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IBS, frequent bowel movements, taking Normaxin, Magaldrate, Ranitidine and Dompendone. Is this the right medicine?

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Gastroenterologist
Practicing since : 2000
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ibsi am suffering from ibs for last 5 years. mainly diarria dominant. my bowels in the morning are not clear and full. i fill to go to bowel every time. i go 3 to 4 times a day. i was taking livazeo 25 for last one year alongwith fobolite isabgol. it helped me to some extent but not full. now the dox has advised me normaxin rt twice and XXXXXXX (magaldrate 400, ranitidine 150, dompendone 20) tab twice daily. after taking the medicines for two days i got slightly loose motion in the morning. whether it is the right medicine should i continue or not. whenever i go outside my problem increases. plz advice me alternative as i have to go outside. i would like to mention here that i have done colonoscopy and othr tests and everything is normal.
Posted Tue, 8 May 2012 in Digestion and Bowels
Follow-up: IBS, frequent bowel movements, taking Normaxin, Magaldrate, Ranitidine and Dompendone. Is this the right medicine? 18 minutes later
i am continuing fabolite isabgol. i m also taking stalopam 10 for last one year
 
 
Answered by Dr. Poorna Chandra K.S 5 hours later
Hi XXXXXXX
Thanks for posting your query.
Today’s research indicates that a move toward individualizing the dosing of prescription agents is warranted and it can happen only after physical consultation. However, diarrhoea predominant IBS is usually managed with fibre, and some antispasmodics like normaxin or mebeverine. However, these drugs can only be obtained on prescription from your treating physician after a thorough evaluation has been done.
It is also important that your physician rule out some diseases which are commonly mistaken for IBS. These include celiac disease (wheat allergy), bacterial overgrowth in the small bowel and microscopic colitis. Please check with your physician if he/she has ruled these conditions out.
As such, IBS is a functional disease which is usually causes a lot of discomfort to patients. Pain or discomfort is a predominant symptom which gets relieved after a bowel movement. It generally follows an indolent course without any sudden changes in its character.
As I believe the more information a person gives the better is the doctor reply. Thus it improves satisfaction levels of the both. Hence I would like to ask you the following questions
•     Your age
•     Other symptoms such as nausea, vomiting, belching
•     Other medical conditions that you have/had (past and present)

I would also request you to upload all your reports so that we can evaluate you better.
I hope I answered your query.
Regards
Dr XXXXXXX
Above answer was peer-reviewed by
 
Follow-up: IBS, frequent bowel movements, taking Normaxin, Magaldrate, Ranitidine and Dompendone. Is this the right medicine? 2 hours later
my age is
33 years. no other such symptoms exists. i am also.suffering from high blood pressure for which i am taking revas h and nebicard sm daily. again my bowel movement automatically increases whenever i go travelling. and at that time i take antibiotics and loperamide to control my bowel movement. my doctor has advised me to stop milk and milk products completely which i am following. i would like to mention here that when i was 22 yrs old i suffered from severe jaundice. it was only after that my problem get started. all my reports are too old. i am ready to undetake any tests u suggest me and upload the reports. thanking you XXXXXXX
Follow-up: IBS, frequent bowel movements, taking Normaxin, Magaldrate, Ranitidine and Dompendone. Is this the right medicine? 2 hours later
i would mention here that i donot fee any pain in abdomen but i fill fullness of stomatch. urge to go for laterene and during anxiety mainly when i m outside urgent need to pass stool. so urgent that i feel it will come out in pant itself. this is the serious problem with me. again when i m at home my stool movements are generally normal and no such urgency is feeled. i m in doubt whether i m suffering frm ibs or anxiety problem. plz help me and suggest me any medicines when i m outside as i have to go to outside for a week.
 
 
Answered by Dr. Poorna Chandra K.S 3 hours later
Hi and thanks for the clarification

Historical information that you are more affected when you are outside and that anxiety worsens it suggest a functional disorder. However urgency can also be a manifestation of rectal inflammation.
You should go for stool routine examinations (on three days), Serum CRP (Quantitative), complete blood count and Fasting TSH tests.

Meanwhile as adviced give up milk, take Zinc (Cobadex CZS), Isapghul husk - 3 tsp and some probiotics, In case of emergencies you could use loperamide. Rest of the managemant would be based on the test reports.

Hope I have answered all your queries. You are welcome to ask any follow-up questions you might have.

Please accept the answer if you do not have any more questions.

Regards,

Dr XXXXXXX
Above answer was peer-reviewed by
 
Follow-up: IBS, frequent bowel movements, taking Normaxin, Magaldrate, Ranitidine and Dompendone. Is this the right medicine? 9 days later
i have uploaded my reports as advised by you. (except for the stool report). i was unable to have stool test. i have started to take zinc tablets as advised by you. as regarding stool test i have done stool test earlier and the report was normal (only undigested food particles are found). i am unable to get that report. kindly advise me medicines for treatment.
 
 
Answered by Dr. Poorna Chandra K.S 2 days later
Hi and thanks for the follow up information.

All the test results are normal but I would need the stool routine examination before advising as further. So please repeat a stool test and upload the report so that I can advise you better.

Regards.
Dr XXXXXXX
Above answer was peer-reviewed by
 
Follow-up: IBS, frequent bowel movements, taking Normaxin, Magaldrate, Ranitidine and Dompendone. Is this the right medicine? 10 hours later
sorry for the delay in submitting the reports as i was out of station for a week. i would also like to share my history of tour for further information. during the tour i have taken the following medicines to avoid my urgency problem.
1 zenflox oz two times daily.
2 loperamide three times daily.
also continued my regular medicines as below
3 levazeo 25 three tims daily.
4 becelac forte one daily.
5 fabolite isabgol three teaspoon at night
immediately after the tour i stopped 1 and 2.
my present situation is i m having slightly loose motion 1 to 2 times daily. during the tour i was fine except for two occassions when i felt the urgency need. my question is whether my medicines during the tour was right or should i try some other medicines as may advise by you. and abt my current situation is it due to side effects of medicines taken during the tour which was about seven days. kindly advise me. i am confused.

Follow-up: IBS, frequent bowel movements, taking Normaxin, Magaldrate, Ranitidine and Dompendone. Is this the right medicine? 7 hours later
i am uploaded my stool reports. kindly guide me.
 
 
Answered by Dr. Poorna Chandra K.S 29 hours later
Hi and thanks for the feedback,

I would urge you from not taking too frequent antibiotics as they themselves acn cause "persistent diarrhoea". The urgency at stools is not a feature of IBS and usally is a fetaure of proctitis or inflammation of the rectum. Hence I would suggest you to undergo a colonoscopy and rectal as well as colonic and terminal ileal biopsy.

Meanwhile be on Isabghul, zinc - vit B12-folic acid supplements, probiotics and absteinence from milk. Loperamide or amitryptilline may be used on an sos basis till the biopsy reports.

Wishing you good health.

Regards
Dr XXXXXXX
Above answer was peer-reviewed by
 
Follow-up: IBS, frequent bowel movements, taking Normaxin, Magaldrate, Ranitidine and Dompendone. Is this the right medicine? 6 hours later
thanks for helping me. should i continue levazeo 25 or discontinue the medicine. i would like to mention that this medicine is helping me to some extent.
 
 
Answered by Dr. Poorna Chandra K.S 2 hours later
Hi XXXXXXX

Thanks for writing back.

Lavazeo is Levosulpiride and is a prokinetic i.e. it increases motility and is more specific to stomach and esophagus. It has no actions on the intestines. It helps in cases of bloating secondary to poor gastric motility or gastritis and in reflux disease.

In your case bloating may be secondary to more generalised disorder, which is likely to involve the intestines also as you have diarrhoea also.

Further in some people Lavazeo causes sedations, dystonia or muscle spasms, loss of libido. So depending on the benefit you are deriving, you decide on the need to continue with the medication.

Hope, this helps. Please accept my answer in case you do not have follow up queries.

Regards.
Dr XXXXXXX
Above answer was peer-reviewed by
 
Follow-up: IBS, frequent bowel movements, taking Normaxin, Magaldrate, Ranitidine and Dompendone. Is this the right medicine? 9 hours later
Thanks for your reply. But i am taking levazeo for last one year. the benefit i got from the medicine is that earlier i used to go to leterene 3 to 4 times daily. but now it has decreased to 2 times daily and again i got formed bowel movement. But i am also facing some side effects of levazeo mainly decrease in sexual desire and dysfunction etc. which is creating problem. I am affraid of stopping the medicines as once i have tried to stop but my going to toilet habbits increased and my doctor advised me to restart the medicine (although i didnot told him the side effects problem). Kindly advise me should i stop totally or should i continue or should i take any other medicine (kindly advise). Again i would like to XXXXXXX you for further treatment as advised by you (colonoscopy and biopsy). Kindly give the detailed address for a appointment. In the mean time kindly advise me alternate medicine for levazeo or as directed by you. Thanking you.
Follow-up: IBS, frequent bowel movements, taking Normaxin, Magaldrate, Ranitidine and Dompendone. Is this the right medicine? 7 minutes later
i could not find amitryptilline. i got amitryptiline an antidepressant. if the medicines are same should i take it daily or as and when required. kindly advise me. i am taking stalopam plus 10 daily. should i stop it before starting amitryptiline.
 
 
Answered by Dr. Poorna Chandra K.S 2 hours later
Hi,

I should warn you in the beginning that these medicines are not available without a prescription and this drug will have to prescribed to you in the correct dose by a doctor.

So I urge you to visit your treating doctor to get it prescribed.

Sorry for the spelling mistake. Amitryptiline has anticholinergic property and hence slows down intestinal motility there by reducing the stool frequency. It is also used in depression as it elevates the mood. Some drowsiness may occur but this is negligible at the dose required to obtain the desired effect in you. These medicines can be taken on a continious basis for the initial period of 1 month and then they can be made to a on demand basis. This will be decided by your doctor again.

Before deciding on starting this medicine you should discuss with your treating doctor.

The information provided here is only for educational purposes only. It is never a substitute for a physical consultation.

Hope I have answered all your queries. Please accept my answer if you do not have any more queries.

Regards
Dr XXXXXXX
Above answer was peer-reviewed by
 
Follow-up: IBS, frequent bowel movements, taking Normaxin, Magaldrate, Ranitidine and Dompendone. Is this the right medicine? 11 hours later
what abt levazeo. should i continue alongwith with ur medicines or not. kindly guide me. after that i will consult with my doc. thanks and i think this is my last question. thanks for u help.
 
 
Answered by Dr. Poorna Chandra K.S 16 hours later
Hi XXXXXXX

Thanks for writing back. As written earlier

Lavazeo is Levosulpiride and is a prokinetic i.e. it increases motility and is more specific to stomach and esophagus. It has no actions on the intestines. It helps in cases of bloating secondary to poor gastric motility or gastritis and in reflux disease.

In your case bloating may be secondary to more generalised disorder, which is likely to involve the intestines also as you have diarrhoea also.

Further in some people Lavazeo causes sedations, dystonia or muscle spasms, loss of libido. So depending on the benefit you are deriving, you decide on the need to continue with the medication.

Hope, this helps.
Regards.
Dr XXXXXXX
Above answer was peer-reviewed by
 
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