Hello Sir, I am 34, male, height 5.5 and weight 55kg. Suffering from Very very excessive flatulence since two years old patient(Slow Gas Leak with out knowing). It is affecting my work in confined walls and social life, working as a system engineer. It is totally disabling me and very depressed(Shifted my work station to an isolated place in office). Additionally last three months loose and watery bowl movements twice a day. But in this two years, some two to three months, I lived very happily with out any flatulence. Endoscopy with biopsy, Colonoscopy, CT scan, Blood test are normal.

High Flatulence: After 1-2 hours of food, increases in afternoon and night.
Stool: Soft and watery
Bowl movement : Twice (Urge after food)

Diet: Hotel Food (Idly, dosa, Meals)
Restriction: Diary, Caffeine, Spicy, and Gassy foods
Better: Very little significant betterment with home made food and complete rest (for a Month)
Past Food habit: Excessive Tea and smoking. No Alcohol.

Other complaints: Frequent belching, Mild Burning sensation in upper Stomach, Skin Itchiness, nervousness, emotional.

Surgery: Inguinal hernia at age 33.
Past Treatment: Chest Tuber closis at age 16, Migraine/Headache treatment for two years old patientat age 25.

Past Medication:

Librax, VSL3, Pan20 for two weeks - No difference (made worse)
Riffagut, Pan20,Nextio5mg for two weeks - No difference
Econorm, Mebeverine and Hifibre ispaghula husk for two weeks - No difference (made worse)

Current Medication:
Riffagut400 1-0-1
Providac (LACTOBACILLUS ACIDOPHILUS) 1-0-1,
Histac 0-0-1
enteric-coated 40 mg pantoprazole 1-0-0,
Mebeverine 1-0-1 - Significant improvement (Volume of gas not reduced, Smell changed and significantly reduced).

Past one week I am under this medication feeling better up to 12.00 p.m and flatulence increases as day progress. Tried and tiered of using ginger, fennel, papaya, Pineapple, cumin, figs and buttermilk just increases no of bowl movements no comparative betterment. But to my surprise with out any specific medication , for some two to three months I was fully flatulence free.

Kindly help me.

Regards,
Ravi.