Jesse P. Houghton, MD

Sometimes patients will feel worse after taking a medication designed to treat these very symptoms. These are usually individual reactions that certain patients experience.
Your options are to try a fast-acting antacid such as Gaviscon (acid be gone), or try something stronger such as OTC omeprazole, Nexium, lansoprazole.
Always consult with your physician if your symptoms do not go away.

Well, you are assuming these symptoms are secondary to food allergies, which may not be the case. It could be a gastroenteritis (stomach flu), IBS, lactose intolerance, amongst other things.However, the most common food allergens are usually eggs, soy, dairy, wheat, seafood/shellfish, and nuts.Be well. Sent from Yahoo Mail on Android

This could be just gas pains from something you ate, or perhaps you were slightly backed up from constipation. Acid reflux is also a possibility. In any case, if the symptoms were short-lived and are not a chronic problem, I wouldn't worry. If this symptoms become recurrent, I would contact your provider so you can be seen in the office. Be well!

You may want to go ahead and purchase another bowel prep, and then just drink enough so that your bowels are clear. You probably wouldn't have to drink another entire prep. Magnesium citrate laxative was useful for this type of situation, however, it has been pulled off the shelves and we don't know when it will be back. Stay on clear liquids the day before as well.

I'm not sure if this question is related to food specifically. There is some data that a Mediterranean diet is beneficial for IBD. Otherwise, a healthy diet with more fruits and vegetables, and less red meat and refined sugars are recommended. However, if someone is in an active IBD flare or if someone with Crohn's disease has any strictures in their intestines, then a low-residue diet is recommended (avoid raw veggies and fruits with skins).In addition, patients with IBD should avoid NSAIDs if possible (ibuprofen, Naprosyn, Advil, Aleve), as NSAIDs can aggravate IBD symptoms and potentially cause a flare.

In general, any pain or symptom that is made better or worse by activity or moving around is unlikely to be GI related. Still possible, but not likely. That would make this pain more likely "musculoskeletal" in nature. If it were to be GI related, the two most likely causes would be gallbladder or pancreas. Gallbladder pain is classically located in the upper right abdomen underneath the rib cage and can radiate to the upper right back. Pancreas related pain is usually located in the upper center of the abdomen and can radiate straight through to the back. Kidney stones are also a possibility. It is likely that these symptoms will get better over time without doing anything specific to treat them. Be sure to see your doctor or provider if the symptoms persist.

These symptoms are most likely secondary to being constipated. The initial recommendations for constipation include fiber supplementation (Metamucil, Benefiber, fiber capsules or gummies, high fiber cereal such as Fiber One, fiber bars to name a few) along with increasing water intake and exercise.If this is not enough to help with constipation, I usually recommend starting with over the counter Miralax or polyethylene glycol, 1 capful in 8 oz fluid daily. This may take up to 1 week before it starts working consistently.
Always consult with your healthcare provider if your symptoms do not improve.

It sounds like you have fairly good insight into your symptoms. You are certainly doing a good job in terms of the exercise. Exercise has been shown to help symptoms of IBS. I also see that you have been prescribed dicyclomine (Bentyl). Dicyclomine usually works quite well for lower abdominal cramping. You can take 1 tablet every 6 hours as needed. You could also take 2 at a time if needed. Just be aware that this can potentially make your constipation worse.I would also add a fiber supplement of your choice, whether it be a fiber powder like Metamucil, or a fiber bar, high-fiber cereal, fiber capsules, or gummies. Choose one that you can commit to taking every day. If constipation is a problem, I would suggest Miralax 1 capful in a full glass of water daily, if adding the fiber is not enough. Miralax is a laxative and not a fiber supplement, as my patients often think. Adding a probiotic can also be quite helpful. Culturelle, Florastor, Align, Phillips Digestive Health, and EnVive, are all good options. Lastly, avoiding dairy can be helpful for abdominal cramping, as many people have lactose intolerance.
If you continue to have problems, follow up with your doctor.

Hello,
You may have had mild gastroenteritis (stomach bug) which affected the motility (contractions) of your GI tract. This would cause delayed stomach emptying, which would cause the bloating and full feeling, and could have also slowed down your intestinal contractions (causing constipation). The stomach bug is probably long gone, however, the motility issue can persist for a few weeks (and rarely longer). I usually suggest taking an OTC probiotic (Culturelle, Align, Florastor, and Envive are good choices). I would also recommend avoiding dairy temporarily, eating small, frequent meals as able, drinking plenty of water, and making sure you are getting enough rest. You can use Miralax daily for constipation. I do have some concerns with the black stools, as this can indicate blood loss through your upper GI tract (esophagus, stomach, small intestine). Keep an eye on this and call your doctor's office if it persists. To be safe, you may want to take OTC omeprazole, Prilosec, or Nexium once daily for 2 weeks. These would protect your stomach from ulcers and inflammation. As always, contact your doctor's office if your symptoms worsen or are not going away.

Jesse P. Houghton, MD, FACG Senior Medical Director of Gastroenterology 
SOMC Gastroenterology Associates
1711 27th Street Braunlin Building, Suite 403 
Southern Ohio Medical Center
Portsmouth, Ohio 45662
740-356-6828 (f) 740-356-6820
*Board Certified in Internal Medicine and Gastroenterology
*Adjunct Clinical Assistant Professor of Internal Medicine, The Ohio University Heritage College of Osteopathic Medicine*America's Best Doctors 2022*Top Doctor 2022—OH Top Docs*Castle Connelly Top Doctor 2022
http://www.gastrodoc1.com

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If you are unable to reach your doctor and the Linzess is not available, you can try an over-the-counter Dulcolax suppository or a Fleet enema. These products usually work fairly quickly. I would also continue the senna and Miralax until the Linzess becomes available, as your colon is likely used to the stimulant laxative.

It is not uncommon to have a sore throat after endoscopy, although most patients will not have this. Some patients have more narrow openings to their esophagus than others, and this can make it more difficult for the endoscope to pass down. If dilation or stretching was performed during the procedure, that can cause soreness. In addition, biopsies in the esophagus can cause some discomfort. It is certainly nothing to be concerned about. Gargling with warm salt water, drinking plenty of fluids, and avoiding meats and bread for a couple of days can help this resolve more quickly. There is also a medication called Carafate, which I will sometimes prescribe for a sore throat after an endoscopy. This helps to coat the esophagus and heal any irritated areas.

That is a good question. That is about right; Nexium and the other PPIs generally do not last the full 24 hours. Dexilant has the best data in terms of lasting the full 24 hours, as it has a dual delayed release mechanism. He may do better with the 20mg dose twice a day, however, what I would do first is have him take the 40mg Nexium about 30 min prior to dinner. This way, it will last through the night and into the morning, when the majority of your grandson's symptoms occur.

Jesse P. Houghton, MD, FACG

I appreciate the difficulty in having procedures and surgeries cancelled during this pandemic. It is a situation many of our patients have recently found themselves in.
The short answer to your question is to be sure to continue all of your previous medications that had been prescribed by your doctor. For my Crohn's patients in a flare, I will often use Entocort (Budesonid) 9mg daily with a 3mg per month taper, or a prednisone taper starting at 50mg daily. Your surgery should be able to be scheduled in the near future, as most hospitals are now doing elective cases once again.

The constipation can certainly be a source of abdominal pain. The back pain, not as commonly. The first recommendation I would have is to try and address the constipation. I usually have my patients try Miralax 17g in 8oz water/juice daily. It is unlikely that the PCOS and UTI have anything to do with the constipation or abdominal pain.
As for the pulsation in your abdomen, this is most commonly due to a palpable abdominal aorta, and is normal. This tends to be more commonly felt in very thin individuals.
As always, consult with your personal physician/provider if symptoms do not get better.

When discussing excessive 'gas' with my patients, I always ask them to specify what they mean by gas. Most of the time they are referring to flatus, or gas from below. However, sometimes they are referring to belching or bloating. Excessive flatus may or may not be abnormal. If you are bothered by the amount of gas that you have, there are some things you can do. One, be careful of dairy products (milk, cheese, ice cream, milk chocolate), as many people have a degree of lactose intolerance. Two, you may want to avoid carbonated beverages such as soda/pop, as drinking excessive soda pop can result is belching, bloating, and flatus. Three, it may be helpful to keep a food diary in regards to your gas. So, when you feel that you are experiencing excessive gas, write down the previous 2 meals that you had. You can usually narrow down the foods that are causing the problem after several days.
Now, when you ask, "what should I drink" for the gas, I believe you are refering to what you should take when you are experiencing excess gas. The product I find most helpful is Simethicone, which is the ingredient in Gas-X and Phazyme. Beano is a product that can be helpful for gas caused by gas-producing vegetables. Peptobismol may also be helfpul, especially if you have associated abdominal pain.
Keep in mind that excessive gas is almost always caused by something that you are eating, so pay close attention to what you have eaten when you get those bad bouts of gas.
Be well!

Imodium is a medication for diarrhea, and should not be taken for constipation. You may want to try miralax once daily for your son, along with plenty of water intake and fruits and vegetables.
As far as your question, the one time where we try to avoid Imodium in cases of diarrhea, is when there is a likelihood of an infectious cause of the diarrhea. In some bacterial infections of the colon, the bacteria secrete a toxin, and so if that individual were to take Imodium, it could make the symptoms worse. In infections of the colon, we generally like to let the body rid itself of the toxin. A safer option in this case would be Peptobismol, as this has anti-bacterial properties itself. This should be used in caution in children due to the very rare possibility of Reye's syndrome (due to the aspirin component in Peptobismol), in viral infections.

I understand how frustrating your situation can be. I see patients that come to my office with similar long-standing symptoms and no real answers. In reviewing your symptoms and test results, I would mention the following: Your test results are non-specific, meaning the positive lactoferrin, slightly elevated sed rate, and borderline CRP, can be seen in certain conditions, even if you don't have IBD (infections, rheumatologic conditions, other autoimmune conditions). I would suggest getting a fecal calprotectin (which is slightly more specific than lactoferrin), as well as one of the commercially available IBD serology (blood) tests (Prometheus and Mayo labs are two labs that run these). If these are elevated, that would make it more likely that you have IBD and not IBS. You also need to be ruled out for celiac disease and microscopic colitis. Microscopic colitis is diagnosed with random biopsies during the colonoscopy (especially right sided biopsies). Stool tests for infection (C diff, giardia, cryptosporidium) also need to be done. Now, assuming all of the above come back normal, I encourage my patients to try a low FODMAP diet. I also like to test for (or empirically treat) SIBO (small intestinal bacterial overgrowth).
Hope that helps!

It is highly unlikely that your constipation is due to COVID-19. In fact, there have been reports of diarrhea being a part of the initial symptoms of the virus. If the constipation is what we term 'new onset', meaning you didn't have this problem in the past, then common causes of constipation would be pain medications (both narcotic and NSAIDs such as ibuprofen), a new diet (especially low carb), or a new prescription medication, such as blood pressure meds. If your symptoms persist, you should contact your doctor.
Be well!

Gastritis, which is a general term for inflammation of the stomach lining, in and of itself, should NOT cause fatigue and dizziness. That said, one of the more common causes of gastritis is a bacteria called Helicobacter pylori (H. pylori). Infection with this bacteria can potentially cause non-gastrointestinal symptoms such as joint pains and fatigue (less likely dizziness). One other thing; if you have an ulcer in the stomach and are losing blood from it, that can cause fatigue and dizziness, by making you anemia.

I tell my patients that the pancreas normally likes to be left alone. What I mean by that is, just try not to do anything to irritate it. So, don't drink excess alcohol first and foremost. Second, don't smoke (we know that smoking is an independent risk factor for causing pancreatitis, or inflammation of the pancreas). Thirdly, keep a healthy weight, as obese patients tend to have worse bouts of pancreatitis when it occurs. In addition, some patients have very high triglyceride levels (over 1,000). This can cause pancreatitis as well. This would be found on a routine lipid panel. Lastly, if you are a diabetic, do your best to keep your blood sugars under control, as chronically elevated blood sugars makes your pancreas work harder.
If you adhere to this advice, your pancreas will stay healthy and not cause you any problems!