sensation in the stomach). I have done biopsy and results are normal. Could you please suggest me how long do I need to take this tablet for gastric? Or do I need to do any other test before continuing the same tablet? Could you please let me know whether these are symptoms of auto immune gastritis or Pernicious Anemia? History and blood test: I was taking Decdan (0.5 mg) tablet at December as I had hair loss in small area of my beard. Has taken PAN-D, and Nuroxind-LC tablet for one month for gastric and numbness in hand and leg problem on January and the same issue is reoccurred on mid of February. I had done Ultra sound and CT scan of abdomen and all are normal. I am not diabetic. I don’t smoke or drink alcohol and not on any pain killer medication. I had done blood test many times the recent(April 10’th) test result are as below. Complete blood count Hemoglobin – 16 gm/dl Total count – 8400Cu.mm(4000-10000) Differential count Neutrophils - 41%(42-74) Lymphocytes – 42%(18-44) Eosinophils – 15%(1-8)( this was varying as its 12 on January and 7 on February) Monocytes – 02%(5-13) Baspphils – 0%(0-2) ESR – 08mm/Hr(0-15) Platelet Count – 2 Lakhs/cmm(150000-450000) Biochemistry CRP (Turbidometric method) – 3 mg/l(0-6) Creatinine – 1.2 mgs%(0.6-1.6) Random blood sugar – 101 mgs%(60-150) Liver Function Test Total Bilirubin – 0.4 mgs/dl(0.2-1.3) SGOT – 31 U/L(5-40) SGPT – 26 U/L(0-40) Alkaline Phosphatase – 66 U/L(40-140) Serology HBsAg - Negative

Answered by Dr. Ketan Vagholkar (16 hours later)

Brief Answer: specific answers are below Detailed Answer: Hi, Thanks for writing in. From the reports which you have sent, it is a case of inflammatory polyp with hiatus hernia. To answer your queries specifically: You need to take the medication Rabekind Plus for 6 weeks minimum. You need not do any other tests before continuing the same tablet. These are unlikely to be symptoms of auto immune gastritis or Pernicious Anemia. You would need a surveillance endoscopy after 1 year. If you are not overweight then I would suggest the following. 1. Multiple small feeds. 2. Avoid spicy and oily items. 3. Sucralfate suspension( i tablespoon after every meal ) Continue this treatment for 6 weeks and then stop it. Regular exercise for stress relief is also advisable. I hope this answers your doubts. Regards

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Ketan Vagholkar (1 hour later)

Thanks for the detailed information. i have few queries 1. I am taking Rabekind Plus from last 6 week, but still I have gastric problem 2. What may be the reason for feeling numbness & pulling sensation in palm of the hands and weakness. 3. what may be the reason doctor gave me B12 vitamin injection and asked to stop taking Nuroxind-LC tablet 4. whether the symptoms could be due to H.pylori infection or gastroparesis? or biopsy report says there is no H.pylori infection?

Answered by Dr. Ketan Vagholkar (5 hours later)

Brief Answer: Nothing to worry Detailed Answer: Hi, Thanks for the feedback. I will answers all your questions sequentially. 1. A combination of an proton pump inhibitor with a coating agent is preferable. This will give you better relief than one single drug. 2. Overuse of antacids leads to impairment of absorption of vitamin B components. This can lead to early neurological symptoms as you have described. 3. To prevent an increase in the severity of symptoms the doctor has advised inject able Vitamin B 12 shots. 4. There is no evidence of antral gastritis which is typical H pylori infection. As there is no physical evidence of antral gastritis you need not worry about H pylori infection. I hope this answers all your questions. Regards

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

Follow up: Dr. Ketan Vagholkar (52 minutes later)

Thanks for the detailed answer. 1. could you please suggest me some proton pump inhibitor with a coating agent or is Sucralfate suspension is only enough. 2. Do i need to take any vitamin tablets as i have pulling sensation in Palm or only proton pump inhibitor is enough. 3. Do i need to take anything(Tablet or syrups) along with Rabekind Plus.

Answered by Dr. Ketan Vagholkar (23 hours later)

Brief Answer: Answers to your questions Detailed Answer: Hi. 1. Cap omeprazole (20mgms) once a day at bedtime for 3 weeks along with sucralfate 1 t sf three times a day after meals.The two do not come together 2. Yes it is preferable. Vitamin b complex preparation. One tablet after breakfast for 3-6 weeks. 3. No other medication is required. I hope this answers your query. Regards

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