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Dr. Andrew Rynne

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Chronic bloating and constipation. Following IC friendly diet. Opinion?

I am a 36 years old female with more than ten years history of chronic bloating and chronic constipation . Different tests showed no abnormalities in my bowels, so Gastro suspected IBS-C and just recommended to manage with diet and laxative (Milk of Mg, Miralax, etc). I tried drugs like zelnorm and amitiza w/o success. Lactulose made bloating even worst. Also, off-label use of a drug similar to colchicine , which name I can t remember. This one seemed to work but stopped it because I was afraid of its teratogenic effects. High-fiber diet does not make a difference. Eighteen months ago, I gave birth, and bloating and constipation were a little better after delivery. About a month ago, constipation and bloating have been terrible again, and started to have symptoms like an UTI. The OB-GYN diagnosed me with Interstitial cystitis . I am currently, taking Elmiron, Hydroxyzine , IC-friendly diet, and having a series of bladder instillations. I feel better regarding my IC symptoms, but noticed that whenever the constipation and bloating are bad, IC flares up. Currently, I am having liquid bowel movements (with Milk of Mg) and noticed my breath and stool smell like a chemical substance. Bloating is still there, even if I have a bowel movement, and aggravates along the day. I am following the IC-friendly diet, but there are some things that are IC friendly (ie wheat), that aggravates my GI problem. I read about a low FODMAP diet, but I would like to consult a Gastro about these because I am feeling like doing both diets is very limiting. Also, I would like to have things under control as I am thinking of getting pregnant again. I am worry about nutrition, and gaining weight during pregnancy. I will see a gastro in a couple of weeks, and want to bring up this IC diagnosis, and possibly evaluate for SIBO or celiac. No Dr has ever mentioned any of these conditions, but I read that IBS-C and these have overlapping symptoms and you can end up being misdiagnosed. Can you please provide an opinion? I need some help in the meantime.
Wed, 3 Apr 2019
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General Surgeon 's  Response
Hello,

* Sounds more likely in relation with functional bowel issue rather than the inflammatory issue.
* Addition of digestive enzymes, triphla and ayurvedic approach with ispaghula and gut prokinetic drugs as itopride help greatly in this regards. The same should be discussed with your consultant in next follow up a conversation.

Do feel free for further doubt clarification at this platform.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Bhagyesh V. Patel, General Surgeon
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