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Suggest Treatment For Symptoms Of Irritable Bowel Syndrome

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Posted on Thu, 16 Feb 2017
Question: Hi!

Male 24 have been diagnosed with IBS by 2 gastroenterologists and 1 GP .

Symptoms following consumption of street food:

January 2016 - April 2016 - Unformed mushy stool 2times(rarely 3 times) with severe burning urgency but no pain . Pain when pressed in right side colon area below ribs . Undigested food particles found in stool . Lost a lot of weight . Left gym .

April 2016-december 2016 : right sided inflammation feeling and hardness. Strict diet changes (oats, dal and fish and rice) . Supplemented with l glutamine and it helped form the stool . I started having normal stool but yellow and floating . Then burning mushy and bulky stool once every 7-8 days .
From September I started dosing rabeprazole and it helped . I have no symptoms for every 20-30 days . But I cannot stay on PPis for long . It has been 5 months.

Tests : stool routine , occult blood , crp , CBC , CEA , celiac , LFT , ultrasonography , thyroid , lipid profile , lipase amylase , urea creatinine , sgpt fbs

Findings : all normal except grade 1 fatty liver , creatinine slightly higher than upper limit and "indirect bilirubin" is slightly elevated . Stool reaction acidic .

Medicines : providac(didn't help) , gut ok / velgut(helped) , zanocin , rabeprazole(HELPS) , rifagut ., Vitamin b , c and e .

Every time I try to go off rabeprazole , symptoms come back . It has been 14 months . I feel fit . But I want to know if I can consider bile acid malabsorption as symptoms sound similar and I have found patients suffering same symptoms and talked to them . Can I try cholestyramine XXXXXXX ? Please reply with necessary details .
doctor
Answered by Dr. Abhijit Deshmukh (10 hours later)
Brief Answer:
Hi

Detailed Answer:
Hello
Welcome to HCM.
Thank you for your query.
I understand your concern.
Your history does to some extent fit in irritable bowel syndrome.
However worthwhile getting and colonoscopy and if needed an endoscopy done too look for any bowel inflammation or swelling.
Also worthwhile getting a test called fecal calprotectin after consulting your physician. If these reports are already dons and normal no need to repeat them.
Also lifestyle modification is of utmost improve
Ensure adequate dietary intake of curd buttermilk.
Go for regular brisk walk
Avoid sleeping two hours after meals
Ensure proper eating and sleeping time.
Avoid stress if any
Sleep adequate for 7to 8 hours a day
All this will help protect reduce the sensitivity of your intestines.
In addition if the symptoms are still persistent then worthwhile adding a low dose of drug like amytryptiline after consulting your physician to reduce the irritability of intestine
Hope this answers your questions.
Happy to help.
Wish you a speedy recovery.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Abhijit Deshmukh (59 minutes later)
I have done crp and ESR tests as I have typed. . Aren't those inflammation markers ? My urgencies come in cycles . it used to be every 7 days . now its every 24 days . However I have not had any issues in the last 30 days (I always carry loperemide just in case...maybe use 1-2 once per week) .My only help is rabeprazole . That's the only thing that helped me get normal bowel movements . I have joined the gym and it has helped somewhat .

Also please refer to the bile acid malabsorption part . Is a trial of cholestyramine safe ?
doctor
Answered by Dr. Abhijit Deshmukh (7 hours later)
Brief Answer:
Hi

Detailed Answer:
Thank you for your query.
Well crp and esr being normal is good but still does not completely rule out any inflammatory pathology of intestine. It's good to know that you are better can try and reduce the dose of rabeprazole to 10mg and see how you feel.
Regarding empirical use of cholestyramine I don't think so to use it, in that case rabeprazole is a better alternative. Do continue your exercises too.
Best wishes.
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
Dr.
Dr. Abhijit Deshmukh

Gastroenterologist

Practicing since :2001

Answered : 597 Questions

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Suggest Treatment For Symptoms Of Irritable Bowel Syndrome

Brief Answer: Hi Detailed Answer: Hello Welcome to HCM. Thank you for your query. I understand your concern. Your history does to some extent fit in irritable bowel syndrome. However worthwhile getting and colonoscopy and if needed an endoscopy done too look for any bowel inflammation or swelling. Also worthwhile getting a test called fecal calprotectin after consulting your physician. If these reports are already dons and normal no need to repeat them. Also lifestyle modification is of utmost improve Ensure adequate dietary intake of curd buttermilk. Go for regular brisk walk Avoid sleeping two hours after meals Ensure proper eating and sleeping time. Avoid stress if any Sleep adequate for 7to 8 hours a day All this will help protect reduce the sensitivity of your intestines. In addition if the symptoms are still persistent then worthwhile adding a low dose of drug like amytryptiline after consulting your physician to reduce the irritability of intestine Hope this answers your questions. Happy to help. Wish you a speedy recovery.