Not getting relief from ibs symptoms - #9780

Thanks for sharing, Rohit. I am here to help you with all my efforts. I understand it can be frustrating to deal with persistent symptoms, especially when initial medications don’t offer relief. Based on your symptoms and diagnosis of Irritable Bowel Syndrome (IBS), here’s a structured clinical-style summary with next steps and suggestions. Follow-Up Clinical Note – Suspected IBS with Incomplete Relief Patient Name: Rohit Age/Sex: 25 / M Chronic Illnesses: Hypothyroidism Date: 12-04-2025 Chief Complaints: Persistent pain in upper left and lower left abdomen Diarrhea in the morning, followed by constipation in the evening Worsening pain with physical activity (e.g., running) No significant relief despite 5 days of: Tab Clistar-RT (antispasmodic/prokinetic) Tab Esopase 40 mg (proton pump inhibitor) Likely Diagnosis: Irritable Bowel Syndrome – Mixed Type (IBS-M) (Note: Functional gut disorder often linked with stress, food sensitivities, gut motility changes.) Points to Consider: IBS symptoms can take 2–4 weeks to respond to medication, lifestyle, and diet changes. Left-sided abdominal pain, especially worsening on exertion, may also involve: Gas entrapment in the colon/splenic flexure Mild colitis (even with normal reports) Functional bloating Hypothyroidism can slow gut motility, worsening IBS symptoms. Stress, irregular meals, sleep changes, or specific food triggers can contribute. Recommendations / Next Steps: Investigations (if not already done): Stool routine & occult blood CRP/ESR (inflammatory markers) Lactose intolerance and gluten sensitivity test Colonoscopy (if symptoms persist >4–6 weeks without relief) Diet & Lifestyle: Follow low-FODMAP diet for 3–4 weeks (removes fermentable carbs that trigger IBS) Avoid: dairy, artificial sweeteners, onions, garlic, legumes, and spicy food Eat small, frequent meals; avoid large gaps Stay hydrated with 2–3L water daily Gentle exercise or yoga, not intense running right now Consider CBT or stress-relief techniques – IBS strongly linked with brain-gut axis When to Revisit: If no improvement in 10–14 days If weight loss, blood in stool, fever, or fatigue develops You need proper treatment plan for this. Dr Shayeque Reza MD 9800280276

hi rohit, this is dr aman shaba. your symptoms — left-sided abdominal pain, morning diarrhea, evening constipation — with normal reports fit ibs, which is a functional gut issue. often, it’s triggered by stress, diet, and irregular bowel habits. pain while running could be gas or muscular strain but other causes like gastritis or mild pancreatic/spleen issues should be ruled out if pain continues. ibs has a strong mind-gut link — stress and emotions can worsen gut sensitivity. treatment is usually tailor-made: a mix of diet changes, stress management, and sometimes psychological support, not just medicines. since you have hypothyroidism, keeping thyroid in control is also key. if symptoms persist, a re-evaluation is important for proper diagnosis and long-term relief. Dr Aman Shaba Consultant Psychiatrist 7992489808