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I suffer from ibs-d and this causes lots of gas and

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Hi. I suffer from...

Hi. I suffer from ibs-d and this causes lots of gas and bloating. As a result my stomach makes really loud noises. I'm afraid going to quiet places. This has of gas and bloating. I'm afraid to be in quiet places. I am a 28 yr old female and this has negatively impacted my life. Is there anything i can do about this?

Doctor's Assistant: How long has this been bothering you? Are you experiencing any vomiting or nausea?

I was diagnosed with ibs about 8 yrs ago. No vomiting or nausea though

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I am currently taking Librax for my ibs, as well as celexa and propranolol for anxiety/depression and hbp

Submitted: 1 year ago.Category: Health
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Answered in 25 minutes by:
4/1/2017
Health Professional: Dr Basu, Experienced Specialist replied 1 year ago
Dr Basu
Dr Basu, Experienced Specialist
Category: Health
Satisfied Customers: 29,282
Experience: MD
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Hi there,
This is Dr Basu, experienced Internal Medicine Specialist.
I am here to address your concerns and provide great service.

These symptoms can also be due to the gallbladder problem.
Excess bile acid will cause intestinal irritation.
When the gallbladder is not functioning well, the bile flow to the intestine may increase causing these symptoms.
This will result in bloating, belching and also diarrhea especially after meals.
These symptoms can be treated with a medication called Cholestyramine 4 gram twice daily will meals.
Inflammatory bowel disorders like Crohn's disease, microscopic colitis, eosinophilic gastroenteritis are other possibilities.
This requires colonoscopy to establish the diagnosis.
Malabsorption syndrome is another strong possibility.
Malabsorption syndrome includes the follow possibilities:
1. Excess bacterial overgrowth in the small intestine known as SIBO syndrome.
This is not usually diagnosed by the colonoscopy.
Small intestinal aspirate can be sent for bacterial count.
Carbohydrate breath test ( D xylose) is a simple test to diagnose this condition.
But, the treatment is much easier.
A 14 day course of Rifaximine improves the symptoms dramatically/
2. Lactose intolerance--- regular milk, dairy products.
3.gluten senisitivity or celiac disease--- Wheat based products.
4. Chronic pancreatitis --- deficiency of the digestive enzymes produced by the pancreas.
5. Gastroparesis -- delayed gastric and intestinal movement.-- treated with metoclopramide or domperidone daily.
You should consider following low fermentable sugar diet ( FODMAP diet) to reduce your symptoms.
Please go to this link for detailed information:
http://stanfordhealthcare.org/content/dam/SHC/for-patients-component/programs-services/clinical-nutrition-services/docs/pdf-lowfodmapdiet.pdf

Please also include prebiotics like Inulin daily to keep your colon acidic which prevent gas producing bacteria.
Also take a probiotic ( lactobacilli, bifidobacterium) daily to restore intestinal microbial balance.
Culturelle 30 Counts twice daily should be fine.
Please consider taking Simethicone ( GasX) strips before each meal and activated charcoal tablets to reduce gas formation.

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