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    Suggest treatment for severe loose motions

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Posted on Tue, 11 Jul 2017 in General Health
Question: My mother is suffering from losses stools from the past 3-4 months. Tried everything from antibiotics to lopamide but condition still the same. Has been taking Rifaximin 200 twice daily from the past 3 days but symptoms still the same. Please advise!!!
doctor
Answered by Dr. Ramesh Kumar 40 minutes later
Brief Answer:
Stop all antibiotics its irritable bowel syndrome and not enteritis.

Detailed Answer:
Hello Dear patient,
Thanks for choosing HealthcareMagic for your query.
Have gone through your details and i appreciate your concerns.
The treatment she is recieving currently is of Gastroenteritis however as she is not responding to above medication mostt likely she is suffering from irritable bowel syndrome
Firstly small briefing for Irritable bowel syndrome.
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 symptoms of unformed stools some have bloating and some may have severe constipation. 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.
What should be 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.All the below mentioned drugs slows down motility of intestines hence will decrease both frequency of motions as well as will increase your power to control them.


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.


Ask your Gastroenterologist to start her initially on clidinium bromide and mebeverine combination initially for 21 days.
Stop all other medicines and see how she responds to the above mentioned therapy.

If possible go for an ultra sound abdomen and fecal calproctin test to rule out inflammation of gut.


Please feel free to follow up it would be a pleasure to help you.

Thanks.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ramesh Kumar 35 minutes later
Thanks a lot Sir.....how about using Colospa Retard a mebeverine product used for IBS. If yes, should we start with Colospa Retard 200 twice daily and for how long should it be used. Also, please suggest is we need to start some other medicine as well.
doctor
Answered by Dr. Ramesh Kumar 14 minutes later
Brief Answer:
Follow up.

Detailed Answer:
Hi again,
Yes start taking colospa retard twice daily for 1 month initially 1 hour before taking a large meal.
Initially take it for 7 days and report how are her symptoms after taking that.
Tab Dicyclomine 10 mg thrice daily can be added to it.

A better option is taking one tablet Cibis Chlordiazepoxide 5 MG+Clidinium bromide 2.5 MG thrice daily before breakfast lunch and dinner.
Along with it take metamucil /isabghullu husk 2 tsf two times a day with half cup of water.

Follow up after 7 days.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ramesh Kumar 58 minutes later
Sir thanks a lot for the advice. Please explain if we start taking colospa retard as suggested by you do we need to take dicyclomine along with it or can we add cibis instead thrice daily. Also, please suggest whether or not we should go for colonoscopy
doctor
Answered by Dr. Ramesh Kumar 17 hours later
Brief Answer:
Follow up.

Detailed Answer:
Hey again dear,
Colospa and cibis both contain mebervarine so start one of them but i would suggest you to take Cibis.
Irritable bowel syndrome is a diagnosis of exclusion which means that when all other causes are ruled out patient is labelled as IBS.
So yes colonoscopy can be done to ruke out chances of inflammatory bowel disease if money is ot a issue.

Thanks!
Above answer was peer-reviewed by : Dr. Kampana
doctor
Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2438 Questions

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