Functional Gastrointestinal Disorders: A Patient's Guide

Q: Functional Gastrointestinal Disorders: A Patient's Guide

1. <br>The effects of Emetrol： It can promote gastric emptying and has a strong anti-nausea effect without causing any adverse mental or neurophysiological effects. <br>2. <br>Medications prescribed by a gastroenterologist can be taken together with Foan, Homagyl, and Diazepam. <

Functional gastrointestinal disorders

Dr.
Su: Thank you for your prompt response.
Today, I have completed liver and kidney function tests.
The results are as follows: (1) GPT: 12 (2) BUN: 8.
Therefore, there should be no issues with liver function.
I would like to ask Dr.
Su: (1) What is the effect of Emetrol Tablet (10mg) (Domperidone), which was prescribed by a previous gastroenterologist? Can it be taken together with Foan 10mg, Homagyl 50mg, and Diazepam 2mg? (2) Another gastroenterologist prescribed me the following: Can these be taken together with Foan 10mg, Homagyl 50mg, and Diazepam 2mg? 1.
Simethicone (Kascoal) 40mg after each meal 2.
Primperan 5mg before each meal 3.
Famotidine (Gaster) 20mg once daily at bedtime (I previously had an endoscopy, which showed a duodenal ulcer that has since healed) 4.
Strocain after each meal.
(2) I previously tried to stop taking Foan 10mg, Homagyl 50mg, and Diazepam 2mg, but experienced symptoms such as increased heart rate, so I currently feel that I still need medication for my mental state.
However, I do not wish to take too many different medications, so for my gastrointestinal discomfort, I only hope to avoid bloating.
Is there any medication from the above that can help with this? (Currently, my food intake has significantly decreased compared to normal, and to address the bloating issue, I walk at least 30 minutes every afternoon, which only slightly alleviates the bloating, but my work schedule does not allow for much flexibility.) (3) The gastroenterologist who examined me today noted that my intestinal motility is still rapid (as I was fasting for the liver function test, the doctor listened to my abdomen).
(4) How should I seek further consultation? (Psychiatry? Gastroenterology?) I apologize for asking so many questions.
Thank you, and best wishes for your health.

Johnson, 30~39 year old female. Ask Date: 2003/08/29

Dr. Su Baojia reply Gastroenterology and Hepatology

1.
The effects of Emetrol: It can promote gastric emptying and has a strong anti-nausea effect without causing any adverse mental or neurophysiological effects.
2.
Medications prescribed by a gastroenterologist can be taken together with Foan, Homagyl, and Diazepam.
3.
Based on your symptoms, you should consult both a psychiatrist and a hepatobiliary and gastroenterology specialist.

Reply Date: 2003/08/29

More Info

Understanding Functional Gastrointestinal Disorders (FGIDs) can be quite challenging for patients, especially when symptoms persist despite normal diagnostic tests. FGIDs encompass a range of gastrointestinal conditions characterized by chronic symptoms without any identifiable structural or biochemical abnormalities. Common examples include Irritable Bowel Syndrome (IBS), Functional Dyspepsia, and Functional Abdominal Pain Syndrome.
From your description, it seems you have been experiencing a variety of gastrointestinal symptoms, including abdominal pain, discomfort, and changes in bowel habits. You have undergone several tests, including endoscopy and imaging, which have not revealed any significant pathology, leading to a diagnosis of functional gastrointestinal disorders. This can be frustrating, especially when symptoms significantly impact your quality of life.

Treatment Strategies for FGIDs
1. Dietary Modifications: One of the first steps in managing FGIDs is often dietary changes. A low-FODMAP diet, which reduces certain fermentable carbohydrates, can be beneficial for those with IBS. Keeping a food diary to identify potential triggers can also help.
2. Medications: Depending on your specific symptoms, various medications may be prescribed:
- Antispasmodics: These can help relieve cramping and abdominal pain.

- Prokinetics: Medications like Primpperan (metoclopramide) can enhance gastric motility and may alleviate symptoms of bloating and discomfort.

- Antidepressants: Low-dose tricyclic antidepressants or SSRIs can be effective in managing pain and discomfort associated with FGIDs, even in patients without depression.

- Antacids and Acid Suppressants: Medications like Famotidine can help manage symptoms related to acid reflux or dyspepsia.

3. Psychological Support: Since stress and anxiety can exacerbate gastrointestinal symptoms, cognitive-behavioral therapy (CBT) or other forms of psychological support may be beneficial. You mentioned taking anxiety medication, which suggests that addressing mental health is an important aspect of your overall treatment plan.

4. Lifestyle Changes: Regular physical activity, adequate hydration, and good sleep hygiene can improve overall well-being and may help alleviate some gastrointestinal symptoms. You mentioned walking for 30 minutes daily, which is excellent for both physical and mental health.

5. Follow-Up and Monitoring: Regular follow-up with your healthcare provider is essential to monitor your symptoms and adjust treatment as necessary. If symptoms persist or worsen, further evaluation may be warranted, including additional imaging or referrals to specialists.

Seeking Help
Given your ongoing symptoms and the complexity of your case, it may be beneficial to consult both a gastroenterologist and a mental health professional. A gastroenterologist can help tailor your treatment plan for FGIDs, while a mental health professional can assist in managing anxiety and stress, which may be contributing to your gastrointestinal symptoms.

In conclusion, FGIDs can be complex and multifaceted, requiring a comprehensive approach to treatment. It’s crucial to communicate openly with your healthcare providers about your symptoms, treatment responses, and any concerns you may have. With the right combination of dietary changes, medications, psychological support, and lifestyle modifications, many patients find significant relief from their symptoms and can improve their quality of life.

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