Brief Answer:
Dear XXXXXXX very likely you are suffering from IBS.

Detailed Answer:

Hello,

As per your queries answer is all your symptoms as well as duration of illness is suggestive of Irritable bowel syndrome overlapped with severe peristalysis causing urge to defecate and hence pain settles down on passing stools.However dear IBS is a diagnosis of exclusion as there is no test to confirm you have IBS,It means that when you have nothing or all your investigations are normal you are labelled as having IBS.
what exactly is IBS?
A common disorder affecting the large intestine is the Irritable Bowel Syndrome. Abdominal pain, bloating, gas and diarrhoea are some of the signs and symptoms of IBS. Foods, stress and other diseases can trigger the problem.
However the exact cause of irritable bowel syndrome is not yet known but studies suggest that a lot of factors play a major role. The intestinal walls are lined with a layer of muscle which contracts and relaxes in a rhythm when they move to your rectum through your intestinal tract. If you acquire irritable bowel syndrome, the contractions can get stronger and last much longer than usual. This causes diarrhea, bloating and gas. In some cases, the opposite can also occur, this can be characterized by weak intestinal contractions, which slows food passage resulting to dry and hard stools.Some patients presents with constipation while other have loose stools.Every patient with IBS is different with varying symptoms.
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, 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 SO in lay mans language till date 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 etc).Initially i would suggest you to go for colonoscopy and stool microscopy test.If both these tests are normal i would like to start you on-
Tab cibis 8mg thrice daily(contains Chlordiazepoxide, Clidinium Bromide, and Dicyclomine) consult your local pharmacy for this salt combination.

Why cibis?
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.

Clidinium bromide is an anticholinergic (specifically a muscarinic antagonist) drug. 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.
They are all antispasmodics and would help with spasms in intestines.

For bloating and gas take Tab Nexium 40mg twice daily can increase it to 80 mg twice daily.Take a probiotic daily with food as proper digestion of food will prevent excess gas formation.When food is not properly digested large amount of gases are produced inside due to incomplete fermentation of food.Hence if digestion improves overall symptoms will also improve.
Food pattern recommended is-
Eat simple and natural home cooked food.
If possible try detox diet (Raw vegans) for at least 3 month. Take normal food in lunch while in supper take uncooked raw (low fiber) natural form of food. This can play wonders.
Avoid taking excessive fibres. A total fiber intake of about 20-25 gram per day would be good for you.
No pizza,Burger, Red meat, and dairies for few weeks.
No alcohol or smoking.

As to take natural food rich in probiotics like Yoghurt, Kimchi,etc.This doesn't 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. Drink cleaner water, it will help a lot.
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.

In case you need any other help feel free to ask.I would be happy to help you.

Take home message-
Get a stool test and colonoscopy done asap.

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Brief Answer:
Follow up.

Detailed Answer:
Hi XXXXXXX
Our body is a complex system and the most special thing about it is that no two persons are similar.How a person would respond to a particular food may differ totally from how other one will respond to it.
The best way for you is to get a food alllergy test done This will tell you the foods your body is allergic to.
Secondly avoid eating food you feel gives problem to you.
There is no medicine which can change the nature of your body.So you have to stop taking things you are allergic to.

Thanks.

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Brief Answer:
Follow up.

Detailed Answer:
Hi again XXXXXXX as explained earlier loose stool and severe constipation can both be seen in phases in patients with IBS.When you constipate food start to get fermented inside intestines causing formation of toxic gases and colonies of bad bacterias.These gases presses intestines and cause pain by compressing the nerves.
For constipation take lactulose 10 ml stat(OTC) with fybogel(psyllium husk).
Take omeprazole for gas.
You have to follow my initial suggestion to treat IBS once the current situation settles down.
Thank you XXXXXXX

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Brief Answer:
Follow up.

Detailed Answer:
Hello again my dear XXXXXXX
Yes you can take simethicone for gas one tablet three times a day is ok.
As per diet is concerned my idea is try a simple pure vegerarian diet for 4 weeks.Just give it a try.
Idea behind it is the more emotional a animal is the more hard is it to digest for our body.
for eg,
Take 200 grams of mammal meat like beef(human is also mammal)
200 gram of chicken meat
200 gram of fish( primitive stage of evolution and have least emotions among the three)
Researches show that more a particular spicy is away from us in series of evolution(primitive) better is our capacity to digest it.
Its no where written in modern medicine but i being a old chap have studied a lots of researches on naturalopathy and ayuvedic sciences which proves that vegetarian food is much better then non vegetarian food for our body.Even XXXXXXX whose genes are 99% matching with us is vegetarian and never suffers from IBS.
So considering the same fact vegetables are least related to us in course of evolution.So going by this theory the easiest thing for us to digest is a pure veg steamed or cooked food.
Fodmap diet etc are good but i would suggest you to eat organic steamed cooked and boiled vegetables fruits for 4 week and tell me how you respond to it.
Try to be as natutal as possible.Frankly speaking eat like a XXXXXXX for 4 weeks and see the changes yourself.

Its a bit different approach but if you would follow this you would definitely feel much better.
As per FODMAP is concerned modern medicine is till date not sure what causes IBS.So million dollar question is when we don't know the part which is defective how can we fix the machine.
Before fodmap try vegan simple plain food for 2 weeks.
On this forum you could also consult a ayurvedic specialist for a better suggestion on such type of diets.

Hope i was helpful.
Do give it a try.
Would be keen to hear from you in a week or two.
Thanks!

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