Brief Answer: Kindly provide the requested data... Detailed Answer: Hi, I have gone through your medical history and feel sorry for the situation you are in. I am also happy that you are not dealing with other problems like celiac, gastroparesis or lactose intolerance. Please bare in mind that IBS is characterized by alternating periods of aggravation and improvement. In your case, there is a need of a good management for IBS (if it is confirmed). First, I need to know the medications you are currently taking. The use of certain drugs can trigger the symptoms similar to IBS or aggravate them. You are also reporting to have bladder problems, can you please specify them together with medications you are taking? Next, I'd like to have more details on the symptoms you are currently experiencing. To my judgment, from what you are reporting, you might need to: - take probiotics - drink more water - try to control stress Looking forward to have the requested details to assist you further! Thank you! Dr.Klerida

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Brief Answer: Rule out organic issues first.... Detailed Answer: Hi, I have gone through all the medications you are currently taking and have noticed that the use of some of them are associated with diarrhea, including metformin, synthroid, sertraline. The use of toviaz and myrbetriq are also associated with abdominal pain and stomach upset. To my opinion, I would suggest to run further investigations in order to determine IBS as the real diagnose in your case. So, you can talk to your doctor about the side effects of the drugs you are currently taking. In addition, can discuss to run further the following tests: - abdominal ultrasound - culture of stool - colonoscopy to rule out organic issues. If you have already conducted such tests, and they resulted negative, then IBS is confirmed. Please bare in mind that IBS has its own periods of aggravation and improvement of the symptoms. As it is a chronic condition, it is also depending on the physical activity and psychological condition of the patient. The more relaxed you will feel and more engaged in the everyday activities, the less its symptoms will be. Hope it helped! Let me know if you have further queries! Dr.Klerida

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Brief Answer: Following suggestion...... Detailed Answer: Hi back, Thank you for following up. I am glad to know that all your tests were negative, meaning that you do not have any organic problems. In my practice, I usually advise patients confirmed with diagnosis of IBS to: - be careful with the foods they consume - control stress - get more involved in physical activities. All these will help improve intestinal movements. With regards to the diet, usually, in my practice, I do not suggest a strict diet as patients find it difficult to follow for long. The most important thing is to consume foods high in fiber and drink more water. A low Fodmaps diet is a very specific diet restricting foods high in Fermentable Oligo-saccharides, Disaccharides, Mono-saccharides and Polyols. These are a group of specific carbohydrates that are being poorly absorbed by the intestines. While they are digested by the bacteria in the intestines, gas is forming aggravating the symptoms. The main idea is to increase the water content in the feces without forming excessive gas. Restricted foods include: - Fruits, high fructose corn syrup, honey, etc. (high in fructose) - onion, wheat, garlic (Fructans = inulin foods) - Dairies (lactose) - Beans, legumes, lentils, etc (high in galactans) - Polyols sweeteners (sorbitol, xylitol, maltitol, mannitol, ettc. and stone fruits = nectarines, plums, peaches, apricots, cherries, etc. This diet is a prescribed temporary (up to 2 weeks) and not life time. That's why I usually recommend life-time foods or diets. Hope it was of help! Dr.Klerida

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