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CamilleRN, Nurse (RN)
Category: Health
Satisfied Customers: 4183
Experience:  Experience: 20 yrs experience in ER, ICU, Neuro, OR, Chemo,Cardiology, Dermatology and MORE.
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I have always had what appears to be IBS...But lately

Customer Question

I have always had what appears to be IBS...But lately everything I eat sends me to the bathroom. I have become a recluse, to afraid to stray too far from a bathroom...last two weeks have been the worse..
Submitted: 6 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 6 years ago.


Normal continence involves the coordinated interaction between multiple different nerve pathways and the pelvic and perineal muscles. Many other factors, like systemic disease, emotional effect, bowel motility, stool consistency, evacuation efficiency, pelvic floor stability, and sphincter integrity, play a role in normal regulation of the anus sphincter and continence. Failure at any level may result in an impaired ability to control gas or stool (especially if the motion is liquid). Following investigations are needed for the identifying the cause;

1) Endoanal ultrasound,
2) MRI,
3) Defecography,
4) Anorectal manometry
5) Anorectal electrophysiology testing

The treatment entails;

1) Biofeedback; Pelvic floor exercises with biofeedback are beneficial when combined with the addition of dietary modifications. Biofeedback educates regarding pelvic floor coordination, recognition of sensory thresholds, and conditioning of the pelvic musculature, and it helps develop improved pelvic floor habits.
2) Dietary modification: a food diary may be useful to detect offensive items, such as citrus or spicy foods, caffeine, and alcohol, that may be associated with incontinence. Avoiding these may decrease the irritant load to the rectum.
3) Medications; The two most commonly used drugs are loperamide and diphenoxylate with atropine. Loperamide is currently the treatment of choice because it not only thickens the stool but also has been shown to increase anal sphincter tone and improve continence mechanisms.
4) Anal sphincteroplasty; it is a surgical procedure and is done when the above medical treatment fails and if the injury of the sphincter of anus is demonstrated.
5) Artificial sphincters
6) Sacral nerve stimulation

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Dr. Arun

Customer: replied 6 years ago.
I appreciated your try on my problem...But, I think this issue is for a gastro specialist..I already knew what you told me...
Expert:  CamilleRN replied 6 years ago.
Welcome to JustAnswer Health...and thank you for your question. I am a verified Expert and am delighted to help you today. I am very experienced with IBS and I would like to help you. Please tell me what you currently take to promote healthy bowel habits... I have some excellent ideas for you.