Hello Dr. XXXXXXX and welcome to XXXXXXX

Thank you for writing to us and honoring us with your presence on this site.

Coming to your query. It appears as though you could be suffering from irritable bowel syndrome (IBS). Before listing some of the most common symptoms/presentations for you, so you could relate to them and conclude on the same yourself; I would like you to know the main thing about IBS, which is the triggering factor. Triggering factors are the food/liquid items which trigger an episode of IBS. If these factors have been realized in a particular individual and avoided, all future episodes of IBS can be completely prevented.

Now let me start with listing the symptoms of IBS. They are:
-Abdominal pain/cramping immediately after coming in contact with the triggering factor
-Abdominal bloating or just the feeling
-Flatulence
-Mucus in the stool (not always)
-Explosive diarrhea (also not always)
-Semi-solid or liquid stool
-Diarrhea or constipation (as there are different types of IBS)
These are some of the most common symptoms of IBS, although there are a few others as well, which are less common.

Now let me list a few of the most common triggering factors for you. You could relate to these and find the cause for your episodes. Please also note that triggering factors are individual-specific and can be totally different in your case. Here are some of the most common ones:
-Coffee or tea
-Carbonated drinks
-Popcorn
-Caffeinated drinks
-Chocolate
-Lactose drinks or food products
-Alcohol
-Oily/fried/fatty food
-Sugar containing food or drinks
-Spicy food
-Some vegetables like broccoli, cabbage, brussels sprouts, cauliflower, peas, onions, beans, nuts
-Stress

The main mode of treatment for IBS is patient education. Lifestyle and dietary modification's can help completely avoid all episodes of IBS. Along with this, consumption of anti-spasmodics (eg. capsule MEVA-C or colospa-RTD) during an episode of IBS can greatly reduce the symptoms and prevent future episodes.

IBS is usually confirmed with the help of clinical presentation, history and a colonoscopy during an episode. Please write back to me with your comments, and we could discuss any further doubts you have on this or discuss other possibilities.

I hope you found my response helpful and informative. It is my pleasure to be able to help another doctor. Do write back to me if you have any further clarifications. I would be happy to help you.

Best wishes.

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Hello once again sir.

Coming to your specific questions.

1. The reason why water can irritate your bowel on an empty stomach is because the temperature of the water can irritate individuals experiencing an episode of IBS. You could try to drink water of a different temperature or avoid drinking water on an empty stomach completely

2.You are experiencing the discomfort immediately after food, as mentioned in my previous response, because the food you are consuming could have a triggering factor in it, which is immediately irritating the gut and thus resulting in a bowel movement

3. Your stools are now fine, thin and semi-solid or liquid because of the irritation of the gut due to consumption of a triggering factor. This irritation of the gut causes inflammation of the gut and prevents absorption of fluid, thus resulting in fine, semi-solid or liquid stools

4.Stomach bloating is also a sign of bowel irritation, once in contact with the triggering factor

5. Good food for preventing episodes of IBS are:
-High-fiber diet
-Eating frequent smaller meals instead of larger less frequent ones
-Gluten and lactose free diet
-Berries
-Citrus fruits
-Rice
-Potatoes
-Oats
-Corn products
-Salad vegetables
-Lean meat, fish and poultry
-Granulated sugar and small servings of maple syrup are well-tolerated
-Probiotics (natural probiotic is yogurt, curd, etc.)

You could also consult a nutritionist who will recommend a FODMAPS diet.

I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications. I would gladly help you.

Best wishes.

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Hello once again.

Side effects of Rabium are only seen from prolonged use. The most important one can be abdominal pain. Other than this, it should not have any other adverse effect. You may continue these, as long as they provide you relief.

Side effects of unienzyme include .

If you are speaking about unienzyme and rabium, it is best to take both these tablets before food, 10 minutes before food.

The only effect insulin can have on your condition, is that it can make you hungry quicker, which is why you will have to have small portions of food, at regular intervals.

That biopsy if normal indicates the absence of any pathology in the tissue and cells. This is normal and good.

The H. pylori test can be repeated once in 6 months, but unless indicated, it should not be required.

The increased amount of acid could result in various pathologies in the stomach (eg. ulcers, etc.), this can be controlled with medication.

From the presentation and complaints it appears as though your diagnosis is 'IBS)', an ulcer can be ruled out as an endoscopy returned normal. Increased acidity can result from long periods of starvation and gastritis could be the second possibility.

I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications. I would gladly help you.

Best wishes.

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