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Dr. Chip
Dr. Chip, Board Certified Physician
Category: Medical
Satisfied Customers: 36122
Experience:  20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
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Doctor, I wonder if you could advise me or reassure

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Doctor, I wonder if you could advise me or reassure me. I have had Gas/Flatulence/Bloating/alternate changes in bowel movements ( such as : Soft brown/ loose stools, some diarrhoea/sausage type shape and lighter and mustard brown in colour ) weeks now every day without much change and I am a little anxious about it. I did see my Gastroenterologist about it who I have seen a few times over the years and he has told me that I have the symptoms of IBS. I have had a previous colonoscopy in April 2013 and a Sigmoidoscopy last year in June, both of which came back normal. He advised me to see a dietician in his practice and suggested I cut out dairy/Lactose and consider Fodmap diet. I did see the dietician and she suggested cutting out lactose weeks and if no improvement then to look at fodmap diet. I am into week 2 of lactose exclusion ( no milk) and although I haven't cut out everything ( I have had the odd cake - no cream) but there hasn't been any real improvement. I know I am an anxious person anyhow and worry about Crohns which I had when I was 17 ( I did have an operation and haven't had any problems since ) . I also worry about colon or bowel cancer which my dad had ten years ago when he was 73. My Gastroenterologist has said that the symptoms I have do not suggest cancer but very striking . I guess I am asking should I look tests to exclude other things ( which all cost money) go back again to my gastroenterologist, or just accept it is IBS and work with the dietician or other treatments. It's just that it has all been going on while now, and I haven't had so much gas before ( Passing wind sometimes up to 40 or 50 times a day ) and I read it could be a sign of bowel cancer so naturally I worry. I would appreciate your view about what I am experiencing. Many Thanks, *****
Mark--let's work through this together. First let me ask you do fried or fatty foods aggravate this? Any abdominal pain with all the gas? And have you been screened H pylori infection in your stomach?
Customer: replied 3 years ago.


I haven't noticed fried or fatty foods aggravate this. I rarely eat fried or fatty foods. There is no abdominal pain with the gas. I don't think I have been screened Pylori - it certainly hasn't been spoken to me about.

OK--how was your Crohn's diagnosed and what operation did you have when you were 17. And since then you never had any flare-ups?
Customer: replied 3 years ago.

I remember It took quite while to discover it. I forget what tests I had done. They removed part of my intestine ( 16 inches I think ) from the small bowel. I have not had any flare ups since.

Well, you're very lucky with that my friend. Are you on any medications ? And sorry the questions
Customer: replied 3 years ago.

No problem at all. Yes i am very thankful . I have just tried some of the buscopan tablets that you get over the counter but nothing else. just been using them the last couple of days so no real effect yet.

OK--so your main concern here is possible colon cancer?
Customer: replied 3 years ago.

yes i guess it is in the back of my mind

OK--let me take that worry away then. The symptoms you describe are nothing like those of colon cancer. That usually doesn't cause any symptoms some time and when they crop up it's usually abdominal pain and narrow stools that one sees--not gas and changes in stool color. The change in color is either from a bit of an increase in transit time through the intestines or possibly a gall bladder problem although without any abdominal pain that isn't very likely. IBS can certainly act like this and you may need a medication like Bentyl or Levsin . Another possibility would be the H pylori I mentioned and you should ask your gastroenterologist to screen you since if you're positive a course of two different antibiotics resolves the problem. The other possibility--not very likely either--would be pancreatic insufficiency--not enough digestive enzymes being produced by the pancreas. A stool study would check . One thing you could try would be a lactobacillus probiotic. We can certainly continue after this if you'd like but I think you're GI will turn out to be correct in surmising that this is simply IBS but I would do the H pylori screening and the stool study
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