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Doctors' Answers to "Frequently Asked Questions" - Irritable Bowel Syndrome

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An indi vidual patient is always advised to consult their own physician.

[posted 03/25/2000]
Question: I have had for several years a problem with recurring bouts of constipation/diarrhea often having both in the same day. In between I have a constant feeling of needing to move the bowels and often must go six or seven times in a day. The doctor has diagnosed it is irritable colon. Is this the same as irritable bowel syndrom? He has prescribed Propulcid four times a day for this. I do not feel that it is helping me. What do you think. Is there any better choice for treatment that you would recommend? The way things stand now it is unsafe for me to leave the house, as I have been caught by surprise with the diarrhea several times with no warning until too late. The doctor just shrugs his shoulders and says I must live with this.

Answer: What diagnostic things have been done? Usually propulsid isn't used in irritable bowel since it increases bowel motility(hence useful with the constipation part-not the frequent bowel movements). Also, propulsid is basically off the market beginning 3/22/00. In general, you would need at least a barium enema and an upper gi. A treatment with flagyl is usually done to eliminate the possibility of giardia. This is a one cell parasite that lives in the upper small bowel, is common and hard to detect. If this has been done, then an SRI antidepressant like Prozac, Zoloft is often useful.

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