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blood work 2 CT scans, ultrasounds , MRA upper GI still sick

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Test after test since April 2014, blood work 2 CT scans , ultrasounds , MRA upper GI, Colonoscopy ok . I suffered with lower left abdominal pain, I have had h pylori , taken meds for that and suffered with Diarerreah took meds for that as well . Then had bacteria overgrown took meds for that . Then given dexilant FOR gerd . Now a change constipation , and I have trouble moving my bowels , taking amitiza and it seems to have stoped working what can I do . I watch wahta I eat made life style changes , increased fiber but still have lower left abdominal pain , and upper left abdominal as well after eating, taking Xifaxin for Bacteria overgrowth that has returned again. WHAT THE HELL IS GOING ON. No answer 2 gi docs and primary doc is confused . I FEEL LIKE NO ONE BELEIVES ME WITHT HE PAIN. What can I DO ? had Diarerreah then a sudden swith to CONSTIPATION. Why is the amitiza not working ? What is next . Please help . yes I have made several eating habit changes.

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replied September 2nd, 2014
Digestive and Bowel Disorders Answer A49050
Thank you for asking

Your symptoms alternating constipation with diarrhea, GERD history and lower quadrant pains and over grown bacteria are all very classic for functional bowels like IBS but it needs a little work up to rule out any assciated co morbidity.

Diet and lifestyle modifications for the functional Gi troubles, More fibres, less fats and carbohydrates, small meals of frequent durations that few larger ones, use of healthy lifestyle and exercise, losing weight if an issue, controlling lipid profile in a limit and compliantly using hypertensive medicines and staying in touch with your doctor is advised.
Fiber supplementation improve symptoms of constipation and diarrhea. Polycarbophil compounds (eg, Citrucel, FiberCon) may produce less flatulence than psyllium compounds (eg, Metamucil).

Judicious water intake is recommended and should be followed. Minimum of 2 litres in a day is advised.

Caffeine avoidance may limit anxiety and symptom exacerbation. Legume avoidance may decrease abdominal bloating. Lactose and/or fructose should be limited or avoided Take care to supplement calcium in patients limiting lactose intake.

Gluten intolerance has been further associated with irritable bowel syndrome. so try gluten free diet and see if it helps.
Meanwhile some prokinetics like metoclopramide and domperidone and erythromycins would keep the propelling work and make the bloating less but it needs a work up as i mentioned to sort out the most likely functional cause as IBS etc.

Seek a gastroenterologist for further management.

Continue diet and lifestyle modifications and seek a gastroenterologist and enlighten yourself from our IBS health centre about your symptoms further.

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