What treatment options are safe for IBS-D in breastfeeding women?

Question

Hi doctor,

I am 34 and my IBS-D has been destroying my life, especially since I had my second baby 18 months ago. The diarrhea happens six to eight times daily. I tried an elimination diet and found that dairy and gluten make it worse, but even avoiding them does not stop symptoms. My gastroenterologist prescribed Imodium and Dicyclomine, but they barely help. Hormonal changes during my cycle make everything worse - symptoms are terrible the week before my period. I tried Rifaximin for two weeks, which helped temporarily, but symptoms came back after stopping. Stool samples were negative for infections, and inflammatory markers were normal.

The colonoscopy last year was normal except for some inflammation. The constant urgency and cramping are affecting my work and relationships. The baby is still nursing, and most medications are not safe during breastfeeding, according to my doctor. I tried probiotics and peppermint oil, but minimal improvement. Stress definitely makes it worse, and being a working mom with two kids is stressful. I lost 12 pounds since delivery and am worried about nutrition. What treatment options are safe for IBS-D in breastfeeding women? Also, I am concerned this might be something more serious since the symptoms are getting worse.

Thanks.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

I have read your query and seen all the previous records she has available online. Given the potential diagnosis of major depressive disorder, and probably after taking the medicines for that, she might have IBS (irritable bowel syndrome), and some side effects could be of the medications she is on.

However, if it coincides with depression of other behavioural disorders, the management can be challenging. I am sure you have tried multiple medicines, but I want to make sure that you take the following medicines and come back to me to see if it improves your symptoms.

Take Rifaximin 200 mg before a meal, tablet Levosulipiride 50 mg twice daily before meals, Ispagol husk two tablespoons with water daily in a glass of water. These medicines are safer for breastfeeding women. Continue avoiding the high FODMAPS (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet.

I also want to recommend that if she has not gone through endoscopy and a colonoscopy, she should get it done to make sure there is nothing wrong with the bowel inside.

I hope this information will help you.

Thanks.