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Dr. Scott
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Experience:  Physician
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I am a 30 year old woman. I've been suffering from bowel

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I am a 30 year old woman. I've been suffering from bowel problems ever since i was a teenager. back then i remember being frustrated from not being able to have one bowel movement once and for all like everybody else every day. instead, i felt i had to go at least 3 or 4 times (sometimes more) in the morning to empty completely. Moreover, the trip to school was always a nightmare since at any moment i could feel the urgent need to empty again. (when i feel the urgent need to empty, i have a sudden pain in the abdomen that goes away upon emptying). I would stress about that every morning and stress made it worse. At times I would have diarrhea for several days and at others i would be constipated, sometimes successively, which confused me.
Symptoms seem to get better at times and worsen at others. They typically seem to get worse near my menstruations. (I suffer from premenstrual syndrome). In addition to that, ever since my late teens and early twenties, I began to suffer from bloating. During my mid twenties, i also began to suffer from chronic lower back pain. I knew I had a weak lower back ever since i was in school but at that time, the pain became very frequent. Today, at thirty, I feel my symptoms have worsened as well as my premenstrual syndrome.
Nowadays I don't leave my house before 11 a.m. - noon because I don't know when I might have bowel movements that require me to go to the toilet right away, or within minutes at most.
Any ideas or advice?

Hello, I would be happy to discuss any questions or concerns via phone if you would like.

Thank you,

Carole NP

Customer: replied 9 months ago.
Thank you, I'd rather not discuss this over the phone.

Have you been diagnosed with IBS (irritable bowel syndrome), or any other conditions in your medical history? Do you currently take any medications for relief in this, or have you previously tried anything that had any effects?

Carole NP

Customer: replied 9 months ago.
Thank you for your reply, Carole. Frankly I've never consulted a doctor about this, but a nutritionist once diagnosed me with IBS.I don't take any medications. I've previously tried probiotics, they're helpful but they don't eliminate the symptoms totally, especially the fact that i need to empty more than once in the morning.
Following a caffeine-free diet rich in soluble fibers (such as oats), moderate in insoluble fibers, and low in fodmaps has decreased diarrhea, constipation and bloating. But the need to empty several times and the feeling of urgency are still there.
Customer: replied 9 months ago.
Just letting you know I'm still waiting :)
Customer: replied 9 months ago.

Hi there,
I am Dr. Scott - it is my pleasure to assist you today.
Please give me a minute to review your question and type up an answer.
Please note that the answer provided is for information purpose only and does not substitute a Doctor - Patient Consultation in Clinic

What type of work up have you had so far?

How long did you take probiotics?

Have you tried to eliminate gluten or lactose?

Customer: replied 9 months ago.
All kinds of muscle exercises at the gym, including stretching and running.
I took probiotics in a row for a couple of months.
I've tried to eliminate lactose and it helped decrease the bloating, but it didn't affect the rest (particularly regular urgent bowel movements in the morning). I haven't tried eliminating glutens.

How long did you go lactose free?

Does anyone else in your family have similar issues?

Customer: replied 9 months ago.
It's been 6-12 months. I'm still going 99% lactose free.
Customer: replied 9 months ago.

6 month is usually long enough.

Now you should try to go gluten free. You might have celiac diseases.

Celiac disease is an autoimmune disease triggered by a response to dietary gluten (a protein which is found in wheat, rye, and barley) in genetically predisposed individuals.

Customer: replied 9 months ago.
I've heard about it, but I don't think I have any of the symptoms. Joint pain, feet numbness, anemia, teeth discoloration, etc, none of that is there.

You are right - celiac's disease can cause some abnormal symptoms, but this is only true for about 50% of people.

If I were you, I would go 110% gluten free for 6 month.

The alternative would be get tested with blood work with your primary care doctor.

I would encourage you to provide a stool sample as well which can help lead you to a diagnosis if there is malabsorption.

You symptoms can also be from gallbladder and pancreatic causes.

Customer: replied 9 months ago.
Alright, I'll keep all of this in mind.
Your colleague mentioned IBS (I don't know if you can see our discussion above). I've looked it up and all symptoms fit. What do you think?

I would make sure it's not celiacs disease first.

Probiotics and exercise usually help IBS.

I hope this helps!
Let me know if you have any additional questions.
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Customer: replied 9 months ago.
Alright, thank you. One more q: How can I make sure if there are gallbladder and pancreatic causes or not?

Stool sample to look for malabsorption.

psyllium will also help IBS.

You can also ask your doctor for some antispasmodics which may reduce IBS symptoms

You can also try loperamide (Imodium)

Customer: replied 9 months ago.
Alright, thank you. Any other recommendations?

eat regularly and take time to eat
drink ≥ 8 cups of fluid daily, especially water or other noncaffeinated drinks
limit tea and coffee to ≤ 3 cups daily
reduce consumption of alcoholic and carbonated beverages
limit high-fiber foods such as whole grain breads, cereals high in bran, and whole grains such as brown rice
reduce consumption of ‘resistant starch’ (starch that resists digestion in the small intestine and reaches the colon intact), which is often found in processed or recooked foods
limit fresh fruit intake to < 240 g daily

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Category: Medical
Satisfied Customers: 820
Experience: Physician
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Customer: replied 9 months ago.
Thank you very much!

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