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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35467
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I have a terrible breathe odor. I am told it smells like

Customer Question

I have a terrible breathe odor. I am told it smells like feces. I was told by a doctor that the opening to my stomach doesnot close completley. Therefore the odor seems to be coming from that disorder. I am so embarrassed, can't get close to anyone with this order. Is there a medical term for this disorder? Is there a medical procedure or treatment for this problem? I suffer with hbp and hiatal hernia also.

Thank You for your answer
Submitted: 6 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 6 years ago.


The medical term to this disorder is gastroesophageal reflux disorder (GERD). Please read about it;

Please feel free for your follow up questions.

Dr. Arun

Customer: replied 6 years ago.

What caused this disorder. I was hoping to get a treatment plan. What can I do? Just stay out of people face and they stay out of mine face. Any helpful advice would be appreciated.

Expert:  Dr. Arun Phophalia replied 6 years ago.


These are the initial strategies for the treatment of GERD;

1) antacids; Maalox
2) acid blocker; Prilosec
3) loosing weight, if overweight.
4) avoiding alcohol, citrus fruits and juices, chocolate, and tomato based products
5) avoiding large meals. Eat 5 small meals in a day.
6) wait three hours after the meal before you sleep.
7) elevate head end of the be by 8 inches.

If these are not helpful, you would need an upper gastrointestinal endoscopy to look for an associated hiatal hernia (with GERD). This may warrant further work up like;

1) 24 hours pH monitoring

2) food pipe pressure study (esophageal manometry).

If these are abnormal and there is no relief with the above conservative measures, you may need surgery.

It is privilege assisting you.

Dr. Arun

Customer: replied 6 years ago.

I have a Hiatal Hernia. I complained to doctors about my bowel movements. I would have about two movements amonth. The largest one would be a my cycle time. This is was the good one. I felt like a load had been taken off me. The doctors told me if this was normal for me , that it was ok. I disagreed with his answer. Each time I saw a new doctor I would tell them about my problem. I was sent to a gastro and was placed on raglan and it seems to regulate my bowels. When I had a stool I felt so relieved.

Would this Hernia add to the problem? If so what can be done ? The doctors have looked from one end to the other and came up with acid reflux. This was some years ago. Thank you for your response.

Expert:  Dr. Arun Phophalia replied 6 years ago.

You are very welcome.

Hiatal hernia is not likely to be related to your constipation. High fiber intake (lot of vegetable and fruits), exercises, walking and plenty of fluids always are part of the management of the chronic constipation. People who do not respond to this and OTC laxative are advised to take the following medications by prescription;

1) Polyethylene glycol 3350 (Miralax)

2) Lactulose

3) Tegaserod (Zelnorm)

These agents are proven for their effectiveness at improving stool frequency and consistency in patients with chronic constipation. The other helpful agents are;

a) Lubiprostone

b) Linaclotide

Ideally you should consult a gastroenterologist who can perform the following investigations which are the mainstay of the evaluation and which will give true perspective of the cause;

1) Blood investigations do give the clue. A complete blood count, biochemical profile, serum calcium, blood glucose, and thyroid function tests are routinely recommended in the evaluation of patients with constipation.

2) Depending on these blood results further blood work is done; serum protein electrophoresis, urine porphyrins, serum parathyroid hormone, and serum cortisol levels, may be done to identify or rule out myeloma, porphyria, hyperparathyroidism, and Addison's disease. These causes are not common causes so clinical manifestation and physical examination clues are important.

3) Barium enema or barium meal with follow through study

4) Colonic transit time; it can provide a better understanding of the rate of stool movement through the colon.

5) Other investigations like Anorectal manometry, balloon expulsion test, Defecography etc.

Dr. Arun