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Suffering from irritable bowl syndrome. Took Rifagut, O2, Norflox, Bayclip. Advised colonoscopy. Should I go for colonoscopy ?

Dec 2014
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Practicing since : 2007
Answered : 4792 Questions
Few of my details : Sex - Male , Age - 27 , Height - 5 feet 8 inches , Weight - 62.5kgs .
I have been suffering from Irritable Bowel Syndrome since many years. Some of the typical medicies
I have consumed over last many years are Rifagut , O2 , Norflox , Bayclip , Nexpro , Fludac , Nomaxin and various other antibiotics. Recently I consulted one Dr and he straightway he suggested colonoscopy. But all my blood test parameters are within normal range except pus cell (/hpf) in urin of 2-3 and 1-2 in stool. I don't drink or smoke and keep a healthy diet. I suffer from sever cramps , suffocation,bloating and incomplete stool passing. Should I need to undergo colonoscopy or should I continue with medicines.
Posted Mon, 22 Apr 2013 in IBS(Irritable Bowel Syndrome)
Answered by Dr. Seikhoo Bishnoi 33 minutes later
Welcome to Health Care Magic

You are a young 27 year old male, of average height and slightly low weight. You have been suffering from Irritable Bowel Syndrome for many years. You took a lot of medicines Antibiotics as Rifagut, Norfloxacin, Bayclip; Antacids as Nexpro; other medicines for IBS as Fludac, Normaxin etc. Almost all of investigations came normal including stool and urine examination. You are currently on Normaxin (Clinidium bromide and Chlordiazepoxide), Loperamide and Zapize. You have past history of Lymph gland TB, tympanoplasty and mastoidectomy. You have been recently advised Colonoscopy.

I would like to tell you that as you are suffering from IBS and all investigations came normal so there is no urgent need for colonoscopy.
You are currently having symptoms like cramps, bloated abdomen, suffocation and incomplete evacuation.
You are currently on right medicines but I think there is need to add one antacid like Omeprazole or Rabeprazole one tablet empty stomach in morning daily to correct bloating. Normaxin and Loperamide will cover all other symptoms.
The symptoms of IBS tend to follow chronic course and medicines take time to act. So don't discontinue treatment abruptly.
If relief is incomplete then Behavior Therapy by a Psychologist will also help you.

Thanks, If you have more queries you can ask again in follow up.

Dr. Seikhoo Bishnoi, MD
Above answer was peer-reviewed by
Follow-up: Suffering from irritable bowl syndrome. Took Rifagut, O2, Norflox, Bayclip. Advised colonoscopy. Should I go for colonoscopy ? 14 minutes later
Sir ,
Are there any serious side effects of taking medicines like Normaxin ? I remember that I use to feel very thirsty at night especially dry in the throat while taking that medication. In any case how long can I continue to take such a course ? In case of SOS at night and I am out of course , can I take Normaxin or any other emergency tablet that will give me relief. At times it becomes very difficult for me to sleep in the night because of cramp.Can you suggest any alternative course ? Pus cell count of 1-2 in stool and 2-3 in urine are suggestive of any serious infection ? Do I need to take any antibiotic course ? I have observed 2 major discomforting situation arising out of IBS. They appear alternately in effect with mild influence of the 2nd factor. 1st is severe abdominal cramp. 2nd one is suffocation or difficulty in breathing. It is unlike asthma where if u take asthalin puff , I may get immediate relief. 4-5 months I used to very uncomfortable with suffocation. Night after nights I have been awake. I used to feel as if I may die. Now that same situation with abdominal cramp. Why these symptoms are manifesting in different time periods ?

Answered by Dr. Seikhoo Bishnoi 19 minutes later
Hello again

Normaxin as I have mentioned earlier consists of Clinidium Bromide and Chlordiazepoxide. Clinidium bromide is a anticholinergic drug. It causes dryness of mouth as side effect. This is the reason behind excessive thirst in you. The medicine will also cover cramping in abdomen. But SOS use is not advised. I will advise you to take this medicine for at least 12-16 weeks for proper relief.

Pus cells less than 3 in urine is considered as normal, similarly in stools 1-2 are definitely normal. There is no serious infection.

There is no urgent need of antibiotic therapy.

The severe cramping along with breathlessness or suffocation occurring in you may be due to Anxiety Disorder. Anxiety itself may present with symptoms of IBS along with mild tremors, breathlessness, suffocation feeling. I will advise you to please visit your Psychiatrist for evaluation. Medicines like SSRI medicine Paroxetine will be very useful in your situation as it will cover anxiety as well as symptoms of IBS also. Apart from that try Relaxation exercises, Yoga, Meditation for your relaxation.

The symptoms tend to occur more during periods of excessive stress or prior to some important event. Also over all course of IBS is also episodic with even period of normalcy in between.

Hope I cleared your doubt. If you are satisfied with conversation please review.

Dr. Seikhoo Bishnoi, MD
Above answer was peer-reviewed by
Follow-up: Suffering from irritable bowl syndrome. Took Rifagut, O2, Norflox, Bayclip. Advised colonoscopy. Should I go for colonoscopy ? 1 hour later
I am getting satisfactory answers from you Sir.Let me ask you about few more symptoms.

1-> Excess urine passing through out the day. I feel I pass more urine than my water intake. Generally I consume 3-4 litres of water/day. But I pass frequent urine. Urine passing especially in the night disturbs my sleep. I feel due to the irritation in abdomen(I guess somewhere in lower stretch large intestine ) , some how my urinary bladder is pressurized which results in frequent urination. Please throw some light.

2-> Occasionally drops of blood comes out with stool. If I pass stool after a gap of 1.5/2 days with sudden great surge of pressure , small quantity of blood smears with the stool. I guess the rectum/anus walls get ruptured due to the pressure. During other times I have not seen blood with the stool.I guess It is not due to any bleeding in intestine. Please throw some light.

3-> Occasionally I get headache in the back side of brain. The symptom is associated with incomplete/no stool passing for that day. This doesn't happen daily. It happens say once per week. Earlier ( few years back )I use to take "vasograin" tablet in times of such an attack of headache. Since last 2 years I don't take any medicines. Somehow I bear the pain and distract myself although the pain persists. Should I take any medicine in such a case ?Kindly throw some more light.

4-> Often I feel drowsy and tired through out the day. Particularly after passing moist and sticky stool with sudden surge , I feel exhausted and almost can feel my heartbeat(My ecg and echo tests were normal). Why do I feel so exhausted after passing stool especially when it appears moist , sticky and with pungent smell ?

5-> Occasionally I get tremors passing through out the body. Suddenly full body contracts especially the arms. Occasionally suddenly middle of the night I wake up with tremors and panting. Sometimes even when my phone rings or door ring bells , I get that tremor sensation . Why do I get such tremors ? Taking medicines as discussed in the previous session will suffice ?
Answered by Dr. Seikhoo Bishnoi 6 hours later
Hello again

- Excessive urination is due to excess fluid intake. It never exceed the amount of intake. If you are having more urine in night and disturbed sleep then you have to take some precautions. Don't take excess water after evening, avoid tea/ coffee/cold drinks in night. Don't take tension of having more urine because anxiety further increases urination.

- Occasional drops of blood that come out or rectum during defecation are nothing but due to rupture of anal mucosa due to straining. I will advise you to not to strain excessively because it may lead to development of piles. Don't strain excessively.

- There is no need to take medicines for pain in head. It is just due to heightened stress. Try to relax yourself and with improvement of bowel habit it will improve.

- The feeling of tiredness and drowsiness after passing moist stool, along with palpitation, occasional tremors are all due to anxiety. As I have mentioned earlier try to do relaxation exercises for anxiety. If you can't control anxiety by own then Paroxetine will be a right medicine for you. It will help in anxiety as well as in IBS. Tremors are only due to anxiety.
Yes try the relaxation exercises and the medicines you will definitely see improvement. But be prepared to take medicines for long. Don't stop medicines without advise of your Psychiatrist.

Dr. Seikhoo Bishnoi, MD
Above answer was peer-reviewed by
Follow-up: Suffering from irritable bowl syndrome. Took Rifagut, O2, Norflox, Bayclip. Advised colonoscopy. Should I go for colonoscopy ? 10 hours later
GoodEvening Sir,
As I understand , you are suggesting stress relieving exercises and medication. Can you suggest any of your known psychiatrist in Bangalore who can help with IBS treatment ?
How Zapiz ( 0.5mg ) is different from Normaxin ?
Can Zapiz (0.5 mg ) be taken in SOS without completing any course ?
How the tablets Rifagut / Bayclip / O2 / Norfloxacin are different ?
In my situation which course shall you advice ?

I purchase 20 litres mineral water can from outside. I doubt the quality of water. If I go for RO filter , we'll it be effective or I should go for ordinary filter.

I have good hunger and feel hungry within few hours of meal.
I guess it is normal ?

I get slight temperature every day in the evening after returning from office( although it is certainly not fever). My body is always warm. Please throw light.

Why is that some people with anxiety get affected by IBS while others even with anxiety they don't get affected ?

I know that I think a lot. But why it affects my digestive system and sleep so severely ?

I have been suffering varying degree of IBS since last 10 years. It is intensifying with time. Did my medication during TB ( AKT-4/AKT-3 ) intensify IBS problem ?
Answered by Dr. Seikhoo Bishnoi 14 minutes later
Good evening and hello again

There are many good hospitals in Bangaluru like NIMHANS from where you can take opinion.

Zapiz is clonazepam which is a benzodiazepine drug. It is used mainly for episodic control of anxiety. You should take it only on SOS basis because it is for your relaxation only.
Normaxin is a fixed drug combination mainly used in IBS.

Rifagut is drug for TB and Baycip is antibiotic. They are used for gut infection if any.

Changing water to filtered water will protect you from intestinal infections. It is a good idea.

The hunger and excessive feeling of having fever are only due to anxiety and stress. Its normal to have some change in temperature by end of the day.

It depends upon personality to personality. Some people of anxiety develop Panic like symptoms, some develop IBS like symptoms while other may develop some obsessions. So it is one of disease of anxiety spectrum disorder.

Excessive thinking about one problem again and again will predispose to anxiety, which will further worsen your symptoms. So worry, anxiety etc. should be controlled.

No medicines of TB have nothing to do with the symptoms of IBS, but you may have heightened anxiety with them.

Hope I cleared your doubt. If you are satisfied with conversation please review. If you have more questions you can ask again.

Thanks Dr. Seikhoo Bishnoi, MD
Above answer was peer-reviewed by
Follow-up: Suffering from irritable bowl syndrome. Took Rifagut, O2, Norflox, Bayclip. Advised colonoscopy. Should I go for colonoscopy ? 2 hours later
First of all I am thoroughly satisfied with your replies. You are the 1st Dr who is discussing in such details with me.

Please suggest some specific guidelines about food intake. Should I consult a nutritionist and try to stream line my food intake ?

The most important Qt sir. Without medication and solely on the basis of stress relieving exercises , is it possible to significantly lower IBS symptoms ?

I have not tried homeopathy although many people have suggested including allopathy doctors. Please tell your opinion.

What are the border lines between thinking and anxiety/worry ?
Please tell me from your experience some specific techniques for reducing stress.
I mean some psychological advice. I have read endless books on motivation/self help . Still I have not been able to manage stress in my own life.

I feel over consciousness , inclination towards perfection and not able to put my views where I feel I should have taken a strong stand leaves me disturbed.
Answered by Dr. Seikhoo Bishnoi 44 minutes later
Hello again

- Regarding foor intake- Take a balanced diet. Diet XXXXXXX in fibers will help to soften stools and will help in easy evacuation. Diet should low in fats. Avoid animal fat for some time.

- Yes solely on the basis of stress relieving exercises and dietary modification it is possible to minimize the symptoms of IBS. due to severe stress and anxiety which ultimately reflects in form of bowel symptoms.

- Homeopathy medicines depends upon individual to individual. There are no definite studies regarding these medicines that show their role in IBS. But it depends upon you to take these medicines.

- Anxiety is nothing but external manifestation of worry. Excessive worry cause stress in brain which ultimately reflects in form of Anxiety.

- For motivation first of all you have to start believing in your self. Control your anxiety first by way of Relaxation exercises as Progressive Muscle Relaxation Techniques (PMR), Deep Breathing Exercises, Yoga etc. You can take help of some good Psychologist for that. Once you will learn to relax yourself then you will see improvement in confidence and your personality. Low motivation in you is only because of stress related to IBS result in low confidence which ultimately increase stress, and stress increase IBS symptoms. Or in simple terms there is a cycle of "Stress- IBS- Low confidence" and our target is to break any one spoke of this cycle. You will definitely see improvement in 4 weeks.

Dr. Seikhoo Bishnoi
Above answer was peer-reviewed by
Follow-up: Suffering from irritable bowl syndrome. Took Rifagut, O2, Norflox, Bayclip. Advised colonoscopy. Should I go for colonoscopy ? 47 hours later
What are the side effects of medicines Normaxin , other IBS drugs when used for long term use ?

What is is the difference between anti depression / anti stress / sleeping pill ?

Zapiz (0.5 mg ) belongs to which category ?

Where can I get help about Progressive Muscle Relaxation Techniques (PMR) ?

Answered by Dr. Seikhoo Bishnoi 12 minutes later
Hello again

In commonly used drugs especially Normaxin there are no major side effects. But side effects on long term may be like imparted psychomotor performance like slowness in thinking, judgement etc. In some individuals dependence may occur. But these side effects are seen when normaxin is used for years.

Antidepressant are used specially for depressive disorder. Antistress or anti anxiety drugs are in anxiety, but most of anti anxiety drugs are basically antidepressants in low doses.
Sleeping pill belong to different category. They are like benzodiazepines as clonazepam, lorazepam etc. In low doses they can be used for anxiety and relaxation also. But they have very high dependence potential.

Zapiz is nothing but clonazepma. It is a benzodiazepine drug. In doses of 0.5 mg it is used in episodic control of anxiety.

For detailed PMR you have to take help of a Psychologist. Demonstrations can be searched on youtube.

Dr. Seikhoo Bishnoi
Above answer was peer-reviewed by
Follow-up: Suffering from irritable bowl syndrome. Took Rifagut, O2, Norflox, Bayclip. Advised colonoscopy. Should I go for colonoscopy ? 43 hours later
Since Friday evening I have been suffering from mild fever. I had taken a crocin tablet on friday evening. Saturday evening I contacted my dept Doctor ( I ama govt of india employee ). He prescribed me one anti biotic ( TopCef { Cefixime + Olfloxacin }) and Zix-p tablet. I had taken one tablet on saturday evening. But sunday i forgot to take anti biotic. Un mindfully I had taken Zix-p tablet twice thinking it as topcef. I am having 99-100.5 fever since last 3/4 days. Today morning after breakfast I have resumed taking topcef.
But today morning on wards I was feeling giddy and weak. I went to Dr once again. He measured my BP and it was 150/100. He advised me to take 1/2 tablet of vertin and take rest. Yesterday night once again I had a disturbed sleep due to stomach cramp and tremors.
Even as I am writing you I am not feeling comfortable. I passed stool twice. Still I feel incomplete and mild cramp.
I have not got such high blood pressure earlier.
As I had said you earlier whenever I get certain kind of stool I feel weak.
This is the first time I have taken medicine for BP. Kindly advise me what I should do regarding medicine , rest and food ?
Answered by Dr. Seikhoo Bishnoi 22 minutes later
Hello again

Taking double dose of Zix P don't have much serious effects. The blood pressure of you was in little higher range as compared to your age. It might happen because of antibiotic dose especially due to ofloxacine. It will return to normal level once you finish the drug therapy. High BP caused giddiness, palpitations in you. Vertin will help to symptomatic control of giddiness and it is not an antihypertensive drug. If you are having disturbed sleep then you can take Zapiz tablet like we discussed earlier. Zapiz will help to keep you calm and relaxed. It will also help in gaining sleep. Don't take tension of cramps, as you know there are occurring only due to stress and IBS. Finish you antibiotic course and add sachets of Probiotics like bifilac, sporlac in you therapy. These probiotics will help to improve the symptoms of IBS also. Get your BP checked again after a week.

Dr. Seikhoo Bishnoi, MD
Above answer was peer-reviewed by
Follow-up: Suffering from irritable bowl syndrome. Took Rifagut, O2, Norflox, Bayclip. Advised colonoscopy. Should I go for colonoscopy ? 29 hours later
Sir my BP was 80/130 today. Still my local physician has asked me to take 1/2 tablet of vertin tonight and tomorrow. My anti biotic course would end tomorrow morning.

So can I start Normaxin tomorrow night onwards ? Or should I start a different course ? If I start Normaxin/Other drug what is the minimum duration for which I should continue to take ? What should be the dose ?

Should I take any other supportive medicine ?

If my mouth becomes dry is there anything to worry ?

Answered by Dr. Seikhoo Bishnoi 8 minutes later
Hello again

BP of 130/90 is almost on normal range. Still you can take vertin 8 mg half tablet if you are having giddiness.
You can start normaxin, there is no contraindication.
Start with twice a day dose, there is no side effect, but I would advise you with relaxation exercises first and then start medicines. A little dryness of mouth will occur but this is not a serious problem
Also take lactobacillus supplements like bifilac XXXXXXX two times a day, this will help you.

Above answer was peer-reviewed by
Follow-up: Suffering from irritable bowl syndrome. Took Rifagut, O2, Norflox, Bayclip. Advised colonoscopy. Should I go for colonoscopy ? 41 minutes later
Respected Sir,
I was thinking other way. I want to start the medicines first. Since last many months there has not been a single day when I was able to sleep properly. Every night I get either cramp or chest pain. I am able to sleep only after 1:30. Next day morning I feel tired and drowsy. My work is suffering. I concentration has suffered. So I feel should start the medicines first sir. What do you think ?

Sir , a single dose per night won't be sufficient ?

Sir, I have heard probiotic supplement is not good . Please clarify.
Answered by Dr. Seikhoo Bishnoi 10 minutes later
See last choice depends upon you because both treatments are equally effective but medicines will provide relief earlier. Don't worry about the dryness of mouth as it is a minor side effect. Just keeping mouth moist by lozenges will help.
There is no side effect of probiotic (lactobacillus), but it will help in normalising gut flora. Cramping will improve with normaxin.
So you can start with medicines but also continue relaxation exercises with medicines.

Thanks and if you have any more queries you can ask again. You can contact me directly any time.
Above answer was peer-reviewed by
Follow-up: Suffering from irritable bowl syndrome. Took Rifagut, O2, Norflox, Bayclip. Advised colonoscopy. Should I go for colonoscopy ? 19 hours later
Can you give me your contact details.

Even today afternoon I had BP of 94/130. Why is persisting on the higher side ?

Is it because of olfloaxin or anxiety ?

In that case how long should I continue to take vertin tablet ?

Should I take any other medicine ?
Answered by Dr. Seikhoo Bishnoi 48 minutes later
Hello again

BP of 134/90 is almost normal, slight increase may occur due to even increase in fluid intake, tea, coffee etc. Even ofloxacin or anxiety may cause increased readings.
As per my opinion there is no need to take Vertin again BP will become normal in some time.
Continue medicines for IBS only and just complete antibiotic therapy.

You can contact Health Care Magic for contact details.

Above answer was peer-reviewed by
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