IBS - tough to manage

[msanta]

I'm a 34 y/o male and I've been suffering with IBS-C for 10 years. I've had extensive medical test already done recently (colonoscopy,Endoscopy,Blood test,Abdominal ultrasound etc) to rule out anything serious. I had small polyps removed from my rectum/sigmid colon and they noted small non-bleeding internal Hemmroids. With dietary changes and citracel I have improved my constipation problem but I still have bad cramping/bloating and abdominal pain. I usually have a BM in the morning and by night time I have major discomfort in the lower left to middle part of of my abdomen. Even though I my BM's are more frequent (once a day compared to once every 3 days), the pain, bloating and feeling that I'm "jammed up" is still there. Like most IBS patients, I feel much better after a BM or passing a small amount of gas.  I have tried Zelnorm and SSRI's (lexapro) with minimal success. Any there any other medications or suggestions you have that I might have missed? Is my colon just over-sensitive to gas or is it a brain-gut problem?

[Kevin Pho, MD]

You have clearly had a comprehensive evaluation already - ruling out most of the major GI causes.  Zelnorm is normally given to treat constipation-predominant IBS, but you report minimal success.  You can also try a variety of antispasmodic agents as well if the Zelnorm is not working.

You can consider more specialized testing, including colonic marker studies and defecography.  Colonic motility studies can also be considered.  

If the constipation becomes more serious, surgical treatment - like a colectomy - may have to be considered.

You can discuss these approaches with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[Inanga]

i had something along the lines of iritable bowel syndrome, gerd, generally bad state of digestion - turned out to be food allergies to wheat and dairy. 100% better now I have elimintaed them from my diet. lok up celiac disease for some background info. good luck

[jockstar]

I have had IBS for some years. My daughters, sister and her daughter have this also.
For all of us it means avoiding many foods. All of us are different and avoid a variety of things that the other doesn't have to worry about.
I have been taking Aloe Vera juice for some years. I have even taken it overseas with me.It is my survival, but must go with certain food restraints.
For me it means avoiding:- milk and like products, but I can tolerate low fat joghurt and small amount of cheese,avoid pulses, high grains, wheat,certain vegetables and fruits. All fatty foods are out or consumed in small amounts only. An elimination and slow introduction saw me loose 10kilograms of weight. The old addage - 'fibre makes you fat'.I hope this is of some help.