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Dr. Andrew Rynne

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Getting stomachache and frequent bowel movement. On medication for IBS. Proper treatment?

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Dr. Charles S Narasi

Gastroenterologist

Practicing since :1962

Answered : 693 Questions

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Posted on Sat, 22 Dec 2012 in Digestion and Bowels
Question: For years I have always had a sensitive tummy and for a while (on and off) I have had bloated tummy, severe wind both ends, tummy cramps (upper & lower)frequent visits to the loo as soon as I wake up I go. Sometimes I was going 3 times in an hour, loose stools. About 20 yrs ago I saw a gastroenterologist as I always had an urgency to go to the toilet and if I had to go I did anywhere, had camera test and cannot even remember results as so long ago but presume nothing. Over a week ago I went to my doc who said it was very much like IBS (which I had thought) and to increase my omrepazole I took when I needed for occasional indigestion/acid reflux as I also occasionally have a feeling of a tight band around chest (I take 4 other tabs a day for previous probs, high bp, statin, clopidogrel) and see how I went for a couple of weeks. That very morning (thurs 9 days ago) I visited doc for the first time I had diarrehea and every morning since loose stools. On tuesday of this week I felt awful, had to come home from work - next morning I was slightly sick and had awful nausea so went to docs again. He examined me, had blood tests and now Im waiting for a scan to check gall bladder etc. I had previously been eating a lot of rubbish for a couple of weeks, cakes, choc you name it, had a real blow out from my normal weight watchers diet and wondering if all this has stemmed from that. Since feeling like this I have been eating much healthier and a lot less. I have been off work since last visit to doc wednesday and have felt better till today but no diarreha, just feel so rubbish.
Can you help please?
Im 5 ft 4, 14 stone
Good general health till now apart from hole in heart found after 3 TIA's 2004. Hole now sealed.
doctor
Answered by Dr. Charles S Narasi 1 hour later
Hello, XXXXXXX,
I can understand your frustration about not getting
better. From the description of your symtoms it
does fit the criteria for Irritable Bowel Syndrome
of diarrhea type. But we always have to make sure
we are not missing anything that may be the
underlying cause.
I will list some of those and you can find out if you
have been tested for these.
Lactose Intolerance-Need breath test to confirm.
Celiac Disease-Special blood tests & may be biopsy.
Eosinophilic gastroenteritis-Need Biopsy to confirm.
Drug related diarrhea-from side effects.
Crohn's disease-Small bowel x-rays, endoscopy, biopsy.
Collagenous colitis (Microscopic colitis)-need scope & Biopsy.
Other- parasites, Giardiasis,Cryptococcus,Listeria,Campylobacter,
Enterococcus, C.Difficile -Stool & Blood studies.
If all of them have been eliminated, you can be sure of the IBS
diagnosis.
Omeprazole is good for GERD and acid control, does not help IBS.
I am not sure if you are taking any probiotic supplements. They
are helpful, taken daily. Bloating and gas can improve with taking
peppermint oil .Avoiding carbonated drinks cuts down on gas.
I hope you can take all this to your doctor and discuss with him
or her.
Latest treatment is the cyclic use of a non-systemic antibiotic
called Rifaximin 7 days a month.
I wish you well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Charles S Narasi 1 hour later
Many thanks for your reply.
I have recently started taking a probiotic drink daily - I did try peppermint capsules but It gave me heartburn therefore stopped taking it. I have also limited carbonated drinks as I did drink a lot of these, I now drink flavoured water e.g squashes.

It is very frustrating feeling like this and not knowing what is causing it
- I do tend to worry but it is the same for everyone I guess. I have a good general practitioner though so hopefully he will get me sorted soon.

Thanks again.
XXXXXXX
doctor
Answered by Dr. Charles S Narasi 22 minutes later
Hello, XXXXXXX,
I am glad that you have changed your dietary habits.
Relaxation methods using yoga,mediation, tapes etc.
will be helpful in relieving stress. So, does walks !
I am sur your doctor can go over the the list of things
I mentioned and see if they have all been ruled out.
Wishing you happy holidays.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Charles S Narasi 42 hours later
Hi

Sorry to bother you again - I attempted to go into work today as I do not like having time off. I didnt last long as I kept feeling sick and was told to come home.
The nausea and loose stools only seems to bemainly in the morning and as the day goes on I eat a little and feel a little better but certainly not 100%. My family keep telling me to go back to the doctor as I am no better but I am not sure what else he could do (I last saw him wednesday) although Im not sure why he didnt request a stool sample to test (?). As previously stated I am waiting for a scan so Im just wondering if I have to just wait for that. I have heard nothing yet and nothing from the doc regarding the blood tests taken last wednesday (he said he would be in touch if anything abnormal).
Should I just put up with this and try and be patient ??. I will have to go back to see the doc to sign me off work. Im worrying myself sick there is something seriously wrong.

Any advice please?
doctor
Answered by Dr. Charles S Narasi 10 minutes later
Hi , XXXXXXX,
Sorry to hear that you are sick again. I am
glad that you had blood tests done. Stool
examination for blood, presence of fat,
and also culturing the stool for bacteria,
testing for C.Diff Toxins is important.
For the time being, just stay on a bland diet
and drink XXXXXXX juice and water.
Call your doctor and ask him about all the tests
he did and the results. You need an answer.
Wish you well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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