My mother is 66 years old. She is suffering from severe gastric trouble. She has had her gall bladder removed 20 years back and since then takes a lot of precautions while eating. Since last week she is having a lot of gastric issues and constipation. She had severe pain last week and has been taking Pantoprazole, Cyclopam (Paracetamol, Dicyclomine), Norflox TZ (Norfloxacin + Tinidazole) for the past one week with very little relief. She again had severe stomach pain in the middle of the night for two consecutive nights. The pain is unbearable, and she cries out of pain for about one hour and even vomited out fluid one night. It only got better when we gave her Digene (Antacid) and a hot water bottle to settle the spasms on both nights. She is now scared to sleep tonight, dreading another bout of pain. She has been eating very little food for the past week and is also constipated.
With the history you have mentioned, abdominal pain, vomiting, and constipation, we need to check for any presence of subacute intestinal obstruction. It can also be due to potassium deficiency in the body which will slow down the intestinal movements and cause such symptoms. Or it could be just simple acute gastritis. This needs direct clinical examination and scan to rule out any significant pathology if present. I would suggest you to take her to a hospital for evaluation just to make sure we do not miss any major issue.
Investigations to be done:
UGI (upper gastrointestinal tract) endoscopy later if everything is normal.
Acute gastritis or subacute intestinal obstruction.
Tablet Pantoprazole + Levosulpiride twice daily half an hour before food for two weeks.
Add Syrup Sucralfate + Oxetacaine 5 ml thrice daily one hour before food for two weeks.
Syrup Lactulose 30 ml at bedtime for constipation.
Do not give Dicyclomine, it will aggravate the constipation issue.
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