How to get rid of symptoms of irritable bowel syndrome?

Question

Hi doctor,

I am a 42-year-old male who weighs 210 lbs, and I am 5.11 feet tall. I have been having severe digestive and related symptoms for quite some time. I was diagnosed with IBS many years ago, but I would like a second opinion. My symptoms include severe nausea, vomiting, diarrhea, fatigue, dizziness, headache, loud digestive noises, cramping, bloating, and food intolerances. I have been gluten-free and dairy-free for many years. I eat very healthy food with lots of fresh vegetables and meats, not a lot of processed foods, very little sugar, rarely coffee or tea, and drink mostly water. These symptoms would come and go throughout my life. The older I get, the worse the symptoms become. Now I am sick all the time and can barely function. All I want to do is sleep. I went to the ER last night and explained the symptoms and medical history, so the doctor did some tests, the reports of which I am attaching. I received IV fluids and was discharged. The doctor stated that my lab results were "benign." I went over my results, and they do not appear "benign" to me, so I would like a second opinion. Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your reports (attachment removed to protect patient identity), and they are fine except for some neutrophilia, which is indicative of some inflammation or infection somewhere. Overall, it is fine. Do you have any fever or burning while urination?

There is a possibility of gastritis and IBS (irritable bowel syndrome). Firstly, you have some dietary modifications like regular meal patterns, reduced intake of fat, insoluble fibers, caffeine, and gas-producing foods such as beans, cabbage, and onions.

For the treatment of IBS and neutropenia, I suggest you try the following.

A course of antibiotic Rifaximin 550 mg three times daily for 14 days.
You should avoid a fatty, oily, and spicy diet.
Go for a walk after having food, instead of taking a rest.
Take multiple small meals instead of heavy meals.
Have regular sleep habits and avoid stress.
Try taking an antacid like tablet Pan (Pantoprazole) DSR 40 mg or Esomeprazole and Domperidone combination before breakfast once a day for three weeks.
Tablet Amitriptyline 10 mg at bedtime, for a few weeks. This is helpful in reducing diarrhea, pain, etc.
For immediate pain relief, you can try an antispasmodic like tablet Dicyclomine 20 or Hyoscyamine 10 mg whenever needed up to three times a day, or sustained release Hyoscyamine 0.375 to 0.75 mg orally every 12 hours.
Also, if diarrhea is troublesome, then try taking tablet Loperamide 2 mg, 45 minutes before a meal on a regular schedule.
Regular physical activities are very important. Try to lose some weight.
Consult your specialist doctor, discuss with him or her, and start taking the medicines after their consent.

Hope this helps you, and get back to me if you have any doubts.

For further queries consult an internal medicine physician online.

Answer 2

Hello,

Welcome back to icliniq.com.

Diverticulitis or diverticulosis is less likely, as it is a disease of old age and associated with constipation; however, inflammatory bowel disease, like ulcerative colitis or Crohn's disease, should be ruled out. So, a colonoscopy should be done.

I think you need to try antidepressants like Amitriptyline, which I mentioned in previous posts, even if you do not have depression symptoms, as they are quite effective. Since you are helped by Kaopectate, you can also have syrup Gelusil or Sucral O a (combination of Sucralfate and Oxetacaine), two teaspoons three times a day.

For more information, consult an internal medicine physician online.