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Dear Dr. Roach, I have been treating irritable bowel syndrome for over 40 years. I have less cramps and loose stools when I stop drinking milk. However, in recent years I have had mild constipation and very frequent bloating. I take 10 mg of dicyclomine, before meals and at bedtime, it helps a little with spasms. When the bloating is more constant, I take Phazyme, Tums and Pepto-Bismol, as well as 150 mg of ranitidine, which helps a little. I'm afraid of taking too many types of pills to control it. I have recently had acid reflux and I feel the pressure in the stomach and under the sternum with a lot of rot.
My question is: is it okay to take all these pills in a few hours or if there is a better alternative?
I was wearing a heart monitor for a month because of irregular heartbeats and heavy heartbeats. Incidents were recorded, but it was not serious enough to worry at the moment. I think the problem was caused by the pressure of bloating.
J.F.
Irritable bowel syndrome is a disorder of the common gastrointestinal tract (10 to 15% of adults), which manifests itself as abdominal pain or discomfort and bloating, as well as by changes in the movements of the bowel. Gut, such as diarrhea or constipation. Abdominal discomfort is usually relieved by bowel movements.
Primary treatment for IBS is a proper diet and a relationship with food. Stopping the milk, for example, seemed to have helped you a lot.
It is possible that other dietary changes reduce the need for medications, and meeting with a gastroenterologist and dietitian nutritionist can have a dramatic effect on your symptoms. Many foods (known as FODMAP, "oligo-, di-, monosaccharides and fermentable polyols") can worsen the symptoms and learning to reduce them takes up more space than I have in 10 columns.
Dicyclomine is an antispasmodic that helps some people with IBS. Phazyme is a brand of simethicone, an anti-gas agent; Tums is an antacid; Pepto-Bismol is an antidiarrheal and an antimicrobial. and ranitidine partially suppresses stomach acid. None of these are specific to irritable bowel syndrome and all are generally considered safe with few serious side effects. I do not know how many of your symptoms are due to acid reflux (acid rising from the stomach, into the esophagus) and how many are due to IBS. I agree with you that you may not need all these drugs. Try to reduce them, especially if you are able to find a dietary treatment.
Irregular heartbeats are common and without other worrying symptoms, such as fainting or chest discomfort, may not need further evaluation unless they continue to bother you.
Dear Dr. Roach, I was recommended a supplement based on fruits and vegetables powder. Would it be beneficial?
D. T.
I believe in nutrition, no supplements, as much as possible. Supplements should be used for specific problems or concerns and not to promote general health, with very few exceptions (omega 3 and vitamin D supplements remain controversial). I would prefer that you spend your money on an extra portion or two of fruits and vegetables a day rather than taking a powder supplement.
Dr. Roach regretted that he could not reply to individual letters, but would incorporate them in the column whenever possible. Readers can send questions via email to [email protected].
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