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Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
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Experience:  MD
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I have had GERD for two years first treated with omeprazol

Resolved Question:

I have had GERD for two years first treated with omeprazol but now Pantoprozol. I think it may not be controlling it as still get pain / soreness just below the sternum (tender to touch). Now also getting discomfort in gut pain moves around and is a gripe pain. Taking
mebeaverine for that also feeling hot at times but no temp. Worried. Dave
Submitted: 2 years ago.
Category: Medical
Expert:  Dr Basu replied 2 years ago.
Dr Basu :

Hi there, This is Dr Basu, Experienced Specialist. I am here to address your concerns and provide great service.

Dr Basu :

Persistent symptoms even with pantoprazole and mebeverine deserve further evaluation.

Dr Basu :

Do you experience any pai after meals?

Dr Basu :

Which side of the stomach?

Customer: Not really specifically after meals. Mainly in the middle of stomach (mid line) or low on left.
Dr Basu :

any constipation?

Customer: Have had but now taking fibeogel daily and am regular.
Dr Basu :

ok

Dr Basu :

See, your symptoms can still be IBS related.

Dr Basu :

But epigastric pain can be caused by stomach ulcer and H pylori infection.

Dr Basu :

H pylori infection will require treatment with antibiotics.

Dr Basu :

The infection can be detected by the urea breath test, or stool antigen test.

Dr Basu :

If you do have non healing stomach ulcer, that will require high dose of pantoprazole along with other ulcer healing medications ( sucralfate).

Dr Basu :

Pancreatitis and gallbladder problem are unlikely since no symptoms with food.

Dr Basu :

Upper Gi endoscopy is advised to rule out the stomach ulcer.

Customer: Had two endoscopys 6 months apart 18 months ago. First diagnosed GERD and esophagitis second found nothing.
Dr Basu :

ok that is very reassuring.

Dr Basu :

Then this is likely IBS nothing else.

Dr Basu :

i will still suggest the H pylori test though.

Dr Basu :

You can get a abdominal ultrasound to rule out gallstones --but symptoms are not typical.

Customer: Does IBS give discomfort in the upper gastric area? And would that explain the fatigue?
Dr Basu :

yes it does --and usually symptoms are self limiting --meaning come and go

Dr Basu :

yes fatigue also can be associated

Dr Basu :

vitamin B12 deficiency should be ruled out.

Dr Basu :

chronic use of pantoprazole can cause vitamin B12 deficiency.

Dr Basu :

start taking B12 supplement 1000 mcg daily.

Dr Basu :

also follow a strict diet.

Dr Basu :

avoid any greasy, fried, spicy food.

Customer: Ok thank you that is all very helpful. I guess I was worrying about the dreaded cancer so reluctant to follow up.
Dr Basu :

not at all

Dr Basu :

you do not have any weight loss, appetite loss, persistent vomiting

Dr Basu :

so that is not possible.

Customer: Thank you
Dr Basu :

It was my pleasure to help you today.
I am Dr Basu experienced in Gastrointestinal Diseases.
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