Can dietary changes help manage IBS and bloating?

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I am reviewing your case history in detail and will get back shortly. Please wait for my detailed response before replying.

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Hello,

Welcome back to icliniq.com.

I have reviewed your history and attached laboratory investigations, including your metabolic profile, antibodies testing, chest X-ray, MRI (magnetic resonance imaging) brain, etc (attachment removed to protect the patients identity). Thank you for mentioning your diet as well.

Regarding your specific concerns:

1. I acknowledge the presence of severe IBS (irritable bowel syndrome), anxiety, and lactose intolerance. However, I did not find strong evidence of a leaky gut. This could indicate a gut microbiota imbalance (dysbiosis), which is very common and can cause similar issues, especially in patients with IBS.
2. Your body weight, height, metabolic profile, MRI (magnetic resonance imaging) brain, and chest X-rays are grossly normal, except for minor sinusitis or bronchitis changes on X-rays, which is reassuring.
3. Headaches and chest X-ray symptoms are likely related to sinusitis and bronchitis. Please look for recent exposure to allergens or changes in weather or environment.
4. Even pain in the ear or behind it can be due to nasal congestion from sinusitis. Wearing a mask and using the aforementioned medication should help. Otherwise, I would prefer to change anti-allergics.
5. For wheat allergy, TTG IGA (tissue transglutaminase IgA) levels should be checked specifically to diagnose wheat allergy or celiac disease (endoscopy and biopsy are necessary). Before doing this, one cannot diagnose wheat allergy, so do not compromise your routine diet.
6. Regarding your syncope episodes in the past, I hope your cardiologist has evaluated your mitral valve prolapse history and beta-blocker medication.
7. Regarding your IBS, it will improve once your anxiety is better controlled.
8. Moving towards your diet, I agree with what you are currently consuming. I would like to add regular use of probiotics. Commercially available sachets or capsules would be great, taken once daily. Adding yogurt to your diet (a good source of probiotics) will help reduce bloating and treat dysbiosis.
9. Gradually reintroduce your routine meals, including wheat. Unnecessary dietary restrictions can lead to macro and micronutrient deficiencies, which would be unhealthy for a young woman like yourself.
10. Tablet Rifaximin 550 mg after breakfast and dinner for ten days is recommended. This is one of the best medicines to treat bloating and dysbiosis in patients with IBS. Consult a specialist doctor, talk to them, and then take the medication.
11. There is a need to adjust your anxiety medication. Good mental health is necessary to avoid undue health anxiety and live a healthy life.
12. We cannot micromanage our gut as humans. Stay relaxed and try to reintroduce your routine meals gradually. Avoid reheated, processed meals and eating out. Try to consume freshly cooked home meals.

Wishing you excellent health.

Kind regards.