question-icon

Suggest Treatment For IBS

default
Posted on Fri, 3 Nov 2017
Question: Hi.. I am 38 male. I am suffering from IBS (irritated bowl syndrome) for few years. Seen 3 docs and they said that there is no cure. Main problem is my pain in the rectum which goes like this -
1. the attack gets triggered once in 7 to 10 days. when it occurs then....
2. I go toilet in the morning, its all good. after half an hour or so, I feel like going again. this time its painful to empty the stomach... pain start growing and in next 3 or 4 such attempts, within an hour, the pain is quite unbearable. It is too much pain around and in the anus, I generally crawl out on my knees, unable to stand, sit or lie down. in no position I feel comfort.
3. used few medications in past which caused drowsiness and now taking over the counter medicines to tackle the pain.
4. No ayurvedic or allopathic medicine working.
5. I am so frustrated the pain takes a whole day to go off.
I follow strict diet plan, low sugar spices chilli beverages etc. and not smoke or drink.
please help me... I am really in great great pain.
doctor
Answered by Dr. Vaishalee Punj (42 minutes later)
Brief Answer:
IBS is a diagnosis of exclusion

Detailed Answer:
Hi
Thanks for your query.

Irritable bowel symdrome is diagnosed after all other diagnosed have been ruled out by doing appropriate tests.

Kindly let me know which tests you have done and upload their reports if possible.
Also such cases are better dealt with by surgeons. Have you visited a surgeon? If not, kindly get examined by surgeon to get to a diagnosis.

In such cases it is better to find a cause.

Meanwhile take following precautions which in my practice definitely work: Drink water from RO system to avoid foodborne infections. Also apply some vaseline around anal area before defecating.

Wishing you good health.
Dr Vaishalee
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Vaishalee Punj (10 minutes later)
i was examined physically for hemorrhoids initially and then for diarrhea. Once a doctor at Govt. hospital understood the problem and he prescribed me COLIWIN-R capsules 1 daily in morning. This 1 cap helped me a lot and all my problems were like gone but this medicine made me feel dizzy and sleepy so I stopped and the problem returned.
I also checked with a specialist gastro at a very reputed hospital. He also said after physical examination that is was IBS.... Suggested to avoid trigger foods and prescribed IBSSIM and Colonize fort which were also good and provided relief till I took... when I quit on the its like before. I also tried on alternating the medication by leaving few days gap and the start again but that also not helped.
I am not very rich to go through all high end tests, and in fact never was advised by any doctor. One said to take laxatives and I preferred SatIsabgol... which after few days stopped working on my gut and I became a victim of gas and bloating.
doctor
Answered by Dr. Vaishalee Punj (1 hour later)
Brief Answer:
Basic tests are not expensive

Detailed Answer:
Hi again

It is better to get atleast some basic tests like complete blood count, typhidot, ultrasound of abdomen and barium enema. These are not expensive tests.
Medicines are better taken after an accurate diagnosis is made.

Rectal pain syndromes are also known to exist and are not irritable bowel syndrome. These are poorly understood conditions due to spasm of muscles of perineal region.

In Colowin-R there are four medicines. Among these chlordiazepoxide and dicycloverine can cause sleepiness. You can take just dicycloverine once a day and see how it works. Another option is colospa 1 hour before your lunch and dinner.

Multidisciplinary approach including pain medications, local treatment regimens, physical therapy and psychological support is needed, while exercising caution toward invasive and irreversible therapeutic procedures.

Hope it helps. Let me know if I can assist you further.
Dr Vaishalee
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Vaishalee Punj (14 hours later)
Hello Doc... Thanx for the information and being so helpful.
1- In the past, out of 3 docs, 2 were surgeon. IBS was first told me by a surgeon.
2- As per the symptoms of my bowl movement, it looks like IBS.
3- An urge to go for loo and feeling like bowl is not completely empty.
4- Feelings like "this time I go to toilet, and then I will feel relax" and yet again and
again urge to go.
5- All I gathered info from Internet by searching for people having same problem... and I think it is IBS-D.
6- I was operated in 2010 Ureteroscopic Kidney Stone Removal. and I got this problem after the operation.

I request you to please advise me for the
A- Tests, I will go for this week positively.
B- Name of a particular medicine, which you think you will give to an IBS
patient having too much pain, and repeated urge. I am suffering the issue
right now and don't think I will subside soon. If I get relief by your
prescription, it can be confirmed.

C- As per my net research, it can be LEVATOR SYNDROM. your suggestion on
this.

And I thank you again for being patient and listening to my problem. I just fear that using so much medication will damage my liver and kidney very soon and I will die well before my time.
doctor
Answered by Dr. Vaishalee Punj (8 hours later)
Brief Answer:
CT scan abdomen maybe done

Detailed Answer:
Hi again
Thanks for writing back.

A. Among tests, laparoscopy is considered gold standard but is invasive and can worsen your condition.
Among non-invasive tests, CT Scan abdomen can be done and is helpful in diagnosing any obstruction or lesion of abdomen. If you find it expensive then do a combination of USG whole abdomen and Barium enema.
Complete blood count and typhidot are blood tests and comparatively non-expensive.

B. Many medicines are under trial for IBS. But there is no medicine that actually cures it. The above mentioned medicines only relieve the symptoms for sometime. These medicine are not reliable for diagnosing the condition.

Best is to manage this condition on clean diet and fiber.

FDA has approved an antibiotic Rifaximin for treatment of IBS-D. It controls the bacteria that cause travellor's diarhea and IBS. For IBS-D it has been found to improve symptoms of bloating and diarrhea after a 10–14 day course. But it can cause GI upset and may not be a good choice on long run.

Dicycloverine can cause drowsiness, therefore its sister medicines glycopyrolate and methscopolamine can be tried to relieve GI muscle spasm. These medicines do not enter the brain and are less likely to cause drowsiness. Glycopyrrolate is easily available in XXXXXXX and can be taken in dose of 1-2 mg 2-3 times/day.

C. Yes I am also considering this diagnosis of levator ani syndrome. As I mentioned in my previous reply it is one of the conditions causing rectal pain syndromes. It can be diagnosed by digital rectal examination as a tensed muscle that causes pain on touch by the doctor. If you felt pain during rectal examination by your surgeon, then it may be the cause. The three treatments employed are biofeedback, electrogalvanic stimulations and digital massage of the levator ani.

Yes too much medicine can affect liver and kidney on long run. Many people continue to take pain killers like brufen and paracetamol for more than 20 years without affecting kidney and liver. Other medicines may affect these organs faster.

I think breathing techniques (in yoga) and yog nidra will definitely help you relax your muscles and atleast relieve pain to some extent. These techniques are safe.

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Vaishalee Punj

General & Family Physician

Practicing since :2003

Answered : 173 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

152 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Suggest Treatment For IBS

Brief Answer: IBS is a diagnosis of exclusion Detailed Answer: Hi Thanks for your query. Irritable bowel symdrome is diagnosed after all other diagnosed have been ruled out by doing appropriate tests. Kindly let me know which tests you have done and upload their reports if possible. Also such cases are better dealt with by surgeons. Have you visited a surgeon? If not, kindly get examined by surgeon to get to a diagnosis. In such cases it is better to find a cause. Meanwhile take following precautions which in my practice definitely work: Drink water from RO system to avoid foodborne infections. Also apply some vaseline around anal area before defecating. Wishing you good health. Dr Vaishalee