Based on your history and response to treatment, your symptoms are most consistent with IBS (Irritable Bowel Syndrome), gas- and flatulence-predominant, with a component of gut bacterial imbalance and altered bowel motility.
The significant relief you experienced with Secnil Forte and Nizonide strongly suggests that gut microbial imbalance or protozoal/bacterial overgrowth is contributing to your symptoms. The recurrence of symptoms after stopping these medicines is common in IBS because antibiotics temporarily reduce abnormal gut flora but do not correct the underlying motility and sensitivity issue. The feeling of incomplete evacuation and the urge to pass stool shortly after meals are classic features of IBS with exaggerated gastro-colic reflex, not necessarily a structural colon disease.
Regarding colonoscopy, in a 22-year-old patient with no alarm features such as weight loss, anemia, bleeding, nocturnal diarrhea, fever, or family history of colorectal cancer, a colonoscopy is not routinely mandatory. It is usually advised only to rule out organic disease when symptoms are persistent or when reassurance is needed, but clinically your presentation fits IBS rather than a serious colon pathology.
Rifaximin is an appropriate choice for gas-dominant IBS, as it targets bacterial overgrowth with minimal systemic absorption. Sompraz is useful if upper GI symptoms coexist. IBSet, which contains antispasmodic components, can sometimes worsen gas and bloating in gas-predominant IBS, so intolerance to it does not mean treatment failure.
Next Steps
Management should focus on gut flora modulation, motility regulation, and dietary trigger control, rather than repeated strong antibiotics or invasive tests. With a structured plan, IBS symptoms are very much controllable, though they may fluctuate.
Health Tips
If symptoms persist despite optimized medical therapy, further evaluation can be considered, but based on your current profile, this appears to be IBS with bacterial dysbiosis rather than a colon disease.