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Gastroenterology (Expert Forum)
IBS???
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
IBS???
by jfem, Feb 03, 2006 12:00AM
Another question for you.
recap: 40 yo female hx of severe abd pain/nausea/loose stool/lack of appetite/feeling full quickly-began 12/05..( after a round of Levaquin 11/28) had stool cultures, blood work, endoscopy, abd u/s,vaginal u/s...all normal.
Came and went for about 3-4weeks.Presently, it's this:
Every am, I am awakened with rumbling of my stomach and urge to defecate-really bad abd pain, and some nausea.Stool is very soft, slightly formed, and ranges in color from light brown to yellow. No mucous,no blood,no liquid. For about an hour after, my stomach is in pain/empty like, feeling almost "hot" or burning.
MD suggested Culterelle, VSL number 3,( twice/day) and Citrucel.
I started to Culterelle first. Been a week, things are ok, not much improvement.
I have never heard of VSL num 3, so I was a bit nervous to take it? Also, why would I take Citrucel if I have loose stool.
The other thing is that during the day, I either have a stomach ache,( middle to upper) like bloating, or I have the urge to go to the bathroom.( crampy like feeling in lower abd)
After I eat some thing, my stomach will gurgle, as if I need to go, but I don't.
I still only go once, only in the AM, but throughout the day, I am plagues by this feeling.
I am eating only rice, crackers, water, chamomille tea, chicken, and bananas.
I have lost about 10 pounds in a month.
I'm getting a little frustrated by doctors asking me if I am stressed...no, but I am now-with this.
And saying that everything is normal.
Well, this is NOT normal for me.
What are your thoughts? Does this sound like IBS,? What other tests can I get to rule it out...I have a colonoscopy for the end of Feb.
Also, what are your thoughts on the Culterelle, CItrucel and VSL?
Thank you for your reply.
J
recap: 40 yo female hx of severe abd pain/nausea/loose stool/lack of appetite/feeling full quickly-began 12/05..( after a round of Levaquin 11/28) had stool cultures, blood work, endoscopy, abd u/s,vaginal u/s...all normal.
Came and went for about 3-4weeks.Presently, it's this:
Every am, I am awakened with rumbling of my stomach and urge to defecate-really bad abd pain, and some nausea.Stool is very soft, slightly formed, and ranges in color from light brown to yellow. No mucous,no blood,no liquid. For about an hour after, my stomach is in pain/empty like, feeling almost "hot" or burning.
MD suggested Culterelle, VSL number 3,( twice/day) and Citrucel.
I started to Culterelle first. Been a week, things are ok, not much improvement.
I have never heard of VSL num 3, so I was a bit nervous to take it? Also, why would I take Citrucel if I have loose stool.
The other thing is that during the day, I either have a stomach ache,( middle to upper) like bloating, or I have the urge to go to the bathroom.( crampy like feeling in lower abd)
After I eat some thing, my stomach will gurgle, as if I need to go, but I don't.
I still only go once, only in the AM, but throughout the day, I am plagues by this feeling.
I am eating only rice, crackers, water, chamomille tea, chicken, and bananas.
I have lost about 10 pounds in a month.
I'm getting a little frustrated by doctors asking me if I am stressed...no, but I am now-with this.
And saying that everything is normal.
Well, this is NOT normal for me.
What are your thoughts? Does this sound like IBS,? What other tests can I get to rule it out...I have a colonoscopy for the end of Feb.
Also, what are your thoughts on the Culterelle, CItrucel and VSL?
Thank you for your reply.
J
Doctor's Answer
by Kevin Pho, MD, Feb 04, 2006 12:00AM
, Feb 04, 2006 12:00AM
IBS is certainly possible, however, you probably want to rule out other disease first.
I assume the endoscopy you had was an upper endoscopy, which would rule out most the major upper GI causes (i.e. ulcer, cancer) that can cause your symptoms as well as weight loss.
You can consider more specialized testing, like a gastric emptying scan or 24-hr pH study - looking for gastroparesis and GERD respectively.
I agree that the colonoscopy is a good idea to rule out lower GI causes.
If the tests continue to be negative, then IBS is certainly possible, and can be treated with anti-spasmodic agents.
Citrocel is recommended if IBS is causing your symptoms. There is no data suggesting that Culturelle nor VSL would help in cases of IBS.
These options can be discussed 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.
kevinmd_b
I assume the endoscopy you had was an upper endoscopy, which would rule out most the major upper GI causes (i.e. ulcer, cancer) that can cause your symptoms as well as weight loss.
You can consider more specialized testing, like a gastric emptying scan or 24-hr pH study - looking for gastroparesis and GERD respectively.
I agree that the colonoscopy is a good idea to rule out lower GI causes.
If the tests continue to be negative, then IBS is certainly possible, and can be treated with anti-spasmodic agents.
Citrocel is recommended if IBS is causing your symptoms. There is no data suggesting that Culturelle nor VSL would help in cases of IBS.
These options can be discussed 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.
kevinmd_b
Member Comments (2)
by jfem, Feb 03, 2006 12:00AM
Oh by the way, Celiac ,IgA Ab ,IgA, and Gkiadin IgA all normal.
by Annabel, Feb 07, 2006 12:00AM
hi ive had ibs all my life it is a see saw between diarrhoea and constipation. the peristalsis is interrupted sometimes by inflammation, it is more painful that just a nuisance to deal with. i discovered myself some things that provoked the difficulties, raw foods, i cook everything especially vegetables, oatmeal and barley are big problems, especially oats. i am fine with wheat and bran. small frequent meals, plenty of vit c and i take a yoghurt with friendly bacteria once a day though it doesnt make a difference if its an ordinary yoghurt ive noticed. but i use yoghurt in cooking and with desserts as i don't take fatty animal products like cream. oh and a spoonfull of natural bran in a yoghurt helps to keep the rhythm going to stop diarrhoea and constipation. but everyone is different and finding the foods that agree with you and don't agree with you will help you cope with the problems.
