Thank you doctor,
The patient is 60 years old. She regularly takes some medication, which I mentioned above. She is suffering from gas, abdominal pain, and acid reflux almost for the last four months. Although it is now under control.
Please find the attached new blood test reports, including lipase showing 66 U/L, which is slightly above normal, which is 6 – 60 U/L. She will do a urea breath test within two weeks. She started taking Domperidone 10 mg three times a day. Since she started taking this medication, her uncomfortable feeling for gas is much less or almost gone, with no acid reflux nor abdominal pain. Before taking Domperidone, she took Esomeprazole, and it did not help her stomach gas and pain.
In the previous week, her blood pressure reading shows 141/80, 138/80, 140/79, 150/83, 154/89, 145/89, 149/86, and 150/90. Her previous readings one or two months before were much less than this.
The doctor prescribed for ECG, 24-hour BP monitor, and urea breath test. Can Domperidone or Esomeprazole increase blood pressure? If it does, can she continue with one 10 mg Domperidone tablet a day rather than three tablets? Will this be good for both her high blood pressure and gas? If yes, should she start taking one 10 mg Domperdon immediately? When is the right time (morning/afternoon/evening)? Or should she stop taking it? Or one 10 mg Domperidone only when needed? Is Dexilant 30 mg once a day will be a better alternative to Domperidone for her now? If yes, for how long with her present situation? The blood test was done seven weeks ago for lipase showing 66 U/L, which is slightly above normal, 6 – 60 U/L. Does this have any link with her abdominal pain and gas? Is she currently on the right medication or treatment for this higher lipase with Domperidone? What might be the cause of this?
When the lipase test was done at the hospital, the doctor informed me that when the patient did a colonoscopy test one year ago, the injury caused a higher value of lipase. Should she need to do a new lipase test? Is 24-hour ambulatory blood pressure monitoring (ABPM) the same as the Holter monitor test? If not, does the Holter monitor test provide 24-hour BP readings? I am attaching her previous two ECG reports for your suggestions. As some words are in French, I am translating them as below.
Sinus bradycardia T ion abnormality, possible previous ischemia abnormal ECG. Sinus bradycardia nonspecific ST segment and T wave abnormality. ECG abnormal. No previous ECG was available.