Gastroenterologist, Gastroenterology Journal

Question: dear doctor, I am 35 years old. Observed in a gastroenterologist in connection with gastroduodenitis. In recent years become concerned about slack pain in his right side below the ribs. Did ultrasound. In the gall bladder is not found concretions, but the results of the study says that the gall bladder contains flakes and bile. Conclusion Ultrasonography: diffuse changes of the liver parenchyma, indirect signs of biliary dyskinesia. Conclusion after gepatoholetsistografii: motor function of GPI – hypomotoric. Passage of bile on choledochitis and sphincter of Oddi in general timely, given the late arrival of bile in the intestine (after giving the yolks), one can not exclude spasm sf. Oddi. Question: Is it possible with any medication (ursofalk, henofalk) funds to improve the condition of the gall bladder, dissolve or withdraw flakes? I was prescribed only choleretic (hofitol or gepabene). But choleretic I took earlier (odeston) as the stagnation of bile was diagnosed during the ultrasound as early as 2006, but now it added to the flakes and pain in his side. Diet, because of gastritis, I try to respect all the time. And another question. I read that in gastritis in the mineral water can add magnesium sulfate. What advise to use as a means for choleretic efficiency tyubazhey? Thank you.

Answer: You can add magnesium sulfate, can be carried tyubazhi by general rules (http://doktor. ru / qa / gastro / article. html? id = 52169). These Bile means: http://doktor. ru/qa/15613/qa. html? id = 80286.

Question: Dear doctor. I have appealed to you for help, you are so accurately and fully answered my question. Thank you very much. After the treatment, and in the simple advice, the main doverik patient's doctor. I'm very much trust, your kompitentnomu opinion. If I may, I'd like to get you another advice (sorry I can not full-time): March 6, I have been screened in over all those same cramps in my stomach that I have observed after RHPG. They decreased slightly while taking Buscopan, but never completely stopped. Maybe I want to get bymtro the result? Or maybe I'm so until his death and I will get sick (How nepriskorbno.. 6 March, I made REOGASTROGRAFIYU, which showed that acid-forming function of the stomach is reduced-20-22mmol l, a motor activity in the output section is reduced. Question 1 . Why it might not be whether this be related to stomach cramps? Then I made the ultrasound, which showed: liver is normal, gepatoholedoh 4mm, gate Vienna 11mm, pancreas, with distinct irregular contours, normal size 22 12 13 moderately diffusely sealed. Conclusion: Moderately deffuznoe seal of the pancreas. I also made a MRI on March 4) choledochitis 6-7 mm without intraluminal formations, intrahepatic ducts nerasshireny. Pancreas: 2-body-2. 1 hvst 2. 3 LL-inhomogeneous due to the presence of small inclusions gipointensivnyh on T1 WI. Hd. pancreatic duct is expanded to 3 mm. Enlarged lymph nodes in the area of scanning is not revealed. Conclusion: Condition after operpt. intervention: holitsistoektomii. MR painting's. pancreatitis. Vpros 2: Is it all terribly? Prokkomentiruyte please? Do I have a chance to painless life? Analysis: lipase-46, amylase-66. 7 u l ast-7, 85, glucose-4. 8, Toth. billirubin 19. 2, a protein-79. 8, ALT, 10.1, creatinine, 67.6, K-5. 05, Na -137,8 Cl-102, 9, ESR-13mm stab 2%, lymphocytes 22%, segmented-72, monocyte-4. Question 3: What do my tests of liver enzymes and why things get demoted? Is this bad? If possible, show you how long you may experience cramping in the stomach? The doctor said that does not find anything that could lead to these spasms, and that most likely is just a psycho-neurogenic hparaktera. Advises to rest in a sanatorium. What do you think? Yes, I'm really nervous, but by then it had not been nervous, if he had a sore ((Maybe there are some drugs that used to shoot spasms? Thank you.

Answer: There were letters: http://doktor. ru/qa/15613/qa. html? id = 84177 and http://doktor. ru/qa/16265/qa. html? id = 85568. Take Buscopan to 10 tablets a day (if necessary) and go to the sanatorium. Only there categorically refuse of any additional surveys.

Question: I have a neurosis, including with somatic manifestations, and once in 2 years about pass treatment with antidepressants. We have begun to accept such and in the 1 st day, he felt discomfort from the stomach – the swirling, sucking, gas, belching simple. Abdomen swollen and slow pulling pain concentrated in the navel and just above and slightly to the right and slightly below the ribs. There is a tremor slack, which interferes with normal sleep. On day 2, antidepressant night were intestinal cramps, severe diarrhea with characteristic, but the most vilified as takogogo actually there was not (something the average was). A similar picture was in the past year, the truth is more vivid and pronounced, it became clear that this is due to the pancreas. Cured herbal. A few days will not be contact with the doctor that something changed. What do you say? It looks like a pancreas or intestine is just a "fling"? And how to ease these symptoms? Thanks

Answer: It is doubtful that the case in the pancreas, both now and before.

Question: doctor. I do not know which doctor to contact. I have a problem with the skin. Says dermatologist acne. Treatment of a single dose of antibiotics, horse and everything is for 2-3 months but the cause is not ustranyaetsya. Teropevt says that you have that then the stomach, pancreas or liver. I went to the charge office ultrasound. The result of such chronic cholecystitis. About the stomach is silent, said in normal pancreas. And acne said liver disease. Cure not appointed said only eatee less fatty, fried foods. To be honest that the results of ultrasound for some reason, I believe few tons. to. in the liver, I never was no pain, but under the left edge from time to time slaboya dull pain. Пожайлуста'll show than to be treated and properly diagnosed. Thanks in advance

Answer: cholecystitis you can not be by definition. For some reason many people think that the reasons banal adolescent acne found in the stomach. Effectively prolonged local, ie, the combined treatment of skin. Leather and digestion – http://doktor. ru / qa / gastro / article. html? id = 80547.

Question: I beg you to help us. My husband has been about 2 months of weight in pr hypochondrium, heartburn, flatulence (very strong). Gallstones (3 to 1.5 cm). ALT-86, 5 (Norma-up to 49) ACT-39 (Standard) triglycerides 2,8 (N-up to 1,9). GGTP-96 (Ndo 50), L-amylase-101 (N-90). Bilirubin normal. He is 35 years. We understand that we must remove the bladder (the surgeon insists). But apparently (judging by the tests) at the moment he had hepatitis of unknown origin (B, C excluded) or pankreotit. He was discharged Creon, dyufalakt and ursofalk. Chair in his liquid and 2-3 times a day, why Dyufalakt?. The stones are large enough and whether there is a sense in Ursofalke? Pancreas difuzno sealed. Liver slightly uvelichina. What we do at the moment? How to remove the inflammation and as far as possible to improve analysis. Please, help with any hepatoprotectors better and how to treat pancreatic?? Order not to have a question about this increase GGTP-my husband did not consume alcohol. And what would you advise on the operation? "The fact that his father had a gall bladder removed and now he is tormented Mts. diarrhea. I understand from my favorite as there is a danger postholetsistoktomicheskogo syndrome, unfortunately live in Kiev and can not contact you for full-time advice. Thank you for your attention!

Answer: Real contraindications to conduct operations there. Chronic diarrhea after the operation occurs with a frequency of about 5:100.

Question: I am worried about one and a half years from severe acne on the face (mostly along the contour of a person on the cheeks), chest and back. . even slightly dry skin, and acne involved skin and hurt. I applied to TSNIKVI: to make the analysis of hormones (okay), but found dysbacteriosis. Reduced Number of total coliform (260 billion / g) and hemolytic E. coli 13%. I cut koliproteyny bacteriophage and bifiform. the person, nothing has changed. Now more and began pain in the gut (aching), puchit, bloating, disorders of the chair. course bacteriophage told me not to repeat. appointment at Gabrichevskogo, but only a month! take hilak because in principle I do not know what to take. There are some improvements: the pain passed, but the chair is still the problem. please tell me whether hemolytic bacillus cause such severe skin problems. I can still repeat the course bacteriophage (apparently the last of me will never be affected, saw 2 months ago)? I often get nervous and just recently nootropil cut, it has some influence? that this be? Help, please!

Answer: At 10 times on the day the same questions from young people: http://doktor. ru/qa/16264/qa. html? id = 90202 – http://doktor. ru / qa / gastro / article. html? id = 52173. . .

Question: Thank you for having responded (http://doktor. ru/qa/13938/qa. html? id = 90214)! The pain began on April 17, burning in my left side, constant belching, often hungry. April 20 evening, adopted the "Almagel-A" one hour after meal 2 scoops at night. April 21 drank the same "Almagel-A in the morning and afternoon on 2 tablespoons of the 21 st in the evening fever (37.8), headache, nausea. Once torn, nausea passed. At night, drank "Antigrippin. (I thought that I ARI) 22 th, the morning temperature was sleeping, abdominal pain, were cutting-burning, and attacks, severe headache. Began to take: "Omez" morning; "Maalox", "Mezim and Detsitel" before meals 3 times a day. Villages on the appropriate diet. By the evening of 22-th temperature 37,00 23rd temperature and headaches are gone. Now, with the treatment which I have described the pain is not severe, but constant, and seizures occur cutting-burning pain on the left side or around the intestines. Belching preserved. Stool normal. In principle, it became a little easier, but nothing more. I forgot to write the last time that I bend the neck of the gallbladder. Many thanks in advance, waiting for your response! Sincerely, Elena

Answer: The questions were: 1) can now be treated independently for the first phase (pariet, Maalox, ditsetal, mezim) to bring myself up, or 2) must be again tested for the presence of helicobacter and Giardiasis? ? 3) whether there is a less expensive analog parieta replaces whether it Omez? Answers: 1) If the temperature is normal, abdomen soft, paroxysmal pain, and not permanent, it can be treated with diet alone, and you mentioned drugs. 2) no. 3) omez perfect substitute (20 mg x 2 pp.).

Question: Dear doctor! Thank you for your reply! If you can, please indicate whether there is still my husband suspected hepatitis? It is really strange indicators for low-intensity pankreotita caused by cholelithiasis (I wrote the cut-you tests on the stones in the gallbladder and the feasibility of its removal). Please! As we prepare for surgery?? He has a very poor analysis and strong meteriozm. Can poprinimat geptral?, Creon? or (as recommended these parts gastrology-Ursofalk? Does it make sense to take him only a month? "The operation will be done in a month. What about now?" After such a clinic and performance analysis is necessary to do something to prepare for it, I beg you, help us . Unfortunately, in Kiev is very difficult to find a good professional attitude rather formal. Thank you very much for your trouble. Inga

Answer: Continuing http://doktor. ru/qa/15613/qa. html? id = 90201. In Kiev, there are excellent specialists, in this you are wrong. Another thing is that you do not trust anyone. Tests are not bad. Additional special training is not necessary. Analysis of GGTP and ALT repeat, if the numbers do not increase by 2-3 times, then there is nothing terrible.

Question: In addition to the question http://doktor. ru/qa/12931/qa. html? id = 89096. At night, no pain, no-spa does not help (actually any medications do not help), during physical exertion pain virtually disappear or distracted simply cease to notice them. Thanks in advance.

Answer: So, eat rationally, physical work and distract from unpleasant sensations. With this disease it would have been different, as well – a functional disorder.

Question: For several days, worried about feeling pressure in the lower left ribs. Moreover, if I look at them, I see as a protrusion of the chest in this place more than the right. And if I stand almost no concern discomfort, the same lying on his back. More worried about in the morning, if prvy to lie on his side and if hungry. Other symptoms: belching food or air, and sometimes an unpleasant taste (not bitter, not sour – just weird), white patches on the tongue, the chair is not always issued, and sometimes several times a day, unstable in general, potashnivaet sometimes, rumbling in the stomach is rarely, swelling, too. After eating, it becomes easier, appetite is normal and common condition is normal. Tests (blood, feces, urine) in normal, ultrasound showed only steatosis and bending gall, no stones, fibrogastroduodenoscopy – chronic superficial gastritis. The diagnosis of the doctor: chronic colitis, chronic cholecystitis, chronic pancreatitis. From pancreatitis treated with (omez, amoxicillin, Almagel, an antibiotic, pancreatin) – nocturnal symptoms were nausea, from hepatotoxicity (Liv 52, gepabene, hilak forte), too, but then came a feeling in the left hypochondrium. Do you think that this might be? I suppose colitis, but wondering why the left ribs stick out? What could be the cause? Can back (spine) to give such symptoms as a reaction on the part of the digestive tract, because all the abdominal organs in accordance with surveys of apparently healthy?

Answer: 26 years. Suppose somatoform neurosis. Diseases diagnoses that you reward, incurable, and in this age of men at the same time do not occur.