What Causes Severe Lower Abdominal Pain, Dizziness And Loss Of Vision?

Brief Answer:
Irritable bowel syndrome

Detailed Answer:
Hello Mr XXXXXXX
A very Good morning to you too.
I am Dr Kumar.
I am a Gastroenterologist and would be addressing your query.

Before answering your question i would like to give you a briefing and general idea about the problem your spouse is suffering from as this will help you understand the things better. May be you have read all these things a lot of time before yet i would like you to go through every line in detail.

She is having medications for problem medically termed as irritable bowel syndrome.

Irritable bowel syndrome is a common intestinal disorder. 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, only functional abnormality occurs in this condition.So frankly speaking (IBS) represents a functional disorder of gastrointestinal tract without the presence of an anatomic defect.

Recent studies by French scientists have indicated that the most important mechanisms include visceral sensitivity, abnormal gut motility and autonomous nervous system dysfunction. The interactions between these three mechanisms make bowel's function susceptible to many exogenous and endogenous factors like gastrointestinal flora, feeding and psychosocial factors.

Further data indicate that according to the above mechanisms, the influence of genetic factors and polymorphisms of human DNA in the development of IBS is equally important.

So in lay mans language till date we don't know 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 syas it can be hormone anxiety age etc etc).

Intermittent pain and discomfort in the abdomen is the most classical symptom of IBS.As told above pain is not constant, it may come and go. Pain is greatly relieved by passing wind or by passing stool. The severity and degree of pain varies in every person suffering from irritable bowel syndrome. There may be bloating in the abdomen. Some patients have attacks of diarrhea and some may have constipation. Other symptoms that may be present in irritable bowel syndrome include nausea, vomiting, headache, loss of appetite, muscular pains, heartburn, and weakness. Some patients have occasional symptoms whereas others may have symptoms for a long period of time.

So as seen above every patient is different.Intensity of symptoms in every patient is different as so is the response to medicines and life style change.

Every drug is not effective in every patient so we have to try different therapies till we find the drug which suits best our patient.

Dicyclomine 20mg four times a day is to heavy a dose for 80 year old women.
Dicyclomine ios 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(In simple words it messes up with both your peripheral and central nervous system)


As per your history "suffered dizziness, loss of visual perception and was awakw all night, with pain and hallucinations". All the symptoms mentioned above are directly related to your nervos system and in her case are present due to high doses of Anticholinergic she is on.

Dicyclomine can be used in doses as high as 40mg four times a day but as our age increases the functions of our body(like metabolising a drug done by liver ,eliminating it by kidney) also decreases.So the way a 30 years old young person will respond to anticholinergic will be very different from the way it will be handled by body of a 80 years old women.

All the symptoms she is having is because of such high doses of Dicyclomine she is on.Reduce the doses to 10mg twice a day and her symptoms will go away.

Though not asked yet a better approach would be to use optimal doses of two three drugs in combination with each other as optimal doses will not give her side effects.
Giving her single drug in very high doses will relieve IBS symptoms but will cause severe side effects.

Recommendations-

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. This eases the pain and cramps.Can easily be combined with dicyclomine.

Clidinium bromide is an anticholinergic (specifically a muscarinic antagonist) drug. It may help symptoms of cramping.It is much more selective then dicyclomine and is used specifically to treat spasm in IBS.Usually 2.5mg is given in combination with 10mg dicyclomine.

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.

Another OTC medication is Bismuth sub-salicylate. It belongs to a class of medications called antacids and adsorbents marketed by name of Pepto Bismol. Doses up to 1gram can be taken daily to provide symptomatic relief.



Diphenoxylate and Atropine combination(Lomotil)-Atropine/diphenoxylate is an antidiarrheal and anticholinergic combination. It is an excellent antispasmodic it also prolong the time it takes to move the contents through the body.


So my recommendation is instead of loasding her with heavy doses of single salt give her a combination of two to three salts in low doses.

Food pattern recommended is-
Eat simple and natural home cooked food.
If possible try detox diet(Raw vegans) for atleast 3 month. Take normal food in lunch while in supper take uncooked raw natural form of food.This can play wonders.
Avoid taking excessive fibres.A total fiber intake of about 20-30 grram per day would be good for you. Any thing in excess is good for nothing.
No pizza,Burger,Red meat,and dairies for few weeks.
No alcohol or smoking.

Take natural food rich in probiotics like Yoghurt,Kimchi,etc.This doesnot mean that you have to take them as much as you can.Follow your body increase their uptake gradually.
Drink lots of juices and fresh water daily.
Avoid over spicy and heavy food.

If possible go for a detox diet but again don't force your body rather let your body adopt gradually to things.

Remenber-'Animals never have IBS' and the only difference between them and us is that we take cooked and tasty food.Control your buds and follow nature.
So personally i believe in detox diet.
Though difficult to follow yet i can play wonders.

Hope i answered your query well.
In case you need more details please feel free to ask.

Thanks.

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