Digestive Disorder

[richard341]

My wife has what appears to be a digestive problem.  She has suffered with it now for four months.  We are on our second gastrointerologist without relief.   Her symptoms are as follows:

1. Burning sensation and pain in the sternum area.  The burning and pain comes and goes but is occurring frequently.
2. Burning sensation rising from the sternum area up the esophagus to her neck.  However there is not regurgitation of stomach acid.
3. Constant metallic/bitter taste in her mouth.
4. Bubbling sensation in the sternum area.
5. Only able to eat small amounts.  Must eat every two hours or starts to feel strong hunger pangs.  If over eats experiences shortness of breath and pressure in the sternum area.
6. Avoiding fatty foods.  Has been “living” off of homemade chicken soup – chicken, potatoes, carrots, celery, and some salt.  Does not eat the celery and sometimes doesn’t eat the carrots.
7. Hiccups
8. Bloating
9. Nausea without throwing up.
10. Sleep interruption.  Wakes several times a night with pressure, burning and discomfort in sternum area.

The first gastroenterologist put her on Nexium 40 mg after the first visit and then scheduled an endoscopies.  The Nexium didn’t work. When the endoscopies was performed, he told her she had a large hiatal hernia and some irritation in the stomach.  He wanted to do a cat scan to determine if surgery was needed.  After the CAT scan he informed her she didn’t have a hiatal hernia.  He told her she had h-pylori bacteria (biopsy didn't confirm but he suspected).  He put her on 14 days of PrevPac.  The PrevPac increased her suffering but she struggled through the 14 days.

Following the 14 days of PrevPac we waited for about one week for improvement.  There wasn’t any.  We called the doctor and another appointment was scheduled.  At this appointment he recommended a nuclear scan to determine if her gall bladder was properly functioning.  He prescribed Aciphex 20 mg at this appointment.  The nuclear scan was done the next day and the results were not remarkable.  Her gall bladder is functioning as it should.  

She continued the Aciphex for approximately one week and it wasn’t working.  The doctor then prescribed Sucralfate 1 gm.  She started taking the Sucralfate and that made her condition worse giving her loose stool and headaches.  

We changed doctors, the second gastroenterologist reviewed her medical records and examined her.  While taking a stool sample with his gloved finger to check for blood he reported feeling stool "as hard as a rock."  He then prescribed a magnesium liquid laxative with instructions to also take 3 Dulcolax tablets.  She was not constipated before this but we followed his advice.  She had brown liquid diareah for 12 hours and has been having normal bowel movements since but now 6 days have passed and the laxative did not relieve any of her symptoms.  He also has her taking GlycoLax three times each week.  That also isn't helping.

His next step is a small bowel series.  All the anti-acid and laxatives have not worked.  

The first doctor reported after the endoscopy that the stomach has an "hour glass" shape and this is what he based his intial finding of hiatal hernia.

Are these doctors missing something?  

[mira_paresh]

1. Food:
1) Recite prayer before starting your meal. (Thank You God for giving us food.)

2) Start your meal with sweet first. Eat all 6 tastes in each meal.

3) Eat with lips closed. Do not open mouth while eating. Closing eyes while swallowing food is beneficial. Eating with mouth open (or talking) will reduce digestion of food.

4) Don’t drink water 30 min before and 30 min after taking food. Do not drink water, liquid while eating. If very much necessary drink a few sips of water to quench thirst etc during the meal.

5) Do not watch TV while eating.

6) Wash Hands, Legs and Face before eating. Sitting on floor with folded legs is the best position for eating.

7) Think of eating while eating. Do not talk or think. Observe your stomach, taste and be guided by them. If stomach is full ,stop eating. If taste has diminished, stop eating. Stop eating after you get the first Burp (Dakar)

8) If you take bath, do not eat anything for the next 45 min. If you eat, then do not bathe for the next 2 hours.

9) Do not eat when you are not hungry. Don’t eat because it is lunch or breakfast time. Do not eat because of compulsion or because it is offered free to you in office etc.

10)Eat half an hour after you feel hunger. Do not eat when you are tense because in that case the food will go undigested.

11)　　　　　　　　　　　　　　　　　　　 Eat whatever you feel like eating, as guided by taste and stomach. Tea, coffee and white sugar is not recommended.

[boron]

Described symptoms are definitevely GERD. Now, the bitter taste in the mouth suggests gallbladder disorder with biliary reflux. If the gallblader itself is OK, it still may be biliary ducts (biliary dyskinesia or sphincter of Oddi dysfunction).

There are gross differences in diagnosis of stomach condition. Hiatal hernia may come and go, as hernia can slips up and down, so " now you can see it now you don't".

So:
- burning in the esophagus speeks for GERD
- bitter taste speaks for biliary reflux. Cramps under the right ribs after a fatty meal (is this the issue?) speak for gallbladder disease
- The most reliable test for H. pylori is breath urea test (BUT), but if hernia won't be fixed, H. pylori treatment itself won't help.

To prevent bloating she can try to avoid any fruit and sorbitol (art. sweetener). To ease burning sensation, she should avoid anything acidic, including vit C, aspirin, ibuprofen, fruits, wine, vinegar, and PROTEINS (meat, eggs).