Brief Answer:
Kindly take medications for OCD and irritable bowel syndrome

Detailed Answer:
Hello Madam,
Thanks for writing in to us at hcm.
This is Dr.Riyanka and I am glad to be helping you with your query.
I understand your problem.

Firstly , you have to start following self discipline. For this you need to have a fibre rich diet - oats, fibrous fruits and vegetables.

Every morning try drinking a glass of warm milk/ warm water before going to the toilet. Also practise early morning yoga excercises which mobilises bowel movements. Using an XXXXXXX styled toilet also helps.

You need to get over your obsessive compulsion of repeated bath after toilet by explaining to yourself that whether you repeatedly clean yourself or not the situation wont change. try convincing yourself that let me see what happens if i dont repeatedly take bath. It is all about self control.If it is getting uncontrollable kindly visit the psychiatrist for medications for OCDs like N- acetylcysteine (first line of drug for OCDs).

Practising fifteen minutes of meditation every morning and evening builds in self control and a strong mind.

For Irritable bowel syndrome avoid oily foods and food items that produce gas.
Rifaximin400mg is an antibiotic belonging to Rifamycin group which can be helpful in irritable bowel syndrome . Kindly visit your physician and only then take medication.

Hope this answers your query. Don't worry .
Do write back if you have any further doubts.
Get well soon
Regards,
Dr.Riyanka

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Brief Answer:
Kindly visit the psychiatrist for second line of treatment mentioned below

Detailed Answer:
Hello Madam,
Thank you for writing back to us.
I understand your concern and the difficulty to overcome the compulsive disorder.

Since it seems like you have tried most of the self control behavioural therapy i would recommend that kindly consult a psychiatrist again.

Usually psychiatrists give atypical antipsychotics and selective serotonin reuptake inhibitors for OCDs which have shown side effects in many individuals. However, when such medications dont work, the doctor tries other lines of treatment like N - acetylcysteine is currently emerging as a good and safer option. However since psychiatric treatment involves regular monitoring of drug dosage (increase in dose or tappering of doses), i would suggest kindly only take drugs prescribed under supervison of psychiatrist.

Also medication alone in OCDs is not of much help. A combination of medication and psychotherapy has shown better results. These combination therapies are available in premium mental health institutes.

Also, if the condition is very severe then doctors may opt for Electroconvulsive Therapy.

As of now along with visiting a psychiatrist for other line of drugs like
N- Acetylcysteine for the management of OCD can be useful.

Also , eat a balanced diet. You seem weak and exhausted. Kindly eat foods rich in proteins and vitamins( lean meat , milk, fruits and green leafy vegetables) and stay hydrated well. Also learn to adopt relaxation techniques. Even if you cant do yoga . Kindly just keep your eyes closed and listen to soothening music and try to relax.

Donot take unnecessary tensions. Always remind yourself whether you do activities repeatedly or not it makes no difference and things will happen as they should happen.

Hope this answers your query. Don't worry .
Do write back if you have any further doubts.
Get well soon
Regards,
Dr.Riyanka

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Brief Answer:
Medications along with psychotherapy gives best results

Detailed Answer:
Hi,
Thanks for writing back to us.

1. The common side effects of N acetyl cysteine are bowel changes, nausea,
vomiting and rashes. But usually side effects are very mild and this drug is
usually safe in most individuals.

2. Usually treatment alone does not give as good results as when given along
with Psychotherapy ( exposure and response prevention ). Please don’t be
worried these therapies are simple exercises.

3. Ativan is a benzodiazepine given to relieve anxiety and induce sleep.However
if you are experiencing side effects please request your doctor for change of
medications like Non-benzodiazepine sedative pills like Zolpidem , which
have lower risks of dependency.

Also there are certain pills containing hormones like Melatonin 1mg that can be taken not more than twice a week. They have very less side effects. However , kindly take it only after consulting your psychiatrist.

Along with medications:
Also try to organise your sleep by not taking short naps during the day. Limit
intake of caffeine - tea , coffee. Expose yourself to good amount of sunlight
during the day. Natural products like consuming a gravy of XXXXXXX seeds
(khus khus) with vegetables gives a good sleep.

4. For IBS yes you can take the probiotic Yakult. It is good for the gut.

For generalised weakness, you need to take a nutritious diet with good amounts of proteins , vitamins and minerals.You need to have good amounts of green leafy vegetables. Fish and chicken if you are a nonvegetarian and paneer if you are a vegetarian. Take eggs and milk. You can take health drinks along with this.
Kindly take:
1. Tablet AtoZ two times a day daily for 2 months.
2. Capsules Fish cod liver oil 1000mg daily one tablet for 2 months.

Along with treatment the most important thing is you need to learn to do things that make you happy. Spend time doing activities like your hobbies. Talk to neighbours . Donot keep thinking or discussing about your illness as it leads to more anxiousness. Keep a positive attitude so that the medications will work at its best .

Get well soon.
Please do write back for more queries.
Take care.

Regards,
Dr.Riyanka

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