Dr. Sagar Ramesh Makode
Cardiology
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Patient's Query
Hello doctor,
I suffer from anxiety disorder. I am currently on Venlafaxine. I have issues with bloating and constipation. I am physically active as I go to the gym. However, stomach bloating has been a frustration. There are days it soothes and days it gets worse. From previous screenings, the doctors told me there is gas in my stomach. But, I have no known condition to date. Without laxatives, I get constipated and I have no bowel movements for up to four to five days. High-fiber foods such as avocado and mushrooms cause a lot of flatulence. I am currently experiencing a lot of excessive sweating. I have a file with detailed examinations and I will attach it with the query. How to get rid of the bloating? How to soothe constipation? Is there any diagnosis based on this evidence? Your assistance would be greatly appreciated.
Hello,
Welcome to icliniq.com.
Both your symptoms of constipation and sweating are likely as a result of Venlafaxine. It is a known and relatively common side effect. So, you should request your doctor to change it to a different medicine like Ciplar LA (Propranolol) or Alprax (Alprazolam). Bloating may also occur secondary to constipation.
Your reports are fine (attachment removed to protect patient identity), but cholesterol is a bit elevated and you should get a complete lipid panel done and continue a healthy lifestyle.
You should avoid fatty, oily and spicy diet. Have a walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Lots of green leafy vegetables and fruits. Avoid smoking and alcohol if any.
I suggest tablet Pan DSR (Pantoprazole-Domeperidone combination) 40 mg or Esomeprazole-Domperidone combination before breakfast once a day for two weeks. If not adequately relieved, then you should try adding syrup Sucral-O (Sucralfate-Oxethazaine combination) or Gelusil (Aluminium hydroxide and Magnesium hydroxide) two teaspoons three times a day for a week.
For immediate pain relief, you can have antispasmodic like tablet Dicyclomine 20 or Hyoscine 10 mg whenever needed up to three times a day. Consult a specialist doctor, discuss with him or her and start taking the medicines with their consent.
For more information consult an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician
Patient's Query
Hi doctor,
Thank you for your reply. I forgot to add that constipation has been an issue for me since being a kid, long before starting Venlafaxine. It may sound odd but if anything, alcohol has often soothed constipation the next day. I am on Venlafaxine for two years now. Sweating has been present in the last three months. What I have been left wondering is whether constipation and bloating are related to each other. Is there any sort of diagnosis you have in mind? Why does high-fiber get me flatulence? I have been trying to get to the root of this problem for long now but frustratingly, nobody has actually been able to sum it up in a concrete treatable diagnosis.
Hello,
Welcome back to icliniq.com.
Yes, a likely possibility in you is of constipation-predominant irritable bowel syndrome (IBS). You first identify the food which increases bloating or constipation and avoid them.
The first choice of laxative in you is of Polyethylene glycol. You are also a candidate for Lubiprostone especially if polyethylene glycol or other laxatives are not helpful or cause side effects/excessive bloating.
Also, fibers cause bloating in many individuals. This is due to the digestion of food in the large intestine by microbes, so it is natural.
Also, constipation is certainly linked to bloating due to the same reason of digestion and fermentation by bacterias. Also, constipation causing medicines like Venlafaxine should be avoided, and replaced by other. Sweating can be attributed to Venlafaxine or anxiety/panic, etc.
For more information consult an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician
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