Dr. Anshul Varshney
Internal Medicine
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
When I moved to a new city four years back, I used to eat hotel food which caused frequent food poisoning episodes. I got food poisoning more than 20 times over two years. Each time it was treated with a course of antibiotics. Ever since, there has been something that is not normal with my digestive system. For the last three years, I have completely shifted to home-cooked food. I have gas issues with food items which I did not have any issues with in the past. The stool is not well formed. It does not have a rigid consistency. Attempts were made to correct this issue by using probiotics and fiber supplements. Also, a non-absorbing antibiotic called Rifaximin was tried to see if there was an improvement but in vain. Now the diagnosis is favored towards the functional issue of intestines.
I tried the tablet Mirtazapine 7.5 mg. The result was positive, and the stool became rigid in consistency. But due to a side effect (obsessive thoughts) of Mirtazapine, it was stopped after ten days. The next medicine tried was the tablet Librax three times daily, half an hour before food. I tried it for three weeks, but it did not give me a positive result. The only thing which I felt was sedation.
Now that the tablet Mirtazapine has given me a positive result, it is suggested that a similar medicine be used. Therefore, the tablet Ramosetron 5 mcg daily once is suggested.
Can I try the tablet Ramosetron and note the response? What about the side effects of Ramosetron? Can I switch immediately to Ramosetron without tapering the tablet Librax three times daily? If tapering needs to be done, what is the schedule for that?
Hi,
Welcome to icliniq.com.
I read your query and can understand your concern.
You must understand that you suffer from IBS (irritable bowel syndrome). Tablet Ramosetron is a vomiting medicine, though it is used in diarrhea prominent IBS. So, I am pretty sure it is not going to help you. On the other hand, the tablet Librax is an old-time-tested drug that helps a lot with IBS. As far as side effects of Ramosetron are concerned, they are theoretically many but practically not much.
With the current scenario in IBS treatment, a combination of Mebeverine and Chlordiazepoxide (Libirium) helps greatly. In addition, yoga, meditation, and walking are great treatments for IBS.
Hope this helps.
Thanks and take care.
Patient's Query
Hello doctor,
Thank you for your reply.
So is there a chance that patients who do not respond to Clidinium bromide and Chlordiazepoxide will respond to Mebeverine and Chlordiazepoxide? Can you let me know the daily dosage for the Colospa X tablet and the duration of the treatment? Also, can I try it for a week and see if there is a positive response?
Hello,
Welcome back to icliniq.com.
I read your query and can understand your concern.
Usually, the medications respond. If they do not, we add an anti-depressant. You can take the tablet Colospa X initially three times a day for two weeks, then twice daily for three months. However, you need to see a doctor in person to get the prescription as it is a prescription medicine.
Hope this helps.
Thanks and take care.
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Internal Medicine
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