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Dr. Andrew Rynne
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Suggest treatment for diarrhea and IBS

Answered by
Dr.
Dr. Albana Sejdini

General & Family Physician

Practicing since :2006

Answered : 6520 Questions

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Posted on Mon, 19 Sep 2016 in Digestion and Bowels
Question: Hi doctor, I suffer a weird case of stomach and bowel problems which is affected somewhat by my nervousness and anxiety. Some of the symptoms i experience are unexpected diarrhea in the morning (with or without breakfast), major intestine/colon noises not related to hunger in the morning and throughout the day as well (this problem worsens when im in a quiet environment with people around, as my stomach would make weird noises as well as having the urgency to use the bathroom), passing gas and shaky body movements/twitches when under stress. I also experience a weird stomach hunger feeling, even after having a meal, which could be triggered by nerves. All these problems started in the summer of 2012, when I was very anorexic as a cause of exercise and insufficient calorie intake during the start of my high school year. Before highschool of 2011-2012, i was an obese kid and i wanted to get skinny. Unfortunately, i havent kept track of my excersise and diet, and weighed 99 pounds by the end. During that summer, I went extreme with my diet, eating a large variety of foods in large portions every 30 mins or so. Instead of drinking water, i drank milk to increase my weight gain and i would eat something at the last minute before going to bed. I drank lots of milk. I had this belief that doing this during the 2 months of summer would slow down my metabolism and put me at a regular weight. But, i realized i started to experience weird symptoms as mentioned in the beginning of this passage. So far, ive went to two doctors about this problem, had a colonscopy, endoscopy, antidepressants, antacids, lactose intolerant pills and nothing could be done about my problem. I would really appreciate it if you, or someone of your expertise, could help me because this has been occuring for over 4 years and this has put me in a depressing state where i refuse to go to school, work. Thank you, XXXXXXX
doctor
Answered by Dr. Albana Sejdini 6 hours later
Brief Answer:
Irritable bowel syndrome...advice as following...

Detailed Answer:
Hi XXXXXXX

I have gone through your medical history carefully and understood your concern.

I am sorry for the health problems you are going through. You are too young to refuse social works just because of your stomach issues.

Please keep in mind that there is always a solution for the things that are happening in our life although sometimes we can think that there is no solution and get depressed.

After reviewing your case, I admit that your problems have started when you followed such drastic diet 4 years ago. Your stomach has got a tough time if you have skipped your meals.

The most important step toward the solution in your case is dominating Stress. This is a negative factor for all your actual problems; I can say it will aggravate or reverse your health problems for worst.

If you cannot control stress on your own, ask your family member to support you. If not, then, psychotherapy can help.

Next, another important step is toward reducing your actual stomach problems like gas, bloating, etc. Apart PPIs as you are taking now Rabeprazole, and antacids, and diet changes (less lactose foods), I advise to :
- have your meals regularly, do not skip them
- take probiotics to stabilize intestinal flora
- get a stool sample culture for candida overgrowth to treat it adequately
- a stool examination for ova/parasites is also recommended
- increase fluids intake
- avoid drinking fluids with straw
- chew up food slowly and well to avoid swallowing too much air

Hope it was of help! Let me know if you have further queries.
Dr.Albana

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Albana Sejdini 12 hours later
Whats the best probiotic i should try in this case? Also, during my colonoscopy, dont doctors take stool samples already? They found nothing that could solve my problems
doctor
Answered by Dr. Albana Sejdini 10 hours later
Brief Answer:
Following answers to your questions....

Detailed Answer:
Hi dear XXXXXXX

Thank you for writing back.

You can take a probiotic containing various strains of normal intestinal bacilli like L. acidophilus (the most important strain responsible for absorption of dairy foods and all the nutrients); B. longum (helps cleaning the intestines from all types of toxins); B. bifidum (for digestion of dairy foods and breaking down the complex carbohydrates, fat, protein in smaller components).

So, just read the labels of the probiotics you find at your local drug store and choose those containing one or all these strains of intestinal bacilli.

Colonoscopy won't reveal anything about parasites or candida infection. Send your stool at your local lab to get further examined for ova/parasites and culture for candida; these are golden tests to determine these 2 diagnosis.
Colonoscopy will give information regarding the colon mucosa and lumen.

Hope it answered to your queries. Let me know if I can be of further help.
Dr.Albana
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Albana Sejdini 10 hours later
Also, i have to tell you that the earlier i wake up from a sleep, not a nap, the more intense these stomach/intestine gurglings get
doctor
Answered by Dr. Albana Sejdini 25 hours later
Brief Answer:
Typical clinical presentation of irritable bowel syndrome

Detailed Answer:
Hi back XXXXXXX

Thank you for following up.

If you get gurgling more if you wake up earlier from sleeping, this is related to low stomach pH and hyperstimulation of the nerve responsible for the hyperacidity of the stomach.

It's typical clinical presentation for irritable bowel syndrome in your case explaining nothing abnormal has been found during colonoscopy.

Dominating stress is important in reducing such symptoms together with diet changes to stabilize stomach pH.

Hope this answers your question.
Dr.Albana
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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