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IBS or something else
Hi Dr, I wanted to enquire about my recent issue. I was having for the last 3 weeks. It started after I went on a high protein diet. I am a vegetarian so I included a lot of dairy products and due to some injury I also had to take naproxen so I attributed my symptoms to these two. I went to a gastroenterologist and he prescribe me symbulardi and Rifagut which I took for two weeks. I am better now. I’m not having loose tools like before but my stool type is fluctuating between being constipated and type 5-6. I will be booking an appointment with a local doctor here, but I just wanted to understand what this could be. I also had test with CRP,CBC and electrolyte which was all normal and only my ESR was raised at 30. During last week I was in goa and had pretty much everything without any major issues. Please advise what this could be. My appointment is on Monday and I am getting anxious.
Answers (17)
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Key Clinical Summary:
Onset: 3 weeks ago after starting high-protein, dairy-rich diet (vegetarian)
Took Naproxen (NSAID)
Symptoms: Altered bowel habits (type 5–6 stools alternating with constipation)
Medication: Took Symbiolardi (probiotic) and Rifagut (rifaximin) for 2 weeks → improved
Current labs: Normal CBC, CRP, electrolytes; ESR mildly raised at 30
No major symptoms during Goa travel
Patient is anxious, appointment pending
📌 Differential Diagnosis (per Harrison’s guidelines):
1. Irritable Bowel Syndrome (IBS) – Mixed Type
Typical features:
Alternating bowel habits (constipation + loose stools)
No alarm symptoms (weight loss, blood in stool, nocturnal diarrhea)
Often precipitated by diet change, stress, or infection
Improvement with rifaximin + probiotic supports functional GI disorder
2. Post-Infectious IBS or Food Intolerance
Change in diet (increased dairy/protein) and possible NSAID-related gut flora disruption
Naproxen can cause enteritis or low-grade colitis
3. Non-Specific Colitis or Low-Grade Inflammation
Mildly elevated ESR can be non-specific or related to inflammation
Normal CRP, CBC make IBD unlikely
✅ Recommended Next Steps:
🔍 Clinical Workup:
Stool calprotectin or fecal lactoferrin (to rule out IBD vs IBS)
Food diary to track symptoms vs diet
If persistent: consider colonoscopy (if age >40, persistent symptoms, or family history)
💊 Symptomatic Management:
Continue probiotics
Use bulk-forming agents (psyllium) for stool consistency
Avoid excess dairy or protein isolates temporarily
🧘♀️ Lifestyle:
Hydration, physical activity
Low-FODMAP diet trial if symptoms persist
🟢 Favoring IBS Over Organic Pathology:
Normal blood work
Good response to rifaximin
No systemic symptoms
Tolerated travel food without worsening
📘 References:
Harrison’s Manual of Medicine, Irritable Bowel Syndrome: Symptoms include altered bowel habits with normal inflammatory markers.
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kindly connect with me for further evaluation.
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Hiii
Loose stools may have many causes
Not only disease but even stress have effects on our digestive system
In order to explain ur disease in a better way
N for proper treatment
Have to know ur disease in a better way n
Give u solution for this
U can consult me over here
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Hello,
Take balanced diet. For prescription please pay and consult or contact me at WhatsApp at +9195950eight7399.
Thanks.
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Dr. Sivasuriyan S
Consult Now
Ayurvedic Endocrinologist & Internal Medicine Specialist
4 yrs exp
Chennai
Need further evaluation, kindly connect
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Naproxen is an NSAID. So it will cause stomach upset.
Symbulardi is a Probiotic. Rifagut is an Antibiotic. Given together the benefit of Probiotic will not be available to you.
You should be prepared for an upper GI endoscopy. Let's see what diagnosis is given after that.
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Do connect and consult
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Donot worry about ESR,, it is not at all use marker. Regarding your symptoms it appears everything is due to high orotien diet causing indigestion, my advice would be to avoid high protien diet, have fasting and take water, if it due to food, than fasting will help you resolve your condition, if you want to have food than take rice as it is easy to digest, avoid , wheat, high sugar food and pulses as it can exercebrate your diarrhea.
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Please share if any recent stressful event occurred and kindly consult
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Please share more information. Do you remain constipated, were the loose stools after 2 days or more constipa
tion?Did you have heart burn as well?
Share details. Then I can help you.
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Need few more details
Kindly connect.
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Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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Everything looks normal,
Body requires little time to adjust to normal
Just follow your regular routine and eat clean diet.
I think you should not worry much;)
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Connect
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Dr. Manoj Kumar
General Physician
9 yrs exp
Dehradun
Need few more details
Kindly consult
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Dr. Sunil Nagar
General Physician
17 yrs exp
Rewa
Connect
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Dr. Chaithra H
General Physician
5 yrs exp
Bangalore
Needs to be evaluated.
Do consult.
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