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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Done Colonoscopy And Biopsy Of Caecal Mucosa. Prescribed Esomeprazole. Should I Avoid Flunil?

Dear sir, recently i had my full colonoscopy and had a biopsy of caecal mucosa) and examination says: Examination: Sections show colonic mucosa with muscularis mucosae. It shows limited focal areas of increased inflammatory cells including many neutrophils along the bases of mucosal glands, associated with architectural distortion. Crypt abscess and granuloma not seen. Atypical features are not seen. Impression: Infectious colitis/acute self limiting colitis Crohn s Colitis Now he prescribed following medicines Esomeprazole-40, 2 cap daily two times Mebiz( Mebeverine Hydrochloride-200mg) SR, 2 capsules daily two times Vegas OD( Mesalamine Extended Releases) 1.2g - 1 tablet at night FLUNIL( FLUOXETINE CAPSULES 10MG) -1 TIME THIEPIN(Dothiepin) at night Download(Lactitol Monohydrate and ispaghula husk granules)-2 spoon in two glass water. all above medications are prescribed for 45 days and here are my questions: 1) Now i am happy because i am diagnosed well. i have positive thinkings should i avoid FLUNIL and THIEPIN? i don want anti depressants. 2)My examination says It shows limited focal areas of increased inflammatory cells including many neutrophils . neutrophils are the causes of previously taken medicines or not? 3) For past 3 years, I was given many PPI (Omniprazole,pantaprazole, lansoprazole ,rabeprazole). Now he is giving esomeprazole, but nothing helps me as i know. I dont have severe acidity problem now. so i want to avoid that also because all this colonic problem is due to my previous medicines which i used in past three years for gastric treatement which was not severe as endoscopic report says. 4) I also found information about Vegas OD(Mesalamine Extended Releases) 1.2g should not be used with proton pump inhibitors. Is it right? Now please advice me can i go only with following therapy? Mebiz(Mebeverine Hydrochloride-200mg) SR, 2 capsules daily two times Vegas OD(Mesalamine Extended Releases) 1.2g - 1 tablet at night Download(Lactitol Monohydrate and ispaghula husk granules)-2 spoon in two glass water. to cure without essomeprazole or not?
Sun, 25 Nov 2012
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Gastroenterologist,  's  Response
Hello, sagarda7,
The colonoscopy and bipsy findings suggest a very mild form of
"Colitis" and appears to be affecting a small area. I know we have
to consider Crohn's because of the location. Biopsy however did
not show typical findings of Crohn's. It is possible to have non-specific
findings during very early stages of ulcerative colitis which is the other
major form of Inflammatory Bowel Disease,
Mesalamine Extended Release Tablets are for colitis and the dose
is appropriate. Mebiz is to control spasms of the stomach and
intestines and I personally would not recommend that class of drugs
when you have colitis. Sometimes it can cause more complication
such as "Toxic Megacolon" (Due to slowing down the contractions).
As for Esomeprazole , again it is a PPI and works in most people if
they have symptomatic GERD related to excess acidity. If your reflux
problem is not due to that, PPI s don't work. If you are not getting
any relief, I don't see any reason to continue the same.
Flunil is an anti-depressant medication and I am not sure if you were
put on this for depression. But, I don't see any problem taking a PPI
such as Esomeprazole with Flunil.
I hope that your colitis gets under control very quickly and you feel
better soon.
I wish you well.
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Done Colonoscopy And Biopsy Of Caecal Mucosa. Prescribed Esomeprazole. Should I Avoid Flunil?

Hello, sagarda7, The colonoscopy and bipsy findings suggest a very mild form of Colitis and appears to be affecting a small area. I know we have to consider Crohn s because of the location. Biopsy however did not show typical findings of Crohn s. It is possible to have non-specific findings during very early stages of ulcerative colitis which is the other major form of Inflammatory Bowel Disease, Mesalamine Extended Release Tablets are for colitis and the dose is appropriate. Mebiz is to control spasms of the stomach and intestines and I personally would not recommend that class of drugs when you have colitis. Sometimes it can cause more complication such as Toxic Megacolon (Due to slowing down the contractions). As for Esomeprazole , again it is a PPI and works in most people if they have symptomatic GERD related to excess acidity. If your reflux problem is not due to that, PPI s don t work. If you are not getting any relief, I don t see any reason to continue the same. Flunil is an anti-depressant medication and I am not sure if you were put on this for depression. But, I don t see any problem taking a PPI such as Esomeprazole with Flunil. I hope that your colitis gets under control very quickly and you feel better soon. I wish you well.