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HomeAnswersInternal MedicinebloatingI have been having bloating, GERD, and belching with pain. Why?

How to treat stomach problems and digestive issues?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At May 19, 2024
Reviewed AtMay 27, 2024

Patient's Query

Hello doctor,

I have a lot of problems with my stomach, like abdominal bloating, belching, stomach fullness all the time, and occasional GERD, which causes a lot of pain. I have been on depression medications for a long time. Many of the medicines do not suit me and make the problem of GERD very bad. Recently, I came across a problem named SIBO. Could it be the same with me? Are there good treatments available? What, in general, is the treatment?

Kindly help.


Thanks for your question on icliniq.

I can understand your concern.

I have gone through the history you have given. By your history and description, the possibility of uncontrolled GERD (gastroesophageal reflux disease) is more likely. Not only drugs but lifestyle modifications are also required for better symptomatic relief. So follow these steps for better symptomatic relief in GERD:

  1. Avoid stress and tension, and be relaxed and calm.

  2. Avoid oily and spicy food. Avoid junk food.

  3. Go for a walk after meals. Do not sit or sleep immediately after eating.

  4. Avoid large meals; instead, take frequent small meals.

  5. Take Pantoprazole (antacid) and Levosulpiride (prokinetic) combination twice daily on an empty stomach. The combination is better than plain PPI because prokinetic will work excellently for bloating and dyspepsia.

  6. Keep two to three pillows under the head in bed to prevent reflux. It is often used when a patient is having IBS (Irritable bowel syndrome) symptoms along with excess flatulence and bloating. Librax will also be indicated in IBS.

    The possibility of GERD-related symptoms is more likely in your case, whereas SIBO is small intestinal bacterial overgrowth.

    I hope this helps you.

    Thank you.

Patient's Query

Hello doctor,

I do have symptoms of IBS. The stools are generally not proper. They are small and generally tend to be on the liquid side. The GERD problem was very mild initially but became permanent and worse later after prolonged use of Pantoprazole for six months. What are the definitive tests for SIBO?


Thanks for your follow-up question on icliniq.

I can understand your concern.

Honestly speaking, there is no specific diagnostic test for SIBO. Culture of intestinal fluid through lower GI (gastrointestinal) scope and hydrogen breath test (HBT) are diagnostic tests for SIBO. But again false positive results are the problem. Have you ever used a combination of Pantoprazole and Levosulpiride? Are you following the lifestyle modifications suggested by me?

Please revert back with the answers.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Kaushal Bhavsar
Dr. Kaushal Bhavsar

Pulmonology (Asthma Doctors)

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