Dr. Anshul Varshney
Internal Medicine
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Patient's Query
Hi doctor,
I am a 62 year old male. I am suffering from multiple neurofibroma of spinal cord and acoustic neurofibroma. I had bypass surgery four years ago and since then I am under medication, which is given below. My present problem is related to stomach. Since the operation, I started having sudden bouts of loose motion. Earlier, the interval between the bouts was about 15 to 20 days which gradually reduced now to about three days. I have consulted numerous doctors including gastro specialist. Sonography reveals all organs to be normal except grade one fatty liver. No blood, pus cells in stool. My hemoglobin is 16.1. I have undergone deworming course by taking Rcifax 400 bd (twice daily) for five days, Noworm 400 and Nortryptomer od (once daily) for three days, but there has been no effect. The consulted doctors have different opinions, some say that it is due to neurofibroma and some say it is due to reaction of medicines which I am taking. But no remedy has been suggested yet. If the loose motions become uncontrolled, I am forced to take Norflox TZ, which gives temporary relief. These loose motions are sudden, often soil clothes and have imprisoned me in the house. My current medication includes Nikoran 5 bd, Cardivas 3.125 bd, Cardace 2.5 od, Flavedon MR od, Lasix 40 half tablet od, Becosule od, Clopivas 150 od and Rosuvas 10 od. Please help me.
Hi,
Welcome to icliniq.com.
Such diarrhea is seen in Irritable bowel syndrome (IBS). IBS is of three types diarrhea predominant, constipation predominant, mixed variety. You seem to be suffering from IBS diarrhea predominant. However, IBS is a diagnosis of exclusion. We investigate suspected cases of IBS with thyroid profile, fasting blood sugar and ultrasound abdomen. If all investigations are normal as you have mentioned blood and stool test (considering these investigations have been performed), then you are probably suffering from irritable bowel syndrome. In case you ever have had blood or mucous in stools, you require a colonoscopy to rule out any evidence of inflammatory bowel disease. I suggest the following for treatment of IBS: Firstly, proton pump inhibitors like Pantoprazole and Rabeprazole, which will help in neutralizing any acid if you have in stomach. secondly, you should avoid fat and pepper in diet and prefer to take soft, bland diet. Thirdly, you can take smooth muscle relaxant like Mebeverine for stomach pain, in case you have. And lastly, in refractory cases drugs like Chlordiazepoxide and Clidinium bromide can be used, if the condition is not responding. I hope this helps. Thank you and take care. Regards.
The Probable causes
Investigations to be done
Probable diagnosis
Preventive measures
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Internal Medicine
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