Question: Hi Doctor, My daughter is suffering from all the symptoms of Irritable Bowel Syndrome i.e going to the toilet four to five times in the morning, sometimes diarrhea in the afternoon and pain. She has taken Medrol, Librax and Azoran for nearly five months with some improvement. But as soon as she stopped the medicines she gets all the symptoms again. She consulted another Doctor who prescribed her Debridat and Asacol. Treatment with Debridat has been completed and now she is taking Asacol , one tablet daily. A slight improvement was noted in the afternoon episode but in the morning it is still the same. She missed her Asacol tablet on three days and since yesterday she is suffering from abdominal pain and she is not at ease. I want to know whether she is taking the right medicines for what she is suffering because she has not done any test apart from a Colonoscopy where it was found that she has mild inflammation only. I would also like to know what other test she has to do to diagnose her disease.

Hi Doctor, Thanks for your reply. Your questions are answered below: 1. 1st Doctor ( MB FRCP) who treated my daughter did not mention IBS or Crohn's Disease. But in Biopsy report recommended by him the conclusion is " Non- Specific Colitis" and medicines prescribed by Doctor were Medrol, Azoran, Librax . Treatment was for 5 months. A relapse of the symptom were noted when medicines were stopped. 2nd Doctor ( Consultant Surgeon/ Uro Surgeon) did not recommend any test but prescribed Flagentyl, Debridat and Asacol based of tests carried out by 1st Doctor. He presumed that my daughter may be suffering from IBS or Crohn's disease. She is having recurrent abdominal pain or discomfort since one and a half year .Abdominal pain 3-4 times per week and the wish to defecate nearly every day 4-5 times in the morning and 2-3 times in the afternoon. 2.Q: Mucus or Blood in Stool. A: Mucus : No Blood : Only on two occasions before XXXXXXX 2013 ( May be due to constipation ) Q: Persistent Abdominal Pain/ Vague Generalised Pain. A: It is Gas Pain which may last the whole day and may be associated with a loose stool. She feels certain discomfort as if she wants to defecate and feels quite relieve after defecation. Q: How Long frequent stools: A: Since one and a half year Q: Redness of Eyes A : No Q:Any Joints Pain A: Joints pains since she took Medrol otherwise she always feels tired. Q: Constant Mental Stress/ Anxiety. A: Yes, a lot of mental stress Q: Any weight Loss. A : No, she has rather gained weight. She eats a lot of junk foods as she is always hungry. Q : Stool examination: A: Report dated 13/9/13: Semi-solid, Brownish, blood absent, WBC 0-3, RBC 0-2, Macrophages 1-2, Mucous + Hope that the above information will help you make a diagnosis of her disease ( I.e whether it is IBS or Colitis and whether it is treatable). Grateful to have your advice at the earliest. I have her Biopsy Report and stool examination report with me but I am not given the option to send them with " Follow-up Question" Thanks XXXX

Thanks a lot Doctor for your valuable advice. Do you think a CT Scan of her belly is important as the second Doctor has recommended her for a CT scan which has not yet been done Or she may proceed directly with the medicines advised by you without getting the scan done. You also mentioned in your previous reply that you have had a success rate of 100% in cases of IBS. Due to the seriousness of the case of my daughter do you think she can be cured at 100% and if ,in the affirmative,how long does it take for complete cure. Best regards XXXX

Good Morning Doctor, Thanks again for your reply. I will proceed as per your advice and will revert back to you after treatment with medicines suggested by you. Kind regards XXXX