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Suggest Treatment For Recurring Diarrhea, Gas And Bloating

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Posted on Thu, 1 Jun 2017
Question: My wife has had constant diarrhea with gas an bloating for over 20 years. All of here doctors say it is IBS and they have found no cure or basically any relief from her. Could she have intestinal candida?
doctor
Answered by Dr. Ramesh Kumar (1 hour later)
Brief Answer:
Very unlikely that candida is there inapparent from 20 years.

Detailed Answer:
Hello,
Thanks for asking query on this forum.
I am a Gastroenterologist and would be answering your query.
Firstly lets come to your question could she have intestinal candida?

Candida Albicans is the most common type of yeast infection found in the mouth, intestinal tract and vagina. Your wife is having problem from last 20 years in case if candida infection would have been there in her intestine by now it would have infected her mouth(thrush) and vagina also(candidiasis).So possibilities are very low(clinically).
In case she wants to go through a non invasive test then go for stool microscopic examination for ruling out canndida. One stool sample will make the picture clear.Its a non invasive and easy way.
All the symptoms she is having could be caused by candida. However the easiest way to rule out if her intestines are infected with candida or not is to go for a G.i endoscopy or colonoscopy. Doctor should take small tissue samples from her G.I tract.These specimens would be studied under a microscopy.If the results are positive she has candida infection otherwise its just IBS. This the gold standard diagnostic way to tell if it is candida .Just on the basis of history IT is rather not possible to tell if Candida infection is involved or not because all presenting symptoms are almost same.
Though not ask yet i want to give you my experiences with patients of IBS.
You have not mentioned the names of salts she has tried.So i would give you a general briefing with new advances. May be you know all these things but go through the text carefully once. Doctors in united state are over conscious about use of medications so many times patient'S does not seems to have any idea about other salts available these days.

Firstly small briefing for Irritable bowel syndrome and why every patient is a unique case when we deal with IBS.
In IBS there is some problem in the functional ability of the gut that leads to the symptoms of irritable bowel syndrome. The structure of the intestines is normal, only functional abnormality occurs in this condition.So frankly speaking (IBS) represents a functional disorder of gastrointestinal tract without the presence of an anatomic defect.

Recent studies by French scientists have indicated that the most important mechanisms include visceral sensitivity, abnormal gut motility and autonomous nervous system dysfunction. The interactions between these three mechanisms make bowel's function susceptible to many exogenous and endogenous factors like gastrointestinal flora, feeding and psychosocial factors.

Further data indicate that according to the above mechanisms, the influence of genetic factors and polymorphisms of human DNA in the development of IBS is equally important.

So in lay mans language till date we are not sure whats the exact cause of this problem.So the million dollar question is how to repair a system when you don't know which part of it is faulty(Some says it can be brain other says it can be hormone anxiety age etc etc).

Some patients have attacks of diarrhea and bloating and some may have constipation. Other symptoms that may be present in irritable bowel syndrome include nausea, vomiting, headache, loss of appetite, muscular pains, heartburn, and weakness. Some patients have occasional symptoms whereas others may have symptoms for a long period of time.So as seen above every patient is different.Intensity of symptoms in every patient is different as so is the response to medicines and life style change.A patient may respond good to one medication while other patient is totally unresponsive to the same.

Our goal-
Every drug is not effective in every patient so we have to try different therapies till we find the drug which suits best our patient.


Dicyclomine is an anticholinergic drug.An anticholinergic agent is a substance that blocks the neurotransmitter acetylcholine in the central and the peripheral nervous system. Anticholinergics inhibit parasympathetic nerve impulses by selectively blocking the binding of the neurotransmitter acetylcholine to its receptor in nerve cells.

Mebeverine is an antispasmodic medicine and is very useful in IBS and is well tolerated by patient with minimal side effects.Mebeverine works on certain muscles in the wall of your intestines, causing them to relax.

Clidinium bromide is an anticholinergic (specifically a muscarinic antagonist) drug. It may help symptoms of frequent stools.

Chlordiazepoxide works by increasing the action of GABA, a chemical messenger which suppresses the abnormal and excessive activity of the nerve cells in the brain.Can be used in combination with above mentioned medicines.

Another OTC medication is Bismuth sub-salicylate. It belongs to a class of medications called antacids and adsorbents marketed by name of Pepto Bismol. Doses up to 1gram can be taken daily to provide symptomatic relief.

Loperamide can be used but should be avoided as she is already having excessive bloating.


For bloating and gas take Tab Nexium 40mg twice daily can increase it to 80 mg twice daily.Take a probiotic daily with food as proper digestion of food will prevent excess gas formation.When food is not properly digested large amount of gases are produced inside due to incomplete fermentation of food.Hence if digestion improves overall symptoms will also improve.
Food pattern recommended is-
Eat simple and natural home cooked food.
If possible try detox diet (Raw vegans) for at least 3 month. Take normal food in lunch while in supper take uncooked raw (low fiber) natural form of food. This can play wonders.
Avoid taking excessive fibres. A total fiber intake of about 20-25 gram per day would be good for you.
No pizza,Burger, Red meat, and dairies for few weeks.
No alcohol or smoking.

Ask her to take natural food rich in probiotics like Yoghurt, Kimchi,etc.This doesn't mean that you have to take them as much as you can.Follow your body increase their uptake gradually.
Drink lots of juices and fresh water daily. Drink cleaner water, it will help a lot.
Avoid over spicy and heavy food.

If possible go for a detox diet but again don't force your body rather let your body adopt gradually to things.

In case you need any other help feel free to ask.I would be happy to help you.
Hope i answered your query well.

Thanks and Wish her luck.
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2906 Questions

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Suggest Treatment For Recurring Diarrhea, Gas And Bloating

Brief Answer: Very unlikely that candida is there inapparent from 20 years. Detailed Answer: Hello, Thanks for asking query on this forum. I am a Gastroenterologist and would be answering your query. Firstly lets come to your question could she have intestinal candida? Candida Albicans is the most common type of yeast infection found in the mouth, intestinal tract and vagina. Your wife is having problem from last 20 years in case if candida infection would have been there in her intestine by now it would have infected her mouth(thrush) and vagina also(candidiasis).So possibilities are very low(clinically). In case she wants to go through a non invasive test then go for stool microscopic examination for ruling out canndida. One stool sample will make the picture clear.Its a non invasive and easy way. All the symptoms she is having could be caused by candida. However the easiest way to rule out if her intestines are infected with candida or not is to go for a G.i endoscopy or colonoscopy. Doctor should take small tissue samples from her G.I tract.These specimens would be studied under a microscopy.If the results are positive she has candida infection otherwise its just IBS. This the gold standard diagnostic way to tell if it is candida .Just on the basis of history IT is rather not possible to tell if Candida infection is involved or not because all presenting symptoms are almost same. Though not ask yet i want to give you my experiences with patients of IBS. You have not mentioned the names of salts she has tried.So i would give you a general briefing with new advances. May be you know all these things but go through the text carefully once. Doctors in united state are over conscious about use of medications so many times patient'S does not seems to have any idea about other salts available these days. Firstly small briefing for Irritable bowel syndrome and why every patient is a unique case when we deal with IBS. In IBS there is some problem in the functional ability of the gut that leads to the symptoms of irritable bowel syndrome. The structure of the intestines is normal, only functional abnormality occurs in this condition.So frankly speaking (IBS) represents a functional disorder of gastrointestinal tract without the presence of an anatomic defect. Recent studies by French scientists have indicated that the most important mechanisms include visceral sensitivity, abnormal gut motility and autonomous nervous system dysfunction. The interactions between these three mechanisms make bowel's function susceptible to many exogenous and endogenous factors like gastrointestinal flora, feeding and psychosocial factors. Further data indicate that according to the above mechanisms, the influence of genetic factors and polymorphisms of human DNA in the development of IBS is equally important. So in lay mans language till date we are not sure whats the exact cause of this problem.So the million dollar question is how to repair a system when you don't know which part of it is faulty(Some says it can be brain other says it can be hormone anxiety age etc etc). Some patients have attacks of diarrhea and bloating and some may have constipation. Other symptoms that may be present in irritable bowel syndrome include nausea, vomiting, headache, loss of appetite, muscular pains, heartburn, and weakness. Some patients have occasional symptoms whereas others may have symptoms for a long period of time.So as seen above every patient is different.Intensity of symptoms in every patient is different as so is the response to medicines and life style change.A patient may respond good to one medication while other patient is totally unresponsive to the same. Our goal- Every drug is not effective in every patient so we have to try different therapies till we find the drug which suits best our patient. Dicyclomine is an anticholinergic drug.An anticholinergic agent is a substance that blocks the neurotransmitter acetylcholine in the central and the peripheral nervous system. Anticholinergics inhibit parasympathetic nerve impulses by selectively blocking the binding of the neurotransmitter acetylcholine to its receptor in nerve cells. Mebeverine is an antispasmodic medicine and is very useful in IBS and is well tolerated by patient with minimal side effects.Mebeverine works on certain muscles in the wall of your intestines, causing them to relax. Clidinium bromide is an anticholinergic (specifically a muscarinic antagonist) drug. It may help symptoms of frequent stools. Chlordiazepoxide works by increasing the action of GABA, a chemical messenger which suppresses the abnormal and excessive activity of the nerve cells in the brain.Can be used in combination with above mentioned medicines. Another OTC medication is Bismuth sub-salicylate. It belongs to a class of medications called antacids and adsorbents marketed by name of Pepto Bismol. Doses up to 1gram can be taken daily to provide symptomatic relief. Loperamide can be used but should be avoided as she is already having excessive bloating. For bloating and gas take Tab Nexium 40mg twice daily can increase it to 80 mg twice daily.Take a probiotic daily with food as proper digestion of food will prevent excess gas formation.When food is not properly digested large amount of gases are produced inside due to incomplete fermentation of food.Hence if digestion improves overall symptoms will also improve. Food pattern recommended is- Eat simple and natural home cooked food. If possible try detox diet (Raw vegans) for at least 3 month. Take normal food in lunch while in supper take uncooked raw (low fiber) natural form of food. This can play wonders. Avoid taking excessive fibres. A total fiber intake of about 20-25 gram per day would be good for you. No pizza,Burger, Red meat, and dairies for few weeks. No alcohol or smoking. Ask her to take natural food rich in probiotics like Yoghurt, Kimchi,etc.This doesn't mean that you have to take them as much as you can.Follow your body increase their uptake gradually. Drink lots of juices and fresh water daily. Drink cleaner water, it will help a lot. Avoid over spicy and heavy food. If possible go for a detox diet but again don't force your body rather let your body adopt gradually to things. In case you need any other help feel free to ask.I would be happy to help you. Hope i answered your query well. Thanks and Wish her luck.