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Required advise on the condition, IBS, celiac disease, tropical sprue.

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Posted on Wed, 3 Oct 2012
Question: I would like your advice on my condition. Plesae review the details in the attached June-2012-Ltr.pdf and let me know what you think.
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Answered by Dr. Dinesh Kumar Singal (4 hours later)
Dear XXXXXXX

Thanks for asking for an opinion regarding your condition.

I can not see anything of significance in attached reports. I understand you have been living in the US for last 20 years. It is not unusual to get gut infections on visiting India after such a long time.

Your symptoms are consistent with IBS / functional bowel disease which might have been the result of or might have been precipitated by gut infection. There are other possibilities as well namely: lactose intolerance, gluten intolerance (celiac disease), small intestinal bacterial overgrowth, tropical sprue etc.

You should stop taking milk and milk products. Curd and butter milk are allowed. You should also avoid juices or excess of fruits.

For gluten intolerance there are blood tests available, which your doctor can order for you. Alternatively you can stop gluten diet for few weeks and see.

Small intestinal bacterial overgrowth is difficult to investigate, but a short course of antibiotics can help if this is there. Tropical sprue is also treated with a course of antibiotics.

Hope these suggestions help you.

Regards,

Dr Dinesh Singal

Above answer was peer-reviewed by : Dr. Aparna Kohli
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Follow up: Dr. Dinesh Kumar Singal (37 hours later)
Hello Dr Singhal,

I was glad to see this response from you, particularly as you are from India. I am hoping that you can help me with the following specific questions:

- What do you think about the supplements/medicine that my doctor has given me. Do you think they will bring any benefits? Some doctors here sometimes just like to give medicine. Are there any that I shouldn't take?

- Do you know of any Indian nature-based things that might help me. For example, the Sweetish Bitter I am taking contains Indian Gooseberry - Amala - see WWW.WWWW.WW

- I have been spending a lot of money on going to doctors. I have had two colonoscopies done, and several tests. I am just not getting anywhere. Any suggestions that you have? Any other approaches? Is it possible that I could get better treatment in India? Any Yoga and Ayurveda based approaches?

Thank you.
XXXXXXX
doctor
Answered by Dr. Dinesh Kumar Singal (5 hours later)
Dear XXXXXXX

Most of the supplements you have been prescribed are not used in India and neither am I aware of these. Apart from probiotics which are certainly helpful, I don’t think these supplements will be of any use. Diarrhea is a common side effect of many medications; I will not be surprised if some of the supplements you are taking may also be contributing to your problem.

I am not aware of any Indian nature based things.

I am glad that you have had a normal colonoscopy that essentially rules out many organic causes of your symptoms. I think US doctors are good, and there is no need to come to India for this purpose. In my opinion, you should continue with probiotics. Take a 6 weeks course of gut specific antibiotic if your doctor can prescribe it. Also, avoid lactose containing, and gluten containing diet for 6 - 8 weeks. Certainly, yoga and relaxation exercises will also have a positive role in your condition.

Regards, hope you recover soon.

Dr Dinesh Singal

Above answer was peer-reviewed by : Dr. Shanthi.E
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Dr. Dinesh Kumar Singal

Gastroenterologist

Practicing since :1985

Answered : 140 Questions

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Required advise on the condition, IBS, celiac disease, tropical sprue.

Dear XXXXXXX

Thanks for asking for an opinion regarding your condition.

I can not see anything of significance in attached reports. I understand you have been living in the US for last 20 years. It is not unusual to get gut infections on visiting India after such a long time.

Your symptoms are consistent with IBS / functional bowel disease which might have been the result of or might have been precipitated by gut infection. There are other possibilities as well namely: lactose intolerance, gluten intolerance (celiac disease), small intestinal bacterial overgrowth, tropical sprue etc.

You should stop taking milk and milk products. Curd and butter milk are allowed. You should also avoid juices or excess of fruits.

For gluten intolerance there are blood tests available, which your doctor can order for you. Alternatively you can stop gluten diet for few weeks and see.

Small intestinal bacterial overgrowth is difficult to investigate, but a short course of antibiotics can help if this is there. Tropical sprue is also treated with a course of antibiotics.

Hope these suggestions help you.

Regards,

Dr Dinesh Singal