Brief Answer:
montelukast, fexofenadine, probiotics, diet change

Detailed Answer:
Hello,

Thank you for asking at HCM.

I went through your history and would like to make following suggestions to you:

1. Were I treating you, I would suggest you regular montelukast+fexofenadine combination. It will help you for dust allergy.

2. Antibiotics are not useful in allergies. So if you don't have fever, please do not take unnecessary antibiotics unless specifically prescribed by your doctor.

3. As you are having loose motions for around 8 months, I would suggest you allergy testing for common allergy causing foods. Foods which commonly cause allergies are milk & milk products, wheat, rice, peanut, tree nuts, eggs, soy, fish, shell fish and sea foods.

4. If you don't want to go for allergy testing (Quality allergy testing is available at only a few centers and it is expensive as well), I would suggest you to try and withhold above foods one by one for 15 days or so. If you feel improvement on dropping a particular food, you could go for testing for that particular food.

5. For patients like you, I also suggest probiotics like lactobacilli (various combinations available in sachets commercially) for 1-3 months. It helps improve both digestive system and allergies.

6. In general, I would suggest you to avoid packed foods and outside foods. Please follow a simple diet like home made simple foods for 6 months or so. It will also help improve your digestive system.

7. Please do regular exercise like walking which also improves digestion.

Hope above suggestions will be helpful to you.

Should you have any further query, please feel free to ask on follow up.

Wish you the best of the health.

Thank you & Regards.

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Brief Answer:
Would like to see allergy tests, stress reduction

Detailed Answer:
Hello,

Thank you for follow-up.

I can understand your concern.

I hope you have had allergy testing interpreted by allergy specialist and the food restriction was also as per allergist or gastroenterologist advice.

It is important to know that some types of allergies cannot be diagnosed by allergy testing. For those types, "trial of foods and observation for symptoms" is the most practical approach.

Also, IBS may or may not be due to food allergies. That is why your food allergy testing may be negative. In that case, I would suggest to manage your diet as per a gastroenterologist's advice. However, I would like to review your allergy testing reports.

I appreciate that you have started walking and exercise, it will surely help you on a long run to improve your digestion and immunity. Please consult your doctor or gastroenterologist to know how long you need to continue rifaximine so that you do not exceed the recommended duration of rifaximine.

As long as dust allergy is concerned, I am sure you will be benefited by montelukast+fexofenadine. If no improvement, next option would be intranasal corticosteroid sprays.

I would also suggest you to avoid exposure to dusts, smokes and air pollution as much as possible. Diet supplements as suggested previously will also help.

Personally I would suggest you to actively start stress reduction strategies.

Hope above suggestions will be helpful to you.

Should you have any further query, please feel free to ask on follow-up.

Wish you the best of the health ahead.

Thank you & Regards,

Dr Parin N Parmar

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