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Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
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Experience:  MD
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My wife is in a rehab facility. Setting a broken leg caused

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My wife is in a rehab facility. Setting a broken leg caused her to loose all ability to drink or eat any food. Rehab has got her back where she can now eat and drink with some linitions. The preceeding is for backup material only. She has moved to a another rehab facility and shortly after being here she has a problem where about every three days she gets nausiated and vomits her previous meal. Most of the time she feels fine afterwards.
Then the process repeats its self about 203 days later. The rehab doctor had her have a Upper Gastrointestinal Endoscopy. Results from that were negative nothing could be found wrong with her stomach. They did remove a feeding tube that has nit been in use for months. None of these Doctors ever set down and discussed what was happening to her and suggest what might be causing the problem or suggested any remedies to try.
Frustated husband Robert Orr ***@******.***
Submitted: 1 year ago.
Category: Medical
Expert:  DrRussMD replied 1 year ago.

Hello

You have not asked a question.

What is your question?

In this situation, removing the feeding tube should have an effect.

They should also do a gastric empthing study, to see if her stomach empties properly.

And, they should to a follow through x ray of the small bowel to make sure there is not something causing intermittent obstruction.

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Expert:  Dr Basu replied 1 year ago.

Hi there,
This is Dr Basu, experienced Internal Medicine Specialist.
I am here to address your concerns and provide great service.

A different opinion.

Sorry to hear about your wife's symptoms.

Liver problem can cause these symptoms.
These symptoms can also be due to the gallbladder problem.
Excess bile acid will cause intestinal irritation.
When the gallbladder is not functioning well, the bile flow to the intestine may increase causing these symptoms.
This will result in bloating, belching and also diarrhea especially after meals.
These symptoms can be treated with a medication called Cholestyramine 4 gram twice daily will meals.
Malabsorption syndrome is another strong possibility.
Malabsorption syndrome includes the follow possibilities:
1. Excess bacterial overgrowth in the small intestine known as SIBO syndrome.
This is not usually diagnosed by the colonoscopy.
Small intestinal aspirate can be sent for bacterial count.
Carbohydrate breath test ( D xylose) is a simple test to diagnose this condition.
But, the treatment is much easier.
A 14 day course of Rifaximine improves the symptoms dramatically/
2. Lactose intolerance--- regular milk, dairy products.
3.gluten senisitivity or celiac disease--- Wheat based products.
4. Chronic pancreatitis --- deficiency of the digestive enzymes produced by the pancreas.
5. Gastroparesis -- delayed gastric and intestinal movement.-- treated with metoclopramide or domperidone daily.
Your wife should consider following low fermentable sugar diet ( FODMAP diet) to reduce your symptoms.
Please go to this link for detailed information:
http://stanfordhealthcare.org/content/dam/SHC/for-patients-component/programs-services/clinical-nutrition-services/docs/pdf-lowfodmapdiet.pdf

Please also include prebiotics like Inulin daily to keep your colon acidic which prevent gas producing bacteria.
Also take a probiotic ( lactobacilli, bifidobacterium) daily to restore intestinal microbial balance.
Culturelle 30 Counts twice daily should be fine.
Please consider taking Simethicone ( GasX) strips before each meal and activated charcoal tablets to reduce gas formation.
Lastly, there can be chronic infections like C difficile, Giardia, Amoeba, Aeromonas etc.
These infections may be diagnosed by checking 3 stool samples taken on successive days.
They will require proper antibiotics for the treatment.
Please discuss these possibilities with a gastroenterologist.

Best wishes,
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