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How Would Indigestion, Flatulence And Bloating Due To Gut Flora Imbalance Be Treated?

Posted on Wed, 24 Jan 2024

Question: The previous doctor ruled out all possibilities of IBS and said this is more of Gut Flora Imbalance....My Current symptoms are, Few undigested food particles in morning poop with a bit of mucus, No constipation at all or diarrhea...Bowel movement in the morning and then again in 2 hours after having breakfast....I was advised to refrain from all dairy products, non veg and rely simply on whole grain and probiotics and boiled water....Yesterday I had grilled chicken & Sweet Potato and after few minutes had lot of gas and bloating for the rest of the day (This doesnt happen daily though)

Can you please provide your diagnosis to see if the food nutrients are not getting properly absorbed? Is this Gut Flora Imbalance or IBS?

The aggressiveness is seen normally during the morning and tends to settle down as the day progresses. I am eating regular diet with no complains of stomach ache or cramps...but yes do get growling noise from stomach, sometimes after food as well.

Answered by Dr. Bhagyesh V. Patel (27 minutes later)

Brief Answer:
improper absorption of food nutrients are part of gut flora disturbances.

Detailed Answer:

Hello,

I have re evaluated your reports here.

We had interaction on 9th May regarding your issue.

* Food nutrients not to get properly absorbed is part of gut flora disturbances
itself.
IBS gives persistent frequency, colic to varying degree of amounts.

* The current ailment is by grilled chicken, which interfered with the healing lining
of the intestines.

Kindly provide me further details please.

1. After my last discussion and before taking grilled chicken, what were the
symptoms in terms of morning toilet visits ?
2. At what time you are consuming dinner, go to sleep and any recent changes in
that ?
3. Started dedicated deep breathing exercises, YOGA or not ?

Awaiting for your response.
Regards.

Dr. Bhagyesh

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Bhagyesh V. Patel (1 hour later)

Sir...what do you mean by colic to varying degree of amounts? Is this IBS or Gut Flora imbalance?

Answered by Dr. Bhagyesh V. Patel (2 minutes later)

Brief Answer:
follow up .

Detailed Answer:
Hi

Colic is spasmodic pain of various amount in different individuals.
Again this is not an IBS, I would like to elaborate more after getting answers to my questions please.

Thank you.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Bhagyesh V. Patel (23 minutes later)

sir...my symptoms have been the same 2 BM in the morning and the rest of the day is much better. The morning BM has few food particles not the prominent ones but more related to vegetable fibre like lentils sometimes, carrot and pieces of tomatoes.... To be honest I haven't fully started with your prescribed diet plan owing to some family function...but just wanted to make sure before I start with a completely new exercise all together.... 1 I eat my dinner around 7.30 pm and then eat small tea spoon of fennel seeds and go for a walk for around 15-20 min 2. I have started eating Rifagut 550 and Colospa Retard on alternate days 3 1 Capsule of 64 Billion probiotic along with probiotic curd and oats in the morning 4 I am taking Nexium 40 mg once daily empty stomach in morning 5 Yoga is practiced for 15 min early morning 6 I am sleeping around 7 hours at night

Answered by Dr. Bhagyesh V. Patel (38 minutes later)

Brief Answer:
follow up .

Detailed Answer:
Hi XXXXXXX

Thanks for the details.

* IBS does not follow particular day time periods for bowel movements, which is
against your case.

* My recommendations

- Focus more over the life style modifications rather than keeping stress of IBS or
gut flora disturbances, which is not helping you to recover faster.
- Unless strict avoidance of all non veg stuffs is not being put into practice, do not
predict for better results.
- Raise the intake of probiotic curd both times in morning and evening as well for
better flora coverage of intestine, as you are better after the morning session
( you consume curd , that coats your intestine and provide flora ) ; this change
will make a slow progress in morning episodes.
- Continue rest of the things which are being practiced very well by you.

Welcome for further doubts.
Regards.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Bhagyesh V. Patel (8 hours later)

Thank you sir....In all honesty I do believe that smoking is 70% contributing factor for all stomach related disorders and I am determined to quit this weekend once for all. Also, going on strict diet as recommended by you for next 6 months may account for some weight fluctuations....I'm order to make sure I am getting right content of everything without losing weight I intend to follow the given schedule. please feel free to alter or add :

1. Increase probiotics: Should I increase 64 Billion capsule dose to 2? Can I also introduce Kefir in my diet? Is it safe to consume yogurt at night? Can too much probiotic addition cause flatulence or gas?

2. Fruits : Can I eat all kinds of fruits? Should I go on high fiber? Add Isabgol as well? Salads etc?

3 Sugar : Is sugar a complete no for next 6 months? Or can I satisfy my taste buds once or twice a week?

4 Dairy : Milk only after boiling? Soy milk a no?

5 Carbs : Roti, Rice should I continue with? Carbs intake to be increased or decreased?

Just don't wanna lose weight and feel lethargic......Your advise please?

Answered by Dr. Bhagyesh V. Patel (7 hours later)

Brief Answer:
follow up .

Detailed Answer:
Hi XXXXXXX

Welcome for follow up.

* Glad to hear about decision to quit smoking by you, it would be best when it is fully
implemented.

Kindly find following guidelines in regard to your questions above.

1. Capsule of pro biotic should be taken once only.
Can add Kefir in diet with initial quantity of say half cup a day.
It is safe to consume yogurt at night.
We are not exceeding pro biotic for any disturbances.

2. All kinds of fruits, salads can be consumed in moderate amounts.
Isabgol is not recommended at this stage ( as it is a bulk forming laxative ).

3. I have not advised to quit sugar totally, it is recommended to consume 2-3
tea spoonful per day.

4. Dairy milk only after boiling.
Not advisable to prefer soy milk at this stage.

5. 40% of your diet intake should consist of carbohydrates, so aim for 250-300
gm carbohydrates daily. Continue with rice, roti in average amounts.

* You are going to keep a weight chart on daily basis, so there is no issue of
weight loss and feeling lethargic at all.

Regards.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Bhagyesh V. Patel (14 minutes later)

sir weight fluctuations was freaking me out so my wife has hidden it somewhere....Do u want me to measure daily or once a month should be ok?

Answered by Dr. Bhagyesh V. Patel (3 minutes later)

Brief Answer:
follow up .

Detailed Answer:
Hi

If not feasible on daily basis, at least once a week weight measurement is preferable.

Thanks.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Bhagyesh V. Patel (13 minutes later)

Do u think weight loss is expected at this stage or any area of concern? Coz I weighed 79 kg in Nov'17 and in Apr'18 was weighing around 71 kg.....other doctors said this isn't clinically worrisome.....pls advise

Answered by Dr. Bhagyesh V. Patel (7 minutes later)

Brief Answer:
follow up .

Detailed Answer:
Hi

Some level weight alterations are predictable in acute flare up condition of bowel
disturbances.

Now onwards a consistent watch over weight is that`s why recommended on weekly basis for proper evaluation.

By worrying, it will worsen the issue of bowel frequency, so do not panic and just
relax. Everything would be fine.

Regards.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Bhagyesh V. Patel (10 minutes later)

Thank you sir....Do u see any serious issue as of now or is this curable?

Answered by Dr. Bhagyesh V. Patel (5 minutes later)

Brief Answer:
follow up .

Detailed Answer:
Hi

I do not predict any of the serious issue at this point, it is curable provided utmost care is taken in terms of life style modifications, diet control, smoking, alcohol and every thing irrespective of desires.

Thanks.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Bhagyesh V. Patel (15 minutes later)

Thank you sir...for how long should I take Nexium 40 mg? I took it for initial 7 days and then switched over to Pan 40 for 4 days and now started with Nexium from past 3 days again....How much more?

Answered by Dr. Bhagyesh V. Patel (16 minutes later)

Brief Answer:
follow up .

Detailed Answer:
Welcome.

Have to continue nexium regularly for a period of 2-3 weeks from now onwards, further requirements depend upon the progress of the condition.

Regards.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Bhagyesh V. Patel (6 minutes later)

Thank you sir....Wen should I follow up with u? after 3 weeks?

Answered by Dr. Bhagyesh V. Patel (3 minutes later)

Brief Answer:
follow up .

Detailed Answer:
Hi

For current session, follow up after 5 days before this conversion validity expires.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Bhagyesh V. Patel (19 minutes later)

Also is it fine to take Multivitamin capsule at night and fish oil capsules with this existing condition?

Answered by Dr. Bhagyesh V. Patel (7 minutes later)

Brief Answer:
follow up .

Detailed Answer:
Hello

* Can take multivitamin capsule, but not fish oil capsules which actually can hamper
the homeostasis of intestine flora in present condition.

Thanks.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Bhagyesh V. Patel (2 days later)

Hello Dr....hope you are doing fine. I wanted to bring this another problem to your attention for you to see if there is any relevance to the existing condition we have discussed. From past several years I get a sudden flair of headache usually towards the central or back side of the skull...The pain shoots up in few seconds and restricts my head mobility. Also I feel like getting in a dark room and lying at 1 position after taking pain killer. The one I usually have here in Australia is Voltaren 50 mg. This headache is episodic if it gets triggered it would continue to happen for next 10-15 days and occurs almost during the same time. This sometimes gets triggered looking at XXXXXXX or computer screen for long or even travelling in a train or driving for long or very rarely while having sex with my wife. I did consult a Neuro surgeon in XXXXXXX few years back and he diagnosed this to be Episodic Stress Disorder....I have consulted lot of GP here and they say it's Cervical Headache and One of them said it to be more of Occipital Neuralgia. My Cervical MRI scan report is attached for your reference. Because I take so many pain killers is my stomach distension owing to that? Please look into my report and advise what this problem could be and how can I get rid of it? I do not experience any vomiting or blurred vision during this attack. It's more like a flair that comes and gets settled after I take medicine. Please advise.

Answered by Dr. Bhagyesh V. Patel (1 hour later)

Brief Answer:
follow up .

Detailed Answer:
Welcome for follow up.

* The issue of chronic headache of this intensity and type narrate possible occipital
neuralgia more likely.
I would like to comment further after reviewing MRI report ( which is not here as
an attachment, all are of previous ones regarding intestine issue ).

* As far as effect of Voltaren on stomach is concerned, it has definitely caused you
damage for current intestine problem upto varying degree of level.

Thank you.

Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Kampana