Brief Answer:
You are in perfect hands.

Detailed Answer:
Hi Mrs XXXX,
Thanks for choosing HealthcareMagic for your query,
I am a Gastroenterologist and would be answering your query.

Chest pain is usually either related to cardiac or gastric problem.Cardiac problems are very unlikely in female patients below age of 60 unless there is astrong family history of cardiac problems or lady i a chronic smoker.As your preliminary cardiac invetigations are normal this pain could not be cardiac in origin.

Your endoscopy is suggestive of small Hiatel hernia.In the situation of a hiatal hernia, the GE junction(the junction of esophagus and stomach) moves above the diaphragm and into the chest, and the higher pressure zone is lost. Acid is allowed to reflux back into the esophagus causing inflammation of the lining of the esophagus and the symptoms of GERD. In lay mans language the acid which is supposed to be there in stomach(walll of stomach have natural lining which prevent it against acid damage) is now reflexed back into esophagus.This reflux of acid causes continuous irritation of mucosaa lining of esophagus leading to inflammation and pain.

Now to treat your symptoms all doctor needs to do is -
1) Prevent formation of excess acid in stomach(Pan 40 is a proton pump inhibitor and supresses the acid formation by parital cell in stomach).
2)Prevent formed acid to be refluxed back into esophagus-Trials have proved that acotiamide 100mg thrice daily modulates the motility of smooth muscles hence is very effective in treating gastroesophageal reflux symptoms.


Both proton pump inhibitors and Acotiamide are highly effective and have minimal side effects even in long runs.
So rest assure your doctor is treating you according to protocols.


Hope i answered your query well.
Thanks.

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Brief Answer:
Follow up answer.

Detailed Answer:
Hi there ,
As per your query medication duration is decided as per the response of patient.
Protocol is to start aggressive management initially followed by tapering of the medicines and maintaining patient on diet changes only.However the results and protocol varies from patient to patient.3 Months of treatment should initially be given.
Most likely cause of hiatel hernia is weeking of muscles.However a definite reason can't be given.

Suggestions-
-Avoid alcohol or smoking.
- Take light non spicy easily digestible food for few days.
- No Fast food like pizza or burger should be taken.
- Drink a cup of cold milk daily.
- Avoid fatty foods.
- Increase warm water( atleast 8 glass/day) intake
- Do not drink water during and after meals
- AVOID junk food(NO burger , pizza-even if its veg.) altogether
- Mix few drops of "lemon juice" in warm water. Drink on empty stomach, early in the morning, to aid in bowel movement
- Avoid beverages / alcohol/ soft drinks
- Do some exercise (push-ups / squats etc) early in the morning
- Take 2-3 spoon edible virgin olive oil in the morning
-Yes you can take all green leafy vegetables and fruits(except citrus fruits like orange and narangi).
What is Bendi? Are you asking about bhindi...then yes you can eat it.
Some food plans are=
-Whole grains are very beneficial to consume.These can be in the form of XXXXXXX whole wheat bread or cereal, brown rice, whole grain pasta,grains such as whole oats, wild rice, rye, oatmeal and corn are also beneficial and can be taken if suits your food pattern.
-Fruits and vegetables should be a significant part of any diet . They are full of essential nutrients and are easy to digest.Fat contents of diet should be very low.However Olive oil, canola oil and flaxseed oil are all healthy fats that are recommended as part of a diet for patients .Try to avoid citrus fruits.



In case you need further suggestions feel free to question.
Thanks!

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Brief Answer:
Its a separate event termed as Acute Gastroenteritis.

Detailed Answer:
Hi again dear,
This event is not related to hernia and GERD.

After having palak dal you had 4 stools which is suggestive of acute gastroenteritis which means inflammation of gut.Green is due to bile pigment in the stool because peristaltic motion of intestines becomes faster in gastroenteritis so food moves too quickly through the intestines hence chemical can't break down properly leading to green colored stools.

Advice-
Take light food preferably moong ki dal khichri with curd.
Continue loperamide in dosage 4 mg twice daily.
Add tinidazole to Norflox i.e Take Norflox TZ twice daily for 3 days.
Take econorm probiotic twice daily this will improve the overall digestion.
Don't forget to take medicines prescribed by your primary as Norflox-Tz can aggravate symptoms of gastritis.

Thanks!

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Brief Answer:
Follow up.

Detailed Answer:
Hi XXXX,
Yes ideally you should take a antibiotic for atleast 3 days without breaking it in between otherwise bacteria's becomes resistant to the antibiotic.

Andial and loperamide are same thing and yes you can take it as and when required.

Thanks!!

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Brief Answer:
Follow up suggestions.

Detailed Answer:
Hi again dear,
1)Norflox contains antibiotic Norfloxacin which covers onlybacteria's but in asian countries many times Gastroenteritis is caused by protozoans also;they are covered by Tinidazole(TZpart).
So switch over to Norflox TZ twice daily.

2)Norflox Tz as you mentioned is acidic-with antibiotic therapy a proton pump inhibitor(like pantoprazole etc and a probiotic(econorm or vizylac) should always be taken antibiotics release's toxin which can irritate gut so may aggravate gastritis and acid reflux symptoms.

Feel free to ask any other query you have.
Hope you get well soon.

Thanks.

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