My father has irritable bowel syndrome. Can probiotics help him?

Question

Hello doctor,

I am asking about my father, aged 52, who has frequent watery motions four to five times daily with cramping pain, diagnosed as IBSD. He also has diabetes and takes Metformin.

His stool tests and ultrasound were normal. So, my concerns are:

Could Metformin be making IBSD worse?
He was prescribed Loperamide (Imodium), which controls diarrhea, but then he feels bloated and uncomfortable. Is it okay to use it regularly or only as needed?
Should probiotics really help in IBSD, or are they mostly overrated?

We are confused because his symptoms keep fluctuating without a clear reason.

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Your father’s symptoms are consistent with irritable bowel syndrome with diarrhea predominance (IBSD), especially since his stool tests and ultrasound are normal.

IBS commonly causes fluctuating symptoms, including watery stools, cramping abdominal pain, and periods of worsening without a clear trigger.

Regarding medication, Metformin (commonly used for diabetes) can sometimes worsen diarrhea or cause gastrointestinal discomfort in certain patients.

If his symptoms started or worsened after starting or increasing Metformin, it would be reasonable for his physician to review the dose or consider an extended-release formulation, which is often better tolerated.

Loperamide (Imodium) works by slowing bowel movements and is generally safe. It can be used as needed, especially before travel or important activities. Some patients experience bloating or constipation when using it regularly, so adjusting the dose or frequency may help.

Probiotics can be helpful for some IBS patients because they may improve gut microbiota balance and reduce gas or diarrhea, though the response varies between individuals. They are not a cure but may provide modest symptom relief if taken consistently for several weeks.

Other helpful measures include regular meals, limiting caffeine and fatty foods, considering a low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet trial, managing stress, and maintaining good hydration.

If symptoms remain troublesome, a gastroenterologist may consider other IBS-specific treatments tailored to his pattern of symptoms.

I hope this helps.

For more queries, you can reach out to me anytime. I will be happy to help you.

Thank you.