A normal sigmoidoscopy is reassuring and makes serious structural diseases (such as ulcers, tumors, or inflammatory bowel disease in the examined area) less likely. Since you've had IBS symptoms for 15 years, your symptoms are likely due to visceral hypersensitivity and altered gut motility, where certain foods trigger pain despite a normal bowel examination.
The fact that black pepper, chili, garam masala, and full-cream milk trigger your symptoms is not unusual. If avoiding these foods helps, it is reasonable to continue avoiding them.
Regarding buttermilk:
If you tolerate it well, you do not need to remove the foam. The foam itself is not harmful.
If the buttermilk is made from low-fat curd and does not worsen your symptoms, it is generally a better option than full-cream milk for people who are sensitive to dairy.
Since you also have migraine, it is important to note that some foods (aged cheese, chocolate, caffeine excess, processed foods, MSG, and irregular meals) can trigger both migraine and IBS in some individuals. From an Ayurvedic perspective, long-standing IBS often correlates with disturbances in Agni (digestive fire) and Vata dosha, though the exact assessment depends on whether your symptoms are diarrhea-predominant, constipation-predominant, or mixed.
Treatment is individualized and may include:
Correction of Agni.
Dietary regulation.
Lifestyle modifications.
Classical Ayurvedic medicines based on your constitution and symptoms.
Next Steps
Since your symptoms have been present for many years, you must consult us, especially if your symptoms change or worsen. Also seek medical review if you develop: Blood in stools. Unintentional weight loss. Persistent fever. Anemia. Night-time diarrhea or pain that wakes you from sleep. For a personalized Ayurvedic treatment plan addressing both IBS and migraine, you may consult us at 9 3 1 5 6 6 1 5 6 5.
Health Tips
Eat small, regular meals rather than large meals. Avoid prolonged fasting. Keep a food and symptom diary to identify personal triggers. Stay well hydrated. Manage stress through yoga, meditation, or breathing exercises, as stress commonly aggravates both IBS and migraine. With the right combination of diet, lifestyle measures, and individualized treatment, many people with long-standing IBS achieve good symptom control and a much better quality of life. Thank you