Brief Answer: Need to follow-up with a good GI doc Detailed Answer: Hi. I am so sorry to hear about your Gastro-Intestinal Problems. Irritable Bowel is a very long term issue and needs constant therapy. Unfortunately to date, there is no permanent cure for the disease and it's management relies on diet and lifestyle modifications along with certain medications. Diet and Lifestyle Modifications in IBS: _______________________________ Avoiding Pulses and Beans, food with high amounts of refined sugars will help. If you must drink milk try and switch to skim milk (low lactose content). The overall diet plan is called a 'Low FODMAP' diet. Our dieticians can assist you in forming a personalized diet following this scheme. In my experience, the use of Psyllium Husk (One such brand is 'Cremadiet', but there are others) will add bulk to the stools and allow you to regularize you diet. Start by taking it just before going to sleep. Good stress managment, Yoga and Acupuncture have all been used to help manage the symptoms of IBS with good results. Medications in IBS: _______________ Loperamide (Brand Name: Eldoper) has been used in the management of IBS with diarrhea (man many bowel movements a day, like yours). But it must be used with caution because the more you use it, the higher risk of getting an infection in your bowels. If you must use it. Use only 1 or 2 tablets in a day and don't use more than Once or twice a month. If you are regularly seeing a good GI doctor he or she may want to increase that dose. Antispasmodics like Mebeverine (Brand Name: COLOSPA) has also been used to regulate the bowel in IBS. It slows down the gut without ruining normal gut activities and the risk of infection is lower. Lastly, Tricyclic Antidepressants (TCA's) like Amitryptalline have been shown in studies to help with IBS. But those drugs can have many many side effects so they are not commonly used except when all else fails. Acidity and Indigestion are common in IBS and drugs like rantac and pantodac are the drugs which are used. Again, you can't use them for a very long period of time in IBS and they may predispose you to an infection. Talk to your doctor about starting one of those medications. Another way of managing that burning sensation is to sleep with you head and back propped up by about 30-40 degrees when in bed. It will prevent the acid from refluxing back into your throat and mouth. Proctitis is associated with IBS and the treatment for it is the same as the treatment of IBS. The piles can be managed by banding or surgery if absolutely necessary. A good GI doctor will be able to help you with that. I also have seen that Psyllium Husk (Cremaffin, etc) helps alot in these situations. So you may wish to give that a try after talking to your doctor. So to sum up: - A low FODMAP diet will be helpful in reducing symptoms. Talk to a good dietician and they will help you there - Psyllium Husk has many beneficial effects in IBS. - Stress management, Yoga and Accupuncture have been shown to help - Medications like Loperamide, Mebeverine, TCAs, Rantac and Pantodac can all be used to help manage your symptoms. Most important is to find yourself a good GI doctor in your area who you can talk to and follow-up with on a regular basis. That is very very important. I hope this helps. Feel free to follow-up with me on HCM if you need more info or anything else. Vinay

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Brief Answer: Good Medications, Relax, its manageable Detailed Answer: Hi, I've seen the medications you are taking and they seem to be a good choice in my mind Unfortunately there is no cure for IBS. I am very hopeful that there will be one day. But as of now, it is a CHRONIC and LIFE-LONG phenomenon But it can be very well managed and you can have a normal Job, Marriage, Sex Life, Kids, Everything! You will have to live by the dietary Modifications and Lifestyle Modifications that your Doctor prescribes and you will have to be very careful with your stress and anxiety levels as they can make things worse! I hope this helps. Feel Free to followup with me any time you want. Thanks for coming to HealthCareMagic.Com

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Brief Answer: Stick to what your Primary Doctor has given Detailed Answer: Hi there! Thanks for following up! Don't worry about taking the medications I have mentioned. I was giving you an example of the different meds that are available. So a low FODMAP diet is a diet that is low in certain sugars and proteins that re known to make IBS even worse. I just wanted you to know the name of the diet so you could mention it to your dietician. They can plan a diet like that. Pssylium Husk is the stuff INSIDE the Cremadiet powder I mentioned before. I most people it can be used as a laxative. Though in your case thats not what we are using it for. Here we are trying to add BULK to you stools so that the bowel gets regulated better. The stuff sits inside your colon and collects water. That will make it expand and add bulk to the stool. Here your diarrhea is not being caused by an infection or something like that, here the diarrhea is because you gut is constantly being irritated by the IBS. Does that make any sense? Overall, stick with your GI specialist. It will be much better in the long run. I hope this helps. Contact me if you have any more doubts. Thanks for coming to HealthCareMagic.com

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Brief Answer: Disscuss the use of Loperamide Detailed Answer: Given the frequency of your bowel movements, it may be worthwhile to discuss the use of Loperamide with your GI specialist. This is an OTC drug available in any pharmacy. One of the brand names is Eldoper, though there may be many others. I have seen it used to great effect in my neuro patients who have IBS. As for the Acid reflux. This is a sign that the acidity in your stomach is too high. In my practice i recommend my patients take one capsule of Pantoprazole (40mg, brand name is Pantodac, though there will be others as well) twice a day. Once in the morning and once in the evening. The drug prevents your stomach from secreting acid and should help with the reflux. BUT PLEASE REMEMBER that this drug can be very XXXXXXX in your situation when used for more than a few days at a time. The acid in our stomach prevents infections and if we stop producing that acid there is a chance that an infection can occur. Thank you for writing back my friend. Please stay in touch and let me know how it goes. Thanks for coming back to HealthCareMagic.com

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Brief Answer: Keep, calm, stress is bad for IBS Detailed Answer: Hello my friend. I feel very badly for you and I want to help you as much as I can. Pantoprazole and Loperamide are good drugs to take. I just don't want you taking them for long without seeing your GI doctor. ANY medication is XXXXXXX when used for too long or in the wrong way. Take care of yourself. Don't let your disease rule your life. I know it's tough to think like that now, but you WILL beat this, have faith. Stay in touch. Vin

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Brief Answer: I am sorry Detailed Answer: I am very sorry you feel this way. Can you give me one more chance and tell me your specific queries. Please understand that I CANNOT prescribe medications for you directly as I have not been able to examine you. The most I can do is give you advice and information regarding your queries. Again, i'm sorry you feel this way. My sympathies are certainly not fake though. Take care.

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Brief Answer: Acid reflux and Piles. Detailed Answer: I apologize. Let me try and address these now. 1) The Acid reflux and Weight loss need not be related. An infection is most likely NOT the reason you are losing weight. People suffering from IBS and Celiac disease have problems absorbing nutients from the foods they eat, hence the low FODMAP diet, which is better for absorbing nutrients. A good dietician can give you a diet plan where you can get the utrients you need from other sources and help you with your weight loss. 2) As to the Piles, The only treatments that I am aware of as working well are Surgery and Banding. Some piles can go away if you just wait long enough, but I doubt very seriously if that would happen in your particular case. Thank you for your questions.

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