Irritable bowel syndrome, last for long time And withdrawal of medication result in return of symptoms Therefore, I prefer mebeverine which can be used for long periods - in years Even amitriptyline can be used in low dose, but it's less effective as compared to mebeverine Alternative being Escitalopram
TWO TO THREE MONTHS.. IF THERE IS NO SIDE EFFECTS.. THEN DOSE CAN BE ADJUSTED AS FAR REQUIREMENT..
As par researches S.Serotonin is responsible for IBS. Check S.Serotonin level at 12.30 pm. And proceed accordingly.
Obviously till symptoms/ requirements Two months in routine
At least 2to3 months and withdrawal gradually
Give at least for 2to 3 month Then see the drug level If high withdraw gradually
I am agree with@Dr. Vipin Bihari Jain Sir, And@Dr. Shivraj Agarwal Sir.
2 or 3 month
Cases that would interest you
- Login to View the image
18 yrs male pain lower abd. and both iliac fossa since 1 month taking ceftriaxone 1 gm IV BD, ornof tab,pan 40 tramadol , albendazole, suspension sucral,syr neeri,cystone,veltam 0.4 no benefit no RIF tenderness suggest ur opinions plzDr. Satish Kumar3 Likes19 Answers
- Login to View the image
recurrent . heals by steroid but reoccurring . surprisingly no pain . what are D/D ? please helpDr. Diganta Das6 Likes51 Answers
- Login to View the image
Friends today I am discussing about a problem facing by females known as Painful intercourse (dyspareunia). Painful intercourse can occur for reasons that range from structural problems to psychological concerns. Many women have painful intercourse at some point in their lives. The medical term for painful intercourse is dyspareunia (dis-puh-ROO-nee-uh), defined as persistent or recurrent genital pain that occurs just before, during or after intercourse. Talk to your doctor if you're having painful intercourse. Treatments focus on the cause, and can help eliminate or lessen this common problem. Symptoms If you have painful intercourse, you might feel: Pain only at sexual entry (penetration) Pain with every penetration, including putting in a tampon Deep pain during thrusting Burning pain or aching pain Throbbing pain, lasting hours after intercourse When to see a doctor If you have recurrent pain during sex, talk to your doctor. Treating the problem can help your sex life, your emotional intimacy and your self-image. Causes Physical causes of painful intercourse differ, depending on whether the pain occurs at entry or with deep thrusting. Emotional factors might be associated with many types of painful intercourse. Entry pain Pain during penetration might be associated with a range of factors, including: Not enough lubrication. This is often the result of not enough foreplay. A drop in estrogen levels after menopause or childbirth or during breast-feeding also can be a cause. Certain medications are known to affect sexual desire or arousal, which can decrease lubrication and make sex painful. These include antidepressants, high blood pressure medications, sedatives, antihistamines and certain birth control pills. Injury, trauma or irritation. This includes injury or irritation from an accident, pelvic surgery, female circumcision or a cut made during childbirth to enlarge the birth canal (episiotomy). Inflammation, infection or skin disorder. An infection in your genital area or urinary tract can cause painful intercourse. Eczema or other skin problems in your genital area also can be the problem. Vaginismus. These involuntary spasms of the muscles of the vaginal wall can make penetration painful. Congenital abnormality. A problem present at birth, such as the absence of a fully formed vagina (vaginal agenesis) or development of a membrane that blocks the vaginal opening (imperforate hymen), could cause dyspareunia. Deep pain Deep pain usually occurs with deep penetration. It might be worse in certain positions. Causes include: Certain illnesses and conditions. The list includes endometriosis, pelvic inflammatory disease, uterine prolapse, retroverted uterus, uterine fibroids, cystitis, irritable bowel syndrome, hemorrhoids and ovarian cysts. Surgeries or medical treatments. Scarring from pelvic surgery, including hysterectomy, can cause painful intercourse. Medical treatments for cancer, such as radiation and chemotherapy, can cause changes that make sex painful. Emotional factors Emotions are deeply intertwined with sexual activity, so they might play a role in sexual pain. Emotional factors include: Psychological issues. Anxiety, depression, concerns about your physical appearance, fear of intimacy or relationship problems can contribute to a low level of arousal and a resulting discomfort or pain. Stress. Your pelvic floor muscles tend to tighten in response to stress in your life. This can contribute to pain during intercourse. History of sexual abuse. Not every woman with dyspareunia has a history of sexual abuse, but if you have been abused, it can play a role. It can be difficult to tell whether emotional factors are associated with dyspareunia. Initial pain can lead to fear of recurring pain, making it difficult to relax, which can lead to more pain. You might start avoiding sexual intercourse if you associate it with the pain. Here are a few effective homeopathic treatments that can help get rid of pain during intercourse: Sepia and lycopodium: It is the top homeopathic medicine for vaginal dryness. Sepia and lycopodium are evaluated as the best cures. Sepia is suggested where vaginal dryness occurs along with itching. Pain from vaginal dryness during intercourse also calls for the use of sepia. Bellis perennis: This medicine helps cure the wounded sensation in the vagina, if intercourse is obstructed due to pain and spasms. Cactus grandiflora: This is used when the vagina shuts close during the act of intercourse. Intercourse might be simpler just before periods. Coffea: This may be used when, if the vulva and vagina are oversensitive and you feel heat as well as itchiness. Cuprum: This medicine is prescribed for cramping in the vagina and the legs, during intercourse. Ferrum: When your vagina feels dry and aches, this medicine may be prescribed. Gelsemium: This medicine is used to treat any tension preceding intercourse. These symptoms usually show an inclination towards vaginismus. Lycopodium: Dry, smoldering vaginal pain during and after intercourse may be treated with this medicine. The patient may have varicose veins in the vulva. Platina: It is consumed during solid sexual desire. It becomes hard to have sex as the vulva is to a great degree oversensitive. Intercourse is difficult and causes wounded sensation. Rhus tox: Soreness during and after intercourse, regularly joined by physical fretfulness may be treated with this medicine. Staphisagria: It is a good solution for pain after loss of virginity or in occurrences of assault or rape. Thuja: This is ideally taken when the vagina is oversensitive, making intercourse painful and troublesome. Pains include smoldering, soreness and a feeling of being wounded. It may be useful where there is a medical history of sexually transmitted diseases (STDs) as well. Argentum nitricum and sepia: These are the best homeopathic medications for vaginal dryness causing bleeding after intercourse. There are numerous homeopathic solutions for vaginal dryness catering to bleeding during intercourse. The most well known among these are argentum nitricum and sepia. Argentum nitricum is the most reasonable among homeopathic pharmaceuticals for vaginal dryness in situations where sex is painful and bleeding takes after.Dr. Rajesh Gupta9 Likes20 Answers
- Login to View the image
DX? scattered blackish spots on both sides of arms since 2 yrs. .used steroids but temporary supressed. now awakened in strong strength. on the back also. no itching. feels irritable when see the pustules and try to pick by nails. concomitants. lumbago after sex . alternate with fatigue. . these lesions start appearing as pustules then he pricks (habit) leaves black scar. shopkeeper. 29 yr old male (married) SUPER HOT patient. can't tolerate heat in any form. Cold in general ameliorate. . Constitution flabby, sunken eyes. Desire fish, meat all the nonveg items. aversion spinach, sweets. urine normal stool constipation alternates with diarrhoea. . Dreams of accidents, imaginational world living in. . sleep sound. no any history of medical and surgical illness before. .No Addiction mentals . Easily gets angry. wants to throw objects avilable in hand but then suddenly thinks there will be himselfs loss by breaking object. insult intolerable. wants live in imaginational world always. fear to live or accept reality. what's the remedy? possible AYUSH MANAGEMENT?Dr. Akshay Ingole2 Likes16 Answers
- Login to View the image
Common causes of abdominal pain Abdomen pain or abdominal pain is usually experienced in the area between the chest and the stomach. This kind of pain usually comes as a dull cramp that also produces shooting stabs of pains intermittently, or it may be a localised pain in one side of the stomach. This may also be accompanied by inflammation, and other diseases related to organs like intestines, kidneys, pancreas, liver, spleen and stomach. So what are the causes of stomach or abdomen pain? Read on to find out: Food Poisoning: Food poisoning can be caused due to dirty water or contaminated food. This can give rise to various infections as well as conditions like traveller's diarrhoea or loose motions. Gastro Intestinal Conditions: GERD or gastroesophaegal reflux disease and gastroenteritis, among various others can also lead to abdomen pain as a symptom along with severe acidity and nausea. Irritable bowel syndrome is another major ailment which can leave you with persistent abdominal pain. Generalised Pain: This kind of pain occurs in the overall area all around the stomach and may point at the presence of conditions like Crohn's Disease, a traumatic injury, appendicitis, flu, or even a urinary tract infection. Further, when the gas settles and tightens the stomach due to the inability to pass a motion on a normal, regular basis, this may be termed as constipation. This also leads to abdomen pain. Localised Lower Abdomen Pain: Pain that is found specifically in the lower area of the abdomen can be caused due to appendicitis, obstruction or blockage in the intestine or colon, and other ailments. This pain can also be accompanied by nausea and vomiting. Localised Upper Abdomen Pain: This kind of pain may emanate due to the presence of gallstones, liver inflammation or hepatitis, pneumonia, or even in the middle of a heart attack. Localised Centre Abdomen Pain: Pain in the centre part of the stomach or abdomen may be caused due to gastroenteritis, an injury or even the accumulation of waste products in the body, otherwise known as uraemia. Abdomen Pain and Women: For women, such localised pain may be caused due to pelvic inflammatory disease, urinary tract infection, endometriosis, ectopic pregnancy, menstrual cramps which are also called dysmenorrhoea, and fibroids. Miscarriages can also cause pain in this part of the abdomen, for women. Renal Stones: Renal stones or stone in kidney is one of the most common cause of abdomen pain. The pain caused by kidney stone is such that it can make a patient roll in bed and this pain may radiate to toward the groin as well. Persistent pain and nausea that come with vomiting and finally give rise to blood in the vomit or stool should be checked by the doctor immediately, so as to rule out any serious ailment. Imaging tests, ultrasound and an X-Ray can help in diagnosis.Dr. Dinesh Agarwal16 Likes21 Answers