Thank you for your question.
You should have a colonoscopy to rule out inflammatory bowel disease and you also need to have a stool culture to rule out parasites or infections. Assuming these are negative you most likely have irritable bowel syndrome.
With IBS you need to make sure no other serous diseases are present. Some serious diseases may present with bleeding or weight loss. This means you may need to have tests such as colonoscopy, possibly biopsy, barium X-Rays and stool analysis for infection to rule out other diseases such as colitis, infection, or tumor. With IBS no physical abnormalities are found. This is why it is called a functional disease.
Once these tests are done, and they are up to the your doctor's discretion, this diagnosis is made. If your symptoms are very suggestive of IBS your doctor may not want to perform every test.
You may have IBS-diarrhea predominant, constipation predominant or mixed symptom IBS. All types are accompanied by discomfort in the abdomen.
In constipation predominant, you need to take adequate fluids, fiber and bulk in the diet, 2 tbls. twice a day of a water soluble psyllium product such as Metamucil or Citrucel. Also salad twice a day. You should progress slowly to avoid cramps and gas.
In diarrhea predominant, ispaghula husks 2-3 sachets daily, anti-diarrheal agents such as Imodium or Lomotil can be used. Anti-spasmotics such as hyoscine OTC may be tried but have side effects. Anti-depressants have possible use as does peppermint oil (200 mg capsules 2-3/day).
Probiotics, good bacteria, such as Activia may be helpful in both types.
There is no scientific evidence to support alternative medicine options.
Some foods may make symptoms worse and you must exclude those that have a bad effect. Some examples are beans, cabbage, broccoli, carbonated beverages and dairy products. Small frequent meals instead of three large meals may help. For gas and bloating, OTC meds containing simethicone ( Gas-X Mylicon) may help.
Behavioral therapy such as bowel training and psychotherapy may help in some severe cases.
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