Treatment options in Irritable bowel syndrome (IBS)

Dear Ask The Doctor: Dear doctor, I have always been known to have frequent upset stomach or queeziness. I have always been able to cope with it and call pepto bismol my best friend at times. Recently it seems to be getting a lot worse and seems to be taking control of my life. I have had an abdominal and pelvic ct scan, stool test for H-pylori, urine test, blood test and everything seems to come back negative. I never have noticed any blood in my stool. I have anywhere from 2-4 bowel movements a day. Most of them on the loose side. Never really seems to be what I would consider diarrhea. Once in a great while I will have full blown diarrhea and never do I seem to be constipated. I can never really seem to peg my pain and discomfort to one specific area either. Most times it will be lower abdomen discomfort but other times upper stomach. I may experience some discomfort on the left or right side of the abdomen as well. I have tried to cut out any dairy as well as caffeine. I try to eat more fiber and consume more water. I may go as long as a week and feel pretty good only to end up feeling terrible again for 3 or 4 days. Once in awhile I can go a whole day with no problems and not even thinking about my stomach and pray that every day could be like that. I have tried reading up on problems that it may be and the closest I can figure is that it may be IBS. I get to the point where I don't want to go to social events or out in public. Most of my attempts to seek help from my doctor don't seem to accomplish much. Any help would be appreciated. Thanks. Brad

Dear Brad: The symptoms you describe constant nausea, altering bowel habits with a tendency towards diarrhoea, and abdominal pain could be suggestive of irritable bowel syndrome. This can only be diagnosed in the absence of other organic disease. It is reassuring to note that the investigations you have had carried out to date have been normal, and this may also be in keeping with a diagnosis of IBS. I advise attending your family doctor to pinpoint a diagnosis, as standardised criteria is available to follow which help to formulate a clinical diagnosis in IBS. Treatment of IBS varies according to the type of irritable bowel syndrome present but can include anti-spasmodic medication, anti-diarrhoeal medication and dietary modification that can be prescribed by your family doctor.