Question: Dear Doctor,

I am a chronic IBS sufferer for the past 4 years now almost , my symptoms are neither C or D, but lower left abdominal pain cramps especially after lunch, flatulence and trapped gas in my sigmoid colon. i also suffer from incomplete evacuation because of which i go 2ce in the morning to the toilet to make myself feel good. My stools are off late well formed but the issue is i go 2-3 times per day, out of which twice in the morning after waking up in an hour and occasionally once in the afternoon or later. Have consulted several gastro docs here in Dubai , all have confirmed that my lower left sigmoid colon contractions are quite severe and random. No other abdominal pain any where apart from the lower left quadrant which the docs say is typical of IBS. I am symptom free in the mornings usually and in the evenings. Its only the afternoon time where the gas and flatulence and cramps are quite bad. What medication do you suggest apart from the ones i have written below ? Will a course of Pan 40 or Omez for extended period help ? I do avoid all milk products apart from yogurt but given the travelling nature of my job its rather difficult to eat health food all the time. In the night if i have chicken or fish without vegetables it makes it difficult, so i usually take a high fiber diet in the night to make me feel better in the morning and avoid the incomplete evacuation problems. Please advise on medications and any further tests ?

I presume if i can PAN 40 empty stomach morning along with a Duspatalin retard 200 mg morning n evening for a duration of 6 weeks it will improve the symptoms ? Also will Duspatalin help in the trapped wind flatulence and the incomplete evacuation ? Pls advise.