What can be done to treat stomach pain, gas, bloating with indigestion?

Hello,

Welcome to icliniq.com.

I can imagine the level of your frustration for your chronic unresolving symptoms. And I really feel sorry to hear that you been back and forth around doctors for solution of your symptoms. Well, I can very well understand your problem, I will explain to you point by point.

1. Lax LES (lower esophageal sphincter) is not a uncommon findings on endoscopy. It reflects that the valve which controls reflux from stomach to lower part of food pipe is little bit open. However, your endoscopy did not show any ulcer formation in the food pipe which suggest you do not have Gastroesophageal reflux (GERD). Again your symptoms are not related to GERD. It is something else. I tell in a moment.

2. So you see the fundal gastritis (inflammation of the fundus- a part of stomach). Usually inflammation of stomach confines to the other parts of stomach -like antrum and stomach body, but not to the fundus. The one cause of inflammation predominantly to the fundus suggest H pylori infection. This bug initially infect antrum of the stomach then it moves to fundus if chronic infection that has not been treated. I will suggest you investigation before I suggest you an antibiotic course of this H pylori. And remember this H pylori can cause stomach slowing leading to your symptoms of gas. The condition is called gastroparesis. Below I explain to you in more detail the reasons of your symptoms of gas.

3. To simplify the constellation of your symptoms, we doctors classify in to two- the predominant gaseous symptoms or predominantly pain symptoms. You have predominantly gaseous symptoms including bloating, sounds, burping, fullness, early satiety after meals, and some gas in stools as well.

So it is important you should understand why these gases production is in excess in you. The one such reason is:

i) Dysbiosis-which is alteration of human gut bacteria more gas producing species. These bacteria or harmlessly present in the human gut, however; at times the environmental factors, food, water, other dietary habits; change the composition of these bacteria and turn them in to gas producing bacteria. I will give you an antibiotic for a 3 week duration, this will correct your dysbiosis.

ii) The other reason is excessive of food intake that produces gases. These foods are collectively called as FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols). These foods to be avoided as possible as you can. I will share with you a link where you will find the list of such foods which should be avoided.

iii) Less common mechanism is feeling of normal amount of gases-this condition is called hypersensitive gut. For this I would suggest you behavioral therapy called diaphragmatic breathing. I will share you the link how you can exercise it at your home.

I really hope now you would the some idea of mechanism causing your chronic unresolving symptoms. I would just correct your above mentioned mechanism, and you would see the things get improved for you. Please find below treatment plan, and I want you should update me about your symptoms in coming 2 weeks time. Secondly, I also want to suggest you some investigations as we can exclude any other possibility and treat the things accordingly.

Hello, welcome again to ilciniq. Yes Dysbiosis Can cause indigestion. Because this is basically change in the composition of bacteria within our bowel, which ferment the carbohydrates and produce gases. The common gases which are produced by these bacteria are H2 and Co2. Co2 is permissible so it washes away through intestine to blood and through lungs to external environment . However H2 gases reacts with other gases-sulphide to form H2S and with Corbon to form CH4 gas. These both gases are odorous and can frequently cause bloating, distention and has to be excreted from mouth in the form of burping, or via anus in the form of flatulence. The antibiotic I have suggest you will correct this bacterial composition. I have written rifaximin which is a generic name. You can easily purchase it from local pharmacy. Second, It is not uncommon to have change in the color of stools with different diets. These foods contain phytons which are plant derivatives which give color to plant and to stools if taken as food. Do not worry about that. The pale stools can occur if some one has fast transit of stools from bowel-like some one has diarrhea. The normal color of stools is yellow to brown to dark brown, and it is due to bilirubin pigment. The bile needs a contact time before it can give color to stools, in condition of rapid transit of stools from bowel, the bilirubin does not have enough time to change the color of stools, hence excreted as pale. But do not worry regarding the color, this change in color (pale) will revert back to normal once your stool frequency gets normal. The floating of stools is because of gas in it. You know the gas floats over water surface. I hope with treatment I have given you this symptom will also resolve. Lastly I want to assure you that as of now I did not see anything serious in you, so want that you relax and do not get anxious about this. We will try to overcome this problem and will resume your normal life style. I reviewed all of your tests that you shared, some of were old (feb 19) and the latest ones were in nov 19. Despite the fact that you all previous reports are perfectly fine, I want you to repeat the tests which I have suggested to you. This fresh testing will give us clue about your current status of health. Below I write the treatment plan again, and will replace the names with generic if not written previously otherwise.

Hello, welcome to ilciniq,

Good to hear from you, and I hope you must be doing good otherwise and staying safe. Digestive 40 mg only once hald hour before breakfast .Not twice daily. The dose and timing of nimixa is right. Nimxa can cause some gas, bloating, and diarrhea. But do not get worried. It will completely normalize within a week of intake. Keep avoiding High FODMPAS diet and and keep doing diaphragmatic breathing.