Q. How can I get rid of heartburn and a bloated stomach?

Hello doctor,

I am a 32 year old suffering from anxiety disorder, and I took some related medicines for a few years and still take Mirtazapine. I have weight issues from a couple of years. I do blood examinations regularly, which come back normal. Lately, I am having problems with heartburn. I had a helicobacter infection last year, followed by Streptococcus infection last month. Both have been treated with antibiotics. During my last blood examination, the cholesterol level was 5.7. A gastroenterologist said that I am probably prone to Gilbert's syndrome, due to bilirubin levels coming up on the blood test. I like drinking, but I used to drink during my late 20's much more, than I do now. I am a moderate drinker. I have an appetite of a lion, but I tend to limit my food intake at a minimum, to keep my weight under control. Which I am not being able to do. I do not do any physical activity, so that does not go in my favor. Whatever food I have, I can smell the odor when I burp even after several hours. If I go slightly generous with food for three days in a row, my stomach bloats. I took Espumisan and Pantoprazole tablets about a month ago, for two weeks, and I went on a diet. It was better. Now that I am back to my daily routine, these problems are back again. I am also constipated since a child. I would like to get your opinion. Are these symptoms related? Is this coming from the depression? How can I soothe heartburn and bloating? How to lose weight? Your replies would be greatly appreciated. Thank you.

Hello doctor,

Thank you for your detailed answer and diagnosis. Let me inform you that, I tried to find the therapy you prescribed, but I was unable to find it in the whole town. Instead, I found this medicine, the picture of which I have attached. It is called Effecol 3350, its main ingredient is Macrogol 3350. Please let me know your opinion. If this does not work, is there a substitute you would recommend? Thank you.

Hi doctor.

Thank you for your reply. This was the only closest I could get. So for initial clearance, should I put ten sachets in 2 liters of water or less? Do I have to do that in one day? And on day two, should I continue with maintenance dose? And for maintenance, I should take one sachet, that is, 13 g. How many times do I take it in a day? How much water to mix with one sachet? Also, what kind of food do you recommend for me to take on a daily basis? Do you have any suggestion for heartburn relief and stopping of weight gain? Any particular food or natural remedy? Once again, thank you.

Hello doctor,

Thank you again for your time and quick reply. I will do as per your instructions. I would like to be under close supervision for some time to be able to get over these problems. How long should I take Pantoprazole? Is there any way to reduce my appetite and food or sweet craving? My problem is that I have a big appetite. I do not have any sort of regular food that I take. I usually do not eat breakfast. What would you suggest for breakfast? I love meat, and I could not live without meat. I am not so much into vegetables. I like cabbage, lettuce, broccoli, and eggplant, but I do not eat peppers, tomatoes, or cucumbers. Also. I am not that much of a fruit fan. I eat banana or sometimes apple. I do not like pears, berries, plums, and grapes. I like drinking green tea, and I do not drink coffee. I also would not like to quit wine or alcohol, unless I was strictly prohibited. The last time I met a gastroenterologist, he told me to stop garlic, onion, cabbage, coffee, chocolate, banana, wine, and so much more. There was nothing left for me to eat. As for the liver, I have twice done liver examinations. The bilirubin levels indicate that I may have Gilbert's syndrome. Also, there is a lot of fat around my kidney, and one specialist suggested I have a fatty liver. What do you suggest for that? I was worried because, during the last two years, my cholesterol levels have been slightly up. I am wondering if the liver has anything to do with all these problems?