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Suggest Treatment For IBS, Severe Constipation And Diarrhea

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Posted on Fri, 4 Sep 2015
Question: I have had constant bowel issues - diagnosed with IBS without any internal investigations (this is a whole different complication at the moment). I have had severe constipation (abdominal scans show this) so have been trying to get things out obviously - there has been diarrhea. In the process of doing this, my contraceptive pill was passed and I started spotting. On Monday I visited the doctor and we decided to stop my pill and let my period come (it was due anyway, I was just trying to skip it). My question is, I normally start my sugar pills on Saturday and recommence my contraceptive pill on the following Saturday - my period usually takes 3 days to arrive after taking the sugar pills. Due to leaving it until Tuesday to start taking these pills, my period has only really properly started in full swing last night / today (Thursday/Friday). I am unsure whether to recommence my contraceptive pills as normal tomorrow (Saturday) or whether I should be leaving it 2 more days and commencing my contraceptive pill on Monday. Can you please offer some guidance?
doctor
Answered by Dr. Shafi Ullah Khan (43 minutes later)
Brief Answer:
Pill first day of menses, IBS needs management.

Detailed Answer:
Thank you for asking

I read your questions and i understand your concern. Usually contraceptive pills should be started on day one of menses as that is the day one of the cycle. So you may continue with the normal routine or may skip both upto you. You may even start from today. Its all upto you. Better is to start from day one of menses.

Regarding bowel issues like IBS and constipation it needs a lot of management mostly diet and lifestyle oriented.

For Ibs and constipation increasing fiber intake helps. 14 gm of fiber for every thousand calories is minimum intake and necessary. alcohol, chocolate, caffeinated beverages such as coffee and sodas, medications that contain caffeine, dairy products, and sugar-free sweeteners such as sorbitol or mannitol. If gas is a problem for you, foods that might make symptoms worse include beans, cabbage, cauliflower and broccoli. Fatty foods also may be a problem for some people. Chewing gum or drinking through a straw can lead to swallowing air, causing more gas.

Drink as much fluids as possible and take some laxatives on need basis.

I hope it helps. take good care of yourself and dont forget to close the discussion please.

Regards
Khan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shafi Ullah Khan (24 minutes later)
I am still unclear what to do in relation to taking my pill. As I began the sugar pills Tuesday, should I recommence my contraceptive pill Saturday as per normal or should I wait until Monday before I recommence them to allow a full cycle?

Yes my IBS is an ongoing issue. However, I am probably the strictest person you would ever meet in terms of following all recommendations for IBS. I follow the low FODMAP diet and am very very strict with what I eat. I have a meal plan from my nutritionist that I follow to the tee. However, I continue to go through unexplained attacks like this. Throughout this attack, and my last one pain has been so severe the doctor has immediately sent me for scans (which show constipation and full bowels). I am concerned, especially since I have had bowel movements which have just consisted of pure mucus and I am certain I have spotted blood. I am also ridiculously bloated and don't know how to ease this. I am unsure why these attacks to this extent happen as I do everything I should for someone with severe IBS. The doctor has told me to take 2tsp of normacol plus daily to help with keeping things regular - I am unsure whether this will work for me.
I have a gastroenterologist appointment booked, however I am unable to get in until October. This is playing on my mind that it could be something other than IBS...
Any advice on the above comments? Also any advice on reducing bloating?
doctor
Answered by Dr. Shafi Ullah Khan (28 minutes later)
Brief Answer:
Pill not to delay, day on eof menses, bloating needs management of IBS

Detailed Answer:
Thank you for getting back to me

regarding the pills i told you ideal is to start from day one of menses. So start from today even , it is alright. Dont delay it more than saturday. It will increase the odds of periods irregularity.

regarding IBS and recent mucus and blood showing up in stools i believe it is some concomitant infection that has added up to the bloating of the IBS. I would like you to get evaluated for baseline work up like stool routine exam, metabolic profile, colonic transit studies and last but not the least colonoscopy if need be. Hydrogen breath test etc may also be done ot rue out any intolerance like glucose and lactose.

Reduce dairy products intake and try lactose free and gluten free diet and see if it helps. Talk to your doctor and let them decide what is best for you.
regarding the bloating, underlying cause is IBS. treating it will fix the issue. it cant be treated just managed. So you will need symptomatic relief from bloating with some prokinetics ( gastric motility enhancers like metoclopramide or domperidone etc) and some diet and lifestyle modifications which you follow very diligently and i appreciate that.

Nutshell it needs a little work up and a complete correlation clinically to see what is going on.

I hope it helps.
Regards
Khan
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3613 Questions

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Suggest Treatment For IBS, Severe Constipation And Diarrhea

Brief Answer: Pill first day of menses, IBS needs management. Detailed Answer: Thank you for asking I read your questions and i understand your concern. Usually contraceptive pills should be started on day one of menses as that is the day one of the cycle. So you may continue with the normal routine or may skip both upto you. You may even start from today. Its all upto you. Better is to start from day one of menses. Regarding bowel issues like IBS and constipation it needs a lot of management mostly diet and lifestyle oriented. For Ibs and constipation increasing fiber intake helps. 14 gm of fiber for every thousand calories is minimum intake and necessary. alcohol, chocolate, caffeinated beverages such as coffee and sodas, medications that contain caffeine, dairy products, and sugar-free sweeteners such as sorbitol or mannitol. If gas is a problem for you, foods that might make symptoms worse include beans, cabbage, cauliflower and broccoli. Fatty foods also may be a problem for some people. Chewing gum or drinking through a straw can lead to swallowing air, causing more gas. Drink as much fluids as possible and take some laxatives on need basis. I hope it helps. take good care of yourself and dont forget to close the discussion please. Regards Khan