How to manage irritable bowel syndrome?

Question

Hi doctor,

I might have developed IBS (Irritable bowel syndrome) following my history of an eating disorder (anorexia). It has been five years since I started eating normally again, and my weight returned fairly quickly (within three to four months). However, my digestion has not fully recovered. I still experience incomplete bowel movements, excessive gas, irregular bowel habits, and frequent flatulence after bowel movements. I have developed lactose and gluten intolerances, which I have avoided, but neither has helped my symptoms.

I am really struggling to get my life back on track. These issues have caused me to skip university and have impacted my social life, as living with constant flatulence and bowel discomfort has made it difficult to maintain friendships. From what I have read, I expected these symptoms to resolve once I reached a normal weight, but they seem to be getting worse instead.

I am curious to know what might be causing my symptoms, as dietary changes and medications (like Dicyclomine) have not provided any relief.

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I have received your inquiry and can understand your concern.

Abnormal gastrointestinal tract (GIT) function is quite common following prolonged periods of anorexia. We need to adopt some techniques and make adjustments as we progress. Here are my recommendations:

Discontinue Dicetel, as it has not provided any relief.
Start Domperidone tablets, 10 mg, half an hour before each meal, three times daily.
For the next two weeks, maintain a diet consisting of dried items (bread/toast), grilled non-fatty meats, steamed rice and vegetables, and fruits.
Avoid milk products for now, as excess fermentation can worsen your symptoms.
Begin each day with two cups of warm water, which helps restore bowel motility.
Excessive gas may take some time to manage. Begin taking two tablets of Simethicone (an antiflatulent) after each meal.
Lastly, I recommend having your last meal before 8 PM and taking a 20-30 minute walk in fresh air daily. This will have a positive impact on your long-term health.

Let us check in again after one week to monitor your progress. Please feel free to reach out if you have any further questions.

Thank you.