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What Causes Excessive Flatulence, Occasional Bowel Incontinence And Irritation Outside The Anal Canal?
Question: I experience excessive flatulence, occasional bowel incontinence, and daily irritation of the exteriot of the anus. I deficate 2-3 times in the morning, and if I leave the house before doing so, I face urgency that usually results in an accident. I have had a recent colonoscopy which was clear. I have had recent bloodwork to rule out parasites and infections. This has been an issue for about a year. I am 5’10”, 185, active, athletic, and in exceptional health otherwise.
My doc is stumped and has no recomentadions for other treatment, but I am too young to be constantly shitting my pants.
Whatis my next step?
My doc is stumped and has no recomentadions for other treatment, but I am too young to be constantly shitting my pants.
Whatis my next step?
Brief Answer:
Very likely a case of irritable bowel disease.
Detailed Answer:
Hello,
Most likely you are suffering from irritable bowel syndrome.
In IBS there is some problem in the functional ability of the gut that leads to the symptoms of irritable bowel syndrome. The structure of the intestines is normal, the only functional abnormality occurs in this condition therefore almost every test in gastroenterology turns up to be normal, however, the patient is fully symptomatic. Same is with you all tests are normal and you are symptomatic.
In layman's language till now, we are not sure whats the exact cause of this problem. So the million-dollar question is how to repair a system when you don't know which part of it is faulty (Some says it can be brain other says it can be hormone anxiety age etc).
Some patients have symptoms of unformed stools, some people have bloated feeling and some may have severe constipation. Some patients have occasional symptoms whereas others may have symptoms for a long period of time. So as seen above every patient is different. The intensity of symptoms in every patient is different as so is the response to medicines and life style change. A patient may respond well to one medication while others are totally unresponsive to the same.
Protocol-
Every drug is not effective in every patient so we have to try different therapies until we find the drug which suits best our patient. All the below mentioned drugs slow down motility of intestines hence will decrease both frequencies of motions as well as will increase your power to control them.
Dicyclomine is an anticholinergic drug. An anticholinergic agent is a substance that blocks the neurotransmitter acetylcholine in the central and the peripheral nervous system. Anticholinergics inhibit parasympathetic nerve impulses by selectively blocking the binding of the neurotransmitter acetylcholine to its receptor in nerve cells.
Mebeverine is an antispasmodic medicine and is very useful in IBS and is well tolerated by patient with minimal side effects. Mebeverine works on certain muscles in the wall of your intestines, causing them to relax.
Clidinium bromide is an anticholinergic (specifically it may help symptoms of frequent stools).
Chlordiazepoxide works by increasing the action of GABA, a chemical messenger which suppresses the abnormal and excessive activity of the nerve cells in the brain. Can be used in combination with above-mentioned medicines.
Ask your Gastroenterologist to start you initially on clidinium bromide and mebeverine combination initially. Let's see how you respond to it.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Ramesh Kumar, Gastroenterologist
Very likely a case of irritable bowel disease.
Detailed Answer:
Hello,
Most likely you are suffering from irritable bowel syndrome.
In IBS there is some problem in the functional ability of the gut that leads to the symptoms of irritable bowel syndrome. The structure of the intestines is normal, the only functional abnormality occurs in this condition therefore almost every test in gastroenterology turns up to be normal, however, the patient is fully symptomatic. Same is with you all tests are normal and you are symptomatic.
In layman's language till now, we are not sure whats the exact cause of this problem. So the million-dollar question is how to repair a system when you don't know which part of it is faulty (Some says it can be brain other says it can be hormone anxiety age etc).
Some patients have symptoms of unformed stools, some people have bloated feeling and some may have severe constipation. Some patients have occasional symptoms whereas others may have symptoms for a long period of time. So as seen above every patient is different. The intensity of symptoms in every patient is different as so is the response to medicines and life style change. A patient may respond well to one medication while others are totally unresponsive to the same.
Protocol-
Every drug is not effective in every patient so we have to try different therapies until we find the drug which suits best our patient. All the below mentioned drugs slow down motility of intestines hence will decrease both frequencies of motions as well as will increase your power to control them.
Dicyclomine is an anticholinergic drug. An anticholinergic agent is a substance that blocks the neurotransmitter acetylcholine in the central and the peripheral nervous system. Anticholinergics inhibit parasympathetic nerve impulses by selectively blocking the binding of the neurotransmitter acetylcholine to its receptor in nerve cells.
Mebeverine is an antispasmodic medicine and is very useful in IBS and is well tolerated by patient with minimal side effects. Mebeverine works on certain muscles in the wall of your intestines, causing them to relax.
Clidinium bromide is an anticholinergic (specifically it may help symptoms of frequent stools).
Chlordiazepoxide works by increasing the action of GABA, a chemical messenger which suppresses the abnormal and excessive activity of the nerve cells in the brain. Can be used in combination with above-mentioned medicines.
Ask your Gastroenterologist to start you initially on clidinium bromide and mebeverine combination initially. Let's see how you respond to it.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Ramesh Kumar, Gastroenterologist
Above answer was peer-reviewed by :
Dr. Prasad
To reiterate, a colonoscopy cannot rule out IBS?
In essence, IBS is a description of symptoms and a catchall diagnosis when nothibg else fits? Is that correct?
And, thank you. I have gotten more info from you than any other Dr. during the past year.
In essence, IBS is a description of symptoms and a catchall diagnosis when nothibg else fits? Is that correct?
And, thank you. I have gotten more info from you than any other Dr. during the past year.
Brief Answer:
Follow up.
Detailed Answer:
Hello,
Yes, if all tests are normal then we use a term called IBS for that patient.
You can discuss the treatment part with your treating doctor and you would feel much relieved in 3 weeks.
When all tests are normal and the patient is symptomatic medical science uses the term IBS to cover those symptoms.
There is no test to absolutely diagnose IBS.
Hope I have answered your query.
Regards,
Dr. Ramesh Kumar, Gastroenterologist
Follow up.
Detailed Answer:
Hello,
Yes, if all tests are normal then we use a term called IBS for that patient.
You can discuss the treatment part with your treating doctor and you would feel much relieved in 3 weeks.
When all tests are normal and the patient is symptomatic medical science uses the term IBS to cover those symptoms.
There is no test to absolutely diagnose IBS.
Hope I have answered your query.
Regards,
Dr. Ramesh Kumar, Gastroenterologist
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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