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Persistent symptoms even with pantoprazole and mebeverine deserve further evaluation.
Do you experience any pai after meals?
Which side of the stomach?
See, your symptoms can still be IBS related.
But epigastric pain can be caused by stomach ulcer and H pylori infection.
H pylori infection will require treatment with antibiotics.
The infection can be detected by the urea breath test, or stool antigen test.
If you do have non healing stomach ulcer, that will require high dose of pantoprazole along with other ulcer healing medications ( sucralfate).
Pancreatitis and gallbladder problem are unlikely since no symptoms with food.
Upper Gi endoscopy is advised to rule out the stomach ulcer.
ok that is very reassuring.
Then this is likely IBS nothing else.
i will still suggest the H pylori test though.
You can get a abdominal ultrasound to rule out gallstones --but symptoms are not typical.
yes it does --and usually symptoms are self limiting --meaning come and go
yes fatigue also can be associated
vitamin B12 deficiency should be ruled out.
chronic use of pantoprazole can cause vitamin B12 deficiency.
start taking B12 supplement 1000 mcg daily.
also follow a strict diet.
avoid any greasy, fried, spicy food.
not at all
you do not have any weight loss, appetite loss, persistent vomiting
so that is not possible.
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