Gastrointestinal Disorders Online Doctors Consultation — page 4

Any outside food history?? Are you a vegan ?? Do u consume non veg?? History of fever?? Plz tell history gajal.. mean time use tab metrogyl 400mg 10 1-1-1 tab pantop dsr 40mg 5 1-0-0 Tab ondonsetron 4mg 1-1-1 Tab naproxen Domperidone 500mg 10 1-0-1 Sporolac shashet (dissolve powder in water drink it early morning empty stomach) Syrup mucaine gel 10ml TID 15 mins before food

Hii neha.. previously bhi aapko aisey huwa kya?? Kitney din sey aisey horaha hai apko?? Plz tell history of illness correctly...& above mentioned symptoms for u may be becz of food allergies due to pesticides being used in vegetables which u mentioned .. no worries take daily aristozyme syrup 15ml before food tab syrup mucaine gel 15ml before food three times a day.. pantop dsr 40mg empty stomach early morng for period of 10 days.. drink pleanty of oral foods eat more fibere food curd rice and change lifestyle modification..

Change ur diet add more liquids soups porridges .. drink more water ... of severe u can use tab metoclopramide once daily night before sleep along with 20ml syrup cremaffin at night times

Hii swapna as per history given by you seems to be gerd and ulcer in stomach.. plz make clear weather pain increase with intake of food or decreases with intake of food.. time being take Pantop DSR 40mg early morning empty stomach and take syrup sucralfate or syrup mucaine gel 15 mins before food thrice in a day.. drink pleanty of oral fluids

This could be due to a variety of causes. If basic antacids haven’t worked, you can go forward with an endoscopy.

please update it once more.

Hi Rahul, since your endoscopy showed gastritis and GERD, and you’re still losing weight with digestion issues, please consult a gastroenterologist again to rule out H. pylori or malabsorption. Eat small, soft, non-spicy meals frequently. Add bananas, curd, oats, boiled veggies, and soaked dry fruits to gain weight safely. For constipation, try warm water, soaked raisins, and Isabgol at night. A probiotic and B-complex supplement can also help improve digestion and immunity.

**Patient Name**: Piyaly Dutta **Age**: 55 years **Date**: 12-04-2025 **Presenting Complaint**: Piyaly presents with a **chronic history of constipation** and reports an inability to pass stool without the use of **strong laxatives**. She also experiences **bloating** and general discomfort related to irregular bowel habits. She is a known hypertensive and hypothyroid patient, both under control with regular medications. Her blood pressure currently remains stable around **130/90 mmHg**, and thyroid levels are reportedly normal with treatment. --- **Clinical Impression**: Chronic constipation in this case is likely functional, possibly compounded by long-term dependence on stimulant laxatives, sluggish colonic transit, and potential dietary or lifestyle factors. Over time, the colon can become less responsive to natural signals due to excessive stimulant use, leading to what is known as “lazy bowel.” In such cases, a stepwise approach to retrain the bowel, optimize diet, and restore gut health is recommended **Management Plan**: 1. **Dietary & Lifestyle Modifications**: Piyaly is advised to slowly increase her **dietary fiber intake to 25–30 grams/day**, which can be achieved through oats, wheat bran, flaxseeds, vegetables (like spinach, beans, carrots), and fruits (papaya, prunes, pear). **Hydration is crucial**, and she should aim for 2.5 to 3 liters of water per day unless medically restricted. Begin each day with **1–2 glasses of warm water** on an empty stomach. Incorporate **light walking, yoga, or stretching exercises**, especially in the morning, to stimulate bowel movement naturally. 2. **Stool Regulation Without Harsh Laxatives**: - Start **Isabgol (psyllium husk)** 1–2 teaspoons in warm water at bedtime. - Add **Lactulose syrup (15 ml at bedtime)** to help soften stools—this is gentle and non-habit forming. - Introduce a **probiotic supplement** like *Sporlac DS* or *Vibact DS*, once daily after lunch, for 3–4 weeks to reduce bloating and promote gut flora balance. - Soaked raisins or figs overnight can be taken in the morning for natural bowel stimulation. 3. **Habits & Bowel Training**: A fixed daily routine is vital. Even without the urge, Piyaly should sit on the toilet at the **same time every morning**, ideally after warm water intake and light physical movement. This helps retrain the bowel to resume natural peristalsis. 4. **Avoid**: - Prolonged use of stimulant laxatives like bisacodyl or senna (unless absolutely necessary and prescribed) - Highly processed food, refined flour (maida), and fried or spicy meals - Irregular meal timings or skipping meals, especially breakfast **Follow-Up Advice**: - Monitor for gradual improvement over 2–4 weeks. - If no improvement is seen, consider further evaluation: **Colonoscopy**, **thyroid profile**, **electrolyte levels**, and **abdominal imaging**. - Maintain regular BP and thyroid medication adherence. With consistent dietary and lifestyle efforts, along with supportive non-habit-forming agents, the bowel can be retrained and dependency on strong laxatives reduced over time. Regular follow-up is important to ensure sustainable improvement and overall well-being. Dr Shayeque Reza MD 9800280276