I am 34 with IBS-D. How can I best manage my condition?

Question

Hello doctor,

I am a 34-year-old woman who struggles with urgent diarrhea after meals, especially when I am feeling anxious or eating out. My colonoscopy and stool tests were normal. My doctor suspects irritable bowel syndrome with diarrhea (IBS-D).

Please guide me:

What are the best dietary changes, medications, such as Rifaximin (antibiotic) or antispasmodics?
What stress reduction techniques can be used for managing this condition?
Effective strategies to control my symptoms and improve my quality of life?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

Given your symptoms and the colonoscopy findings being normal, irritable bowel syndrome (IBS) is the most probable diagnosis, particularly the diarrhea-predominant type (IBS-D).

Let us look at some of the measures you can take to help manage and reduce your symptoms:

Diet modification: The most important step is modifying your diet. Avoid the following food items, which are known as high FODMAP foods (Fermentable Oligo-, Di-, Mono-saccharides and Polyols). Following a low FODMAP diet has been shown to significantly improve symptoms in individuals with IBS-D.

I advise you to take the following medications:

Take Rifaximin (antibiotic) dosage 550 mg, taken twice daily for a duration of approximately two weeks. It works by reducing bacterial overgrowth in the gut.
Mebeverine (antispasmodic agent) dosage: 200 mg, taken twice daily before meals. It helps by relaxing the intestinal muscles and reducing cramping.
Loperamide (antidiarrheal agent) dosage 2 mg, taken before meals that are known to trigger symptoms. It slows down gut movement, thereby reducing urgency and frequency.
Bifilac (probiotic) contains beneficial bacteria to support gut health. Recommended dosage is three times a day for about one month to evaluate its effectiveness.

Stress management: The gut-brain axis plays a significant role in IBS. Stress and anxiety can strongly influence your gut health and worsen symptoms.

Some helpful strategies include:

Deep breathing exercises.
Yoga and meditation.
Cognitive behavioral therapy (CBT), especially helpful if anxiety is a major contributor to your symptoms.

I recommend that you consider the following things:

If you experience any of the following symptoms, re-evaluation is strongly advised:

Unexplained weight loss.
Blood in stools.
Family history of gastrointestinal cancers.

I hope this helps.

Thank you.