I get recurrent diarrhea with IBS. Kindly suggest medication.

Hello,

Welcome to icliniq.com.

You seem to have given too many medicines and incomplete diagnosis.

Anemia- based only on a Hb value of 9.9 g/dl. This value can be managed by having an effective diet planned by a qualified nutritionist with a diet plan for both anemia (high iron) and irritable bowel syndrome. Iron supplements are not necessary at this stage. Please let me know if you have a history of worm infestations or abnormal bleeding during your menstrual periods or whether they are too frequent and irregular.

Gastritis has many causes including stress, adverse effects of medicines such as pain killers (non-steroidal anti-inflammatory drugs), iron, and H.pylori infection. From your upper GI (gastrointestinal) endoscopy report, there is no indication of H. Pylori testing.

Regarding irritable bowel syndrome, there is no evidence based on the investigations uploaded by you. There is no report of the lower gastrointestinal (GI) endoscopy to diagnose IBS and rule out organic disorders.

Based on the above, my recommendations are to take the following measures:

1. Nutritionist consultation.

2. Lower gastrointestinal endoscopy (sigmoido-colonoscopy).

3. Repeat the hematology blood test.

4. Stool culture.

5. H. Pylori test results from upper GI center.

6. Take a capsule of Econorm (Saccharomyces Boulardi) 250 mg one capsule twice daily (after lunch, after dinner) for seven days, Limcee (Vitamin C) 500 mg one tablet (after lunch) once daily for 15 days, Morease-L sachets (Mebeverine 135 mg plus Isapghula) one sachet twice daily for seven days, Emfol (Folic acid) 5 mg once daily (after lunch) for 15 days, Cintapro one tablet twice daily (before lunch and dinner) for seven days, and Rabeprazole 20 mg one tablet once daily for seven days.

Please revert after completing the above. You can use any brand of the above medicines that is locally available.

Hello,

Welcome to icliniq.com.

It is good to know that we can rule out worm infestation-related anemia now that you have taken antiworm medicines. Heavy periods could cause loss of blood and mild anemia. Maybe you could reduce a bit of blood loss by taking the tablet Drotin M (Drotaverine 80 plus Mefenamic acid) once or twice a day during the heavy period days.

For gastritis, Rabeprazole should take care of unless you have an H.pylori infection, which is why I have advised you to take an H.Pylori test in the next upper GI endoscopy or take the result from the earlier hospital where you did the test.

For mild anemia, please consume iron-containing foods such as figs, peanuts, almonds, walnuts, cashews, pine nuts, and hazelnuts. Pumpkin seeds are rich in iron, and non-vegetarian foods like mutton liver, chicken breast, seafood, and eggs can highly boost iron levels, and folate-containing foods like legumes, asparagus, citrus fruits, beetroot, banana, broccoli, meat liver, eggs, etc.

Additionally, please add tablets of Claribid (Clarithromycin) 250 mg, and Tiniba (Tinidazole) 500 mg to the above and change tablet to Rabeprazole 20 mg one tablet twice daily for seven days (instead of one tablet per day prescribed above).

We shall do the tests after the above medicines including lower gastrointestinal endoscopy, blood investigations like hematology, and serum folate levels, and decide on further treatment, if necessary.

Hence the current prescription is as follows capsule of Econorm (Saccharomyces boulardi) 250 mg one capsule twice daily (after lunch, after dinner) for seven days, Limcee (Vitamin C) 500 mg one tablet (after lunch) once daily for 15 days, Morease-I sachets (Mebeverine 135mg plus Isapghula) one sachet twice daily for seven days, Emfol (Folic acid) 5 mg once daily (after lunch) for 15 days, Cintapro one tablet twice daily (before lunch, before dinner) for seven days, Claribid (Clarithromycin) 250 mg one tablet twice daily for seven days, Tiniba (Tinidazole) 500 mg twice daily for seven days, and Prazohext (Rabeprazole) 20 mg twice daily for seven days.