instruction: hello doctor I have been suffering from stomach pain gas bloating strange sounds in stomach burping indigestion watery stools always floating stools on the toilet commode since last year took several medications for it and of no use finally I underwent endoscopy and colonoscopy last year and the doctor informed me that I have got fungal gastritis and lax less the doctor asked me to take months of medication for it for the first months motilium 0 1before food pantodac 40 0 before food librax 1 after food 4k peg hours after food it is completed
output: hello I can imagine the level of your frustration for your chronic unresolving symptoms and I really feel sorry to hear that you been back and forth around doctors for solution of your symptoms well I can very well understand your problem I will explain to you point by point lax les lower esophageal sphincter is not a uncommon findings on endoscopy it reflects that the valve which controls reflux from stomach to lower part of food pipe is little bit open however your endoscopy did not show any ulcer formation in the food pipe which suggest you do not have gastroesophageal reflux herd again your symptoms are not related to herd it is something else I tell in a moment so you see the fungal gastritis inflammation of the funds a part of stomach usually inflammation of stomach confines to the other parts of stomach like tantrum and stomach body but not to the funds the one cause of inflammation predominantly to the funds suggest pyloric infection this bug initially infect tantrum of the stomach then it moves to funds if chronic infection that has not been treated I will suggest you investigation before I suggest you an antibiotic course of this pyloric and remember this pyloric can cause stomach slowing leading to your symptoms of gas the condition is called gastroparesis below I explain to you in more detail the reasons of your symptoms of gas to simplify the constellation of your symptoms we doctors classify in to two the predominant gaseous symptoms or predominantly pain symptoms you have predominantly gaseous symptoms including bloating sounds burping fullness early satiety after meals and some gas in stools as well so it is important you should understand why these gases production is in excess in you the one such reason is I dysbiosis which is alteration of human gut bacteria more gas producing species these bacteria or harmlessly present in the human gut however at times the environmental factors food water other dietary habits change the composition of these bacteria and turn them in to gas producing bacteria I will give you an antibiotic for a week duration this will correct your dysbiosis I the other reason is excessive of food intake that produces gases these foods are collectively called as fodmaps these foods to be avoided as possible as you can I will share with you a link where you will find the list of such foods which should be avoided I less common mechanism is feeling of normal amount of gases this condition is called hypersensitive gut for this I would suggest you behavioral therapy called diaphragmatic breathing I will share you the link how you can exercise it at your home I really hope now you would the some idea of mechanism causing your chronic unresolving symptoms I would just correct your above mentioned mechanism and you would see the things get improved for you please find below treatment plan and I want you should update me about your symptoms in coming weeks time secondly I also want to suggest you some investigations as we can exclude any other possibility and treat the things accordingly dysbiosis functional bloating and gas pyloric infection overweight complete blood count ash ft3 ft4 liver function tests anti tag ga and egg fasting sugar level fasting lipid profile stool for pyloric antigen stool for giardiasis antigen stool for fecal calprotectin stool for ova and parasites stool for fat globules and reducing substance capsule rifaximin 200 my thrice daily for weeks this is for dysbiosis avoid fodmaps diet diaphragmatic breathing tab digestive metoclopramide 40 my half hour before meals you can stop the motilitum you can continue with pantodac you should stop peg 4k you can continue with librax but increase the dose to one tablet twice daily after meals avoid fodmaps I really hope that your symptoms will improve in coming weeks times till then you get some tests and revert back to me in the end of treatment course I would consider giving you another class of medication that you take for life long