Q. Can you please advise what I can do to overcome IBS symptoms?

Answered by
Dr. Ajeet Kumar Lohana
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Jul 29, 2020 and last reviewed on: Aug 20, 2020

Hi i have had IBS for 25 years now. My symptoms have changed over the years. It started with stomach gas, discomfort and loose stools. Later i had constipation, gerd and stomach oain. For the past 15 years i have had diarrhea, loose stools and also acidity and nausea. Iam not able to eat anything other than rice porridge. I eat anything other than that i get loose stools and severe acidity. I have gone through all the tests from colonoscopy endoscopy to upper gi. Evrything came back -ve. Can you please advise what i can do to come out of this? Thanks.

#

Hello dear. I welcome you to icliniq.

I can only imagine the level of your endurance while being through all this. Given your uncontrolled symptoms make me believe there must be various mishaps while management of your symptoms.

As from your history, given no alarms symptoms like weight loss, decreased appetite and abdominal swelling, it is clear that you have functional GI disorder. Now be noted that, not all your symptoms fit in IBS. IBS is more towards large bowel and sometime to small bowel spasm, excessive secretions and thus resulting in to abdominal pain and diarrhea. It is also common to have another functional Gastrointestinal disorder accompanying with IBS. The once such is called functional dyspepsia which can cause stomach pain, acidity-means more towards upper Gastrointestinal tract disease in contrast to IBS.

Since I think there is no more discussion to the diagnosis of the problem you have, because it is less likely something else for that long and does not happen to cause alarming symptoms at all. So I rather suggest you the treatment strategy from now. Three easy steps.

  1. Mebervine 200 mg twice daily. I am sure you have used it before. So jump to the next one.
  2. Behavioral therapy /counselling/exercise particularly weight loss if overweight, swimming (this is particularly helpful in functional GI disorder, joining a groups of patients with IBS.
  3. Lastly low dose anti depressant medications.

I want to quickly check if you have been on low dose antidepressant and any side effects observed so far.

  • Did you have your liver testing done before?
  • Do you have any cardiac history, like angina/heart pain?
  • have you been tested for diabetes, celiac disease, and thyroid disease?
  • Have you been on low dose antidepressant medications before?
  • what are there names? and what doses and for how much duration you used them?
  • You update me with the above information, and I would be able to select and selective therapy to treat your problem?

If you want you can use phone or video consultation to discuss thing in detail and in no time.


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