What Is The Treatment For Chronic Anxiety With GERD And IBS?

Posted on Tue, 25 Feb 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Tue, 25 Feb 2014 Answered on

Wed, 19 Mar 2014 Last reviewed on

Question : Hello I am a white female that is age 30. I have had a healthy baby a year and a half ago. My weight is 184 lbs and I am 5'7. My blood tests for anemia, thyroid tests t3, t4,tsh and ANA blood test normal. Estrogen and pituitary tests and blood pressure are normal unless they test with those wrist battery testers then its high. Periods are normal. Gallbladder was tested normal last year .I take a prenatal vitamin, vitamin D, cranberry pills for the bladder and Vitamin C 1000mg. My exercise level is full time cashier at a large chain grocery store and I work the swing shift. My Symptoms: I have Fatigue, pale face,foggy brain. Foggy brain clears up at night and I have trouble sleeping at night want to stay awake.My hair is greasy everyday regardless of what I eat. I usually have to sleep at an upright angle; hurts to sleep flat on right side. I am cold most of the time even though my temperature tests normal at 98.6. My bowels have slowed down.Not constipated but stools are sometimes pale, some times pellet sometimes normal. Chronic pain near colon/gallbladder dependent on the volume of food; too much of anything makes me sick. Pain sometimes wraps around lower back and sometimes shoulder. Sometimes I have woken up with sore throat and headache. Gets hot in right abdominal area if I eat a normal meal. No appetite, even trying snacking; one meal a day makes me a happy camper. I have an enlarged overactive ovary and tipped uterus. As I get closer to my period lots of pressure on my bladder and its relieved by my period. I took the laxative-miralax and it made me sick. I was told I had mild diverticula but no diverticulitis. Harmless cyst on liver. Ct scans and ultrasound doesn't show anything. I told them last year during ultrasound that it hurt when they put pressure on kidneys and gallbladder. I have had recent vaginal ultrasounds when bladder is full and it hurt bad on bladder and on stomach ones as well. When I was pregnant my ultrasounds didn't even hurt at all. It takes a month just to see a doctor for an appointment. Arguments between doctors on if it is gi related or ovarian related.Most doctors don't even physically examine my pain. I am frustrated as I have no answers.I have been doing this since my baby has been born. I have lost my baby weight and am losing inches. I am working on losing more weight. What can I do to help my body or help the doctors that I am seeing? I am scheduled to see an internal doctor in two months. I also saw a chiropractor after the baby was born and he said I had a tilted pelvis. I know that I walk with a limp and have minor scoliosis according to the chiropractor. He was always rearranging my appointments due to family issues; so I stopped seeing him. Could my skeletal structure contribute to the pain I have? Who would I see to correct this besides a chiropractor? When, I said that no one wants to examine my pain. What I mean is when I have gone to the gi; he didn't even place his hands on the spots I was having pain. My obgyn/arnp didn't want to either and in fact referred me to another obgyn. My new primary didn't either but at least he listened and ran complete blood tests and referred me to an internalist.

Answered by Dr. Rakesh Karanwal (18 hours later)

Brief Answer: Ask ur doctor to prescribe treatment advised by me Detailed Answer: Hi dear, Thanks for your query. I fully understand the concerns for your problems and frustrations over the so-called indifferent doctors. I have gone through the details very carefully, based on which I have short-listed the following problems you are suffering from :- 1. Chronic mental stress/anxiety with underlying mild depression(feeling of cold, sleeplessness, foggy brain, loss of appetite) 2. GERD (Gastro-Esophageal Reflux Disease) with possible H.pylori infection of the stomach + intestine ( loss of appetite, upper abdominal pain, tendency to sleep in upright position, sore throat + headache which wakes you up from sleep: sore throat is apparently due to reflux of stomach acid to the mouth; chronic pain overlying the colon. 3. IBS (Irritable Bowel Syndrome) :- features of anxiety, upper abdominal + colonic pain, mild/moderate constipation, recurrent abdominal discomfort, 3. Scoliosis-induced band-like pain around the back/shoulders. I strongly feel that- in addition to the blood tests already done- you should undergo the following tests :- * Colonoscopy to directly visualize the inside of the colon for diverticula, polyps, growth or, inflammation of inner lining of colon. * Endoscopy to directly visualize the condition of the stomach/duodenal lining (for inflammation, erosions and ulcers). * Breath test and stools examination for H.pylori infection * Blood Vitamin B12 and D, Folic Acid, Calcium levels to estimate the deficiency. In my vast 35 years of clinical practice, I have seen and treated hundreds of similar cases, with a high success rate. Hence, if I were your treating specialist, I would have advised the following treatment:- (a) A long term (6-12 months or even more, if required) of a combination of # an anti-depressant, such as, Sertraline or Escitalopram # An anti-anxiety drug, such as, clonazepam or alprazolam (b) 2 weeks' course of Anti-H.pylori therapy + Pro-kinetic drug, such as, Metoclopramide; FOLLOWED BY (w.e.f. Day 15) # 3-4 months' course of - Proton Pump Inhibitors (PPIs), such as, Rabeprazole or Esmoprazole - Probiotic drug, such as, Lactobacilli thrice daily - Digestive enzymes thrice daily - Psyllium husk/granules/powder twice daily - Daily supplements of Vitamin B12 (Mecobalamin) 1.5mg + Vitamin D3 (Calcitriol) 0.5micrograms + Folic acid 5mg + Calcium Carbonate 1gm/day # A single-tablet of Albendazole (400mg) on Day 1, repeat after 3 days. Scoliosis has apparently caused disc(s) protrusion/herniation or narrowing of the spinal canal. Consult a Neurosurgeon for diagnosis/exclusion of these conditions. Consult your doctor and apprise him of my opinion. I am certain that he will agree with me; order required tests, and- will prescribe suitable treatment as advised, in appropriate/effective doses. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Take care & JUST RELAX: HAVE FAITH IN ME AND YOURSELF. YOU W-I-L-L BE ALL RIGHT IN NEAR FUTURE. Col (Dr.) Rakesh Karanwal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Karanwal (7 hours later)

Thank you very much. I am starting the vitamin requirements today and the digestive enzymes. Lastly, will the enzymes help with undigested food in stool and stool smelling like bread?

Answered by Dr. Rakesh Karanwal (8 hours later)

Brief Answer: Anti-H.pylori therapy required for maximum benefit Detailed Answer: The root cause of your problems is apparently H.pylori infection. You are UNLIKELY to have much relief with vitamins, enzymes and supplements UNLESS you treat the root cause. Take a course of anti-H.pylori therapy SIMULTANEOUSLY, in order to get maximum benefit. Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar