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Dr. Rick, MD
Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 10771
Experience:  20+ years as a doctor. Internal Medicine Internship in NYC
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During and after a trip to Costa Rica in January I had

Customer Question

During and after a trip to Costa Rica in January I had diarrhea on and off for a month. During that time I developed anxiety - I have no reason - my life is amazing. I seem to get anxiety worse AFTER I have a bowel movement which have been normal for a month now. Nobody believes it ahs something to do with my stomach. Checked for h pilori and parasites - all negative
Submitted: 8 months ago.
Category: Medical
Expert:  Dr. Phil, MD replied 8 months ago.

Thanks for this question

Sounds like irritable bowel to me

Associated with anxiety

have you tried anything for IBS?

I would recommend the FODMAP diet.

It is highly effective

Customer: replied 8 months ago.
Nothing for IBS - it literally started the same time my trip started. I wake up at night for no reason every night now. Everytime I get anxious either I have to have a bowel movement or I just had one
Expert:  Dr. Phil, MD replied 8 months ago.

I think you have developed IBS

I would try this diet

https://stanfordhealthcare.org/content/dam/SHC/for-patients-component/programs-services/clinical-nutrition-services/docs/pdf-lowfodmapdiet.pdf

and probiotic like culturelle

Expert:  Dr. Thomas, MD replied 8 months ago.

Hello

I notice you are 51.

IBS can not be diagnosed without ruling out everything else.

From the past, IBS was alwayss a "diagnosis of exclusion." Excluding everything else. While the view on this has changed, and the diagnosis does not need testing in younger individuals, at age 50 you cross lines with the recommendations for colonoscopy, or flex sig, or anual stool testing for blood. In the case of a change of bowel habits, at age 50, a colonoscopy is recommended.

New diarrhea, without a found cause, indicates that you should have a colonoscopy

for screening.

This should have been done at age 50 typically.

It needs to be done if it has not, as IBS can not be diagnosed properly without it at this point.

IN addition, you might well have IBS [it would be a rather late age onset] and have a colon problem which does not get diagnosed without a scope.

Also, if they only tested for parasites in the stool, I suggest you make them get comprehensive stool cultures for bacteria and fungus.

I am a double board certified US doctor, Dr. Thomas.

Find me anytime for correct, safe, and comprehensive answers.

Please click a positive on this post.

I can go over the definitive diet not only for IBS but for cancer prevention with you. There are new advances in this area; simply find me in medical by request on a new post after you rate positive on the top of this page.

Expert:  Dr. Rick, MD replied 8 months ago.

It sounds like you have spent quite some time trying to get to the bottom of what is going on. I am sure that your previous doctors have thought of, and ruled out, all of the common and easily treatable conditions that could be causing your issues. Would you say this is a correct statement?

Well I think it might be time for you to take a very difficult, and bold, step to see if you can get some relief.

At this point I think the best thing for you to do would be to gather up copies of all your medical records and travel to a large University Teaching hospital. At an institution like that you could be evaluated and treated by a team of sub-specialists who are at the cutting edge of their respective fields. The best thing about these large teaching hospitals is that consultations are available with Professors and leaders in their field by just walking a few steps down the hall.

The Mayo Clinic in Rochester, Minnesota is an excellent example of just such a place as this. That being said there are many excellent teaching hospitals all across the country and I am sure that there is one near you.

I know that it is going to take significant effort on your part, but I believe that going to one of the "Medical Mecca's" is your best chance to – finally -- get to the bottom of what is going on.

Does this make sense to you?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned the top rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS