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| IBS (Irritable Bowel Syndrome) Q&A In Singapore, up to 9% of the population has
IBS (irritable bowel syndrome). IBS belongs to a group of benign conditions known as functional gastrointestinal disorders (FGID). As the featured doctor for this month's "Ask The Specialist" forum, Dr Wang Yu Tien, Senior Consultant from the
Department of Gastroenterology & Hepatology at
Singapore General Hospital (SGH), a member of the
SingHealth group, will answer your questions about IBS and FGID.
This forum is open from
1 Apr to 26 Apr 2019.
If you have problems posting your questions, please email your questions to
marcom@healthxchange.com.sg
Kindly note: Your question will go live/appear when the doctor answers it
Also, take part in our survey!
We are currently developing an app to help patients better manage IBS and would love to hear your views. Click on the link below to complete a simple 4-question survey. Thank you for participating!
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| In Singapore, up to 9% of the population has
IBS (irritable bowel syndrome). IBS belongs to a group of benign conditions known as functional gastrointestinal disorders (FGID). As the featured doctor for this month's "Ask The Specialist" forum, Dr Wang Yu Tien, Senior Consultant from the
Department of Gastroenterology & Hepatology at
Singapore General Hospital (SGH), a member of the
SingHealth group, will answer your questions about IBS and FGID.
This forum is open from
1 Apr to 26 Apr 2019.
If you have problems posting your questions, please email your questions to
marcom@healthxchange.com.sg
Kindly note: Your question will go live/appear when the doctor answers it
Also, take part in our survey!
We are currently developing an app to help patients better manage IBS and would love to hear your views. Click on the link below to complete a simple 4-question survey. Thank you for participating!
| | | | | 25 | 3/25/2019 3:09 PM | 4/30/2019 10:38 AM | No | IBS (Irritable Bowel Syndrome) Doctor Q&A | 2.15037054511756 | 1 | | 3/25/2019 2:55 PM | Forum Admin | | |
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| Posted by Kalyani (Republished by Forum Admin) Dear Dr Wang, I am taking 2 capsules of probiotic (Vivomix) in the morning & evening for my IBS prescribed by SGH doctor. How long do I have to wait to eat after taking the probiotics?. I find that when I eat immediately after taking the probiotics, after few minutes I got the urge to pass motion. Is it normal? Where can I buy the probiotics if I have finished consuming? Thanks Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) While studies have shown probiotics can improve symptoms in around 60% of IBS patients, the exact mechanism of action of probiotics is still not known. The probiotics tend to be more effective when taken in high doses for at least a few weeks. There is no data to guide when best to take it. My suggestion is to take it when it is convenient for you. Gastrointestinal symptoms are common especially on initiation of treatment. When in doubt please discuss with your managing doctor. You should discuss probiotic treatment plan with your managing doctor. |
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| Posted by Kalyani (Republished by Forum Admin) Dear Dr Wang, I am taking 2 capsules of probiotic (Vivomix) in the morning & evening for my IBS prescribed by SGH doctor. How long do I have to wait to eat after taking the probiotics?. I find that when I eat immediately after taking the probiotics, after few minutes I got the urge to pass motion. Is it normal? Where can I buy the probiotics if I have finished consuming? Thanks Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) While studies have shown probiotics can improve symptoms in around 60% of IBS patients, the exact mechanism of action of probiotics is still not known. The probiotics tend to be more effective when taken in high doses for at least a few weeks. There is no data to guide when best to take it. My suggestion is to take it when it is convenient for you. Gastrointestinal symptoms are common especially on initiation of treatment. When in doubt please discuss with your managing doctor. You should discuss probiotic treatment plan with your managing doctor. | | seoach | 1 | | 0 | 4/3/2019 12:24 PM | 4/4/2019 4:19 PM | | | | | | 3/25/2019 2:55 PM | Forum Admin | | |
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| Hi Dr Wang,
Once a while, I have indigestion, stomach churning, a lot of air in the stomach. Hence, I start to eat DUOLAC probiotic, 1 tablet in the night before I sleep. But instead of getting better, I feel breathless and got more air in my stomach. Should I continue with the probiotic?
Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) While studies have shown probiotics can improve symptoms in around 60% of IBS patients, the exact mechanism of action of probiotics is still not known. The probiotics tend to be more effective when taken in high doses for at least a few weeks. There is no data to guide when best to take it. My suggestion is to take it when it is convenient for you. Gastrointestinal symptoms are common especially on initiation of treatment. When in doubt please discuss with your managing doctor. You should discuss probiotic treatment plan with your managing doctor. |
symarkjc
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| Hi Dr Wang,
Once a while, I have indigestion, stomach churning, a lot of air in the stomach. Hence, I start to eat DUOLAC probiotic, 1 tablet in the night before I sleep. But instead of getting better, I feel breathless and got more air in my stomach. Should I continue with the probiotic?
Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) While studies have shown probiotics can improve symptoms in around 60% of IBS patients, the exact mechanism of action of probiotics is still not known. The probiotics tend to be more effective when taken in high doses for at least a few weeks. There is no data to guide when best to take it. My suggestion is to take it when it is convenient for you. Gastrointestinal symptoms are common especially on initiation of treatment. When in doubt please discuss with your managing doctor. You should discuss probiotic treatment plan with your managing doctor. | | seoach | 1 | | 0 | 4/3/2019 5:28 PM | 4/4/2019 4:18 PM | | | | | | 4/3/2019 5:28 PM | | | |
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| Dear Dr Wang
Will taking a PPI (such as dexlansoprazole) combined with probiotics prescribed for IBS for a prolonged period of up to a year have any side effects to our gastrointestinal system?
Will the body become reliant on these medicines / supplement if these are taken for such prolonged periods?
Is it normal for IBS to cause a dull pain at the bottom left at the hip / stomach area, (where one usually puts our left hand at)?
Thank you
Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) While PPI and probiotics are generally safe treatments. There is evidence showing a relationship between prolonged PPI use with adverse effects like osteoporosis and lung and intestinal infections. While these risks are low, treatment should be supervised by a doctor. With regards to probiotics, there is currently no evidence showing long term adverse effect but because its mechanism of action is unclear, it would be prudent to discuss the treatment plan with your doctor. The body does not become reliant (like drug dependence) on PPI and probiotics but because some they may be used to treat chronic problems like gastroesophageal reflux or IBS, repeated use may be necessary. IBS may cause pain in the abdomen, but it should be formally evaluated by a doctor. |
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| Dear Dr Wang
Will taking a PPI (such as dexlansoprazole) combined with probiotics prescribed for IBS for a prolonged period of up to a year have any side effects to our gastrointestinal system?
Will the body become reliant on these medicines / supplement if these are taken for such prolonged periods?
Is it normal for IBS to cause a dull pain at the bottom left at the hip / stomach area, (where one usually puts our left hand at)?
Thank you
Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) While PPI and probiotics are generally safe treatments. There is evidence showing a relationship between prolonged PPI use with adverse effects like osteoporosis and lung and intestinal infections. While these risks are low, treatment should be supervised by a doctor. With regards to probiotics, there is currently no evidence showing long term adverse effect but because its mechanism of action is unclear, it would be prudent to discuss the treatment plan with your doctor. The body does not become reliant (like drug dependence) on PPI and probiotics but because some they may be used to treat chronic problems like gastroesophageal reflux or IBS, repeated use may be necessary. IBS may cause pain in the abdomen, but it should be formally evaluated by a doctor. | | seoach | 1 | | 0 | 4/3/2019 6:05 PM | 4/4/2019 4:18 PM | | | | | | 4/3/2019 6:05 PM | | | |
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| My husband farts around (no smell, just gas) 10 - 20 times throughout the day. He says that there is a lot of gas in his stomach, and the farting gets worse when he eats certain food like yoghurt, fried food, ice cream. He says that this problem is because when he was young, he ate food that was prepared from 5-10 hours ago (mum will cook early in the morning, and he only consumes the food for lunch and dinner). As such, his stomach has been "spoilt" due to eating the cold food for many years. He has went for colonscopy and so far nothing has been found. I would like to know what form of supplement / medicine / food can help to alleviate this condition? What is this condition? and what food should he avoid?
Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) If he has been evaluated and diagnosed as IBS by his doctor then there are several treatment options including probiotics and reduction of fermentable carbohydrates in his diet which may improve his gas related symptoms. The diet intervention should be supervised by his doctor/dietician to ensure it is done correctly and nutritional balance is maintained. |
piggyyap
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| My husband farts around (no smell, just gas) 10 - 20 times throughout the day. He says that there is a lot of gas in his stomach, and the farting gets worse when he eats certain food like yoghurt, fried food, ice cream. He says that this problem is because when he was young, he ate food that was prepared from 5-10 hours ago (mum will cook early in the morning, and he only consumes the food for lunch and dinner). As such, his stomach has been "spoilt" due to eating the cold food for many years. He has went for colonscopy and so far nothing has been found. I would like to know what form of supplement / medicine / food can help to alleviate this condition? What is this condition? and what food should he avoid?
Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) If he has been evaluated and diagnosed as IBS by his doctor then there are several treatment options including probiotics and reduction of fermentable carbohydrates in his diet which may improve his gas related symptoms. The diet intervention should be supervised by his doctor/dietician to ensure it is done correctly and nutritional balance is maintained. | | seoach | 1 | | 0 | 4/3/2019 10:22 PM | 4/4/2019 4:17 PM | | | | | | 4/3/2019 10:22 PM | | | |
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Edited: 4/15/2019 10:36 AM | | | |
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| Hi Dr Wang
Is IBS still very much a debatable topic in the Healthcare industry ?
Is it possible to get MC if I visit the polyclinic / GP for my IBS as it has been causing me so much pain for the past week due to rushing projects' deadlines .
Because most of the time when I do , the doctors will just either laugh it off and say that it is just normal tummy ache , or they can be really mean and say in my face that I just want to fake an MC so that I can take the day off from work . I think that is really rude of them. My abdomen hurt like hell , day and night , I could not even sleep . I dare not go to visit the doctors for an MC as well as I am afraid of being ridiculed by them.
Also , can having gluen-free meals help with IBS? I just find that it does not cause my abdomen to bloat so badly. Not too sure if it will help in the long run .
Thank you. Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) IBS is a well-accepted diagnosis in healthcare. It is very common, and treatment and provision of medical certificate Is individualised depending on your doctor’s assessment. One of the key to successful IBS management is having a good relationship with a regular doctor to help guide your management. Gluten free diet is used to treat celiac disease, when exposure to gluten causes small bowel inflammation. The Low FODMAP Diet, discussed earlier, can be used to treat IBS and many of the gluten containing food are also high in FODMAP, so it is possible that a reduction of these foods has resulted in symptom improvement. |
tmrnvrcome
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| Hi Dr Wang
Is IBS still very much a debatable topic in the Healthcare industry ?
Is it possible to get MC if I visit the polyclinic / GP for my IBS as it has been causing me so much pain for the past week due to rushing projects' deadlines .
Because most of the time when I do , the doctors will just either laugh it off and say that it is just normal tummy ache , or they can be really mean and say in my face that I just want to fake an MC so that I can take the day off from work . I think that is really rude of them. My abdomen hurt like hell , day and night , I could not even sleep . I dare not go to visit the doctors for an MC as well as I am afraid of being ridiculed by them.
Also , can having gluen-free meals help with IBS? I just find that it does not cause my abdomen to bloat so badly. Not too sure if it will help in the long run .
Thank you. Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) IBS is a well-accepted diagnosis in healthcare. It is very common, and treatment and provision of medical certificate Is individualised depending on your doctor’s assessment. One of the key to successful IBS management is having a good relationship with a regular doctor to help guide your management. Gluten free diet is used to treat celiac disease, when exposure to gluten causes small bowel inflammation. The Low FODMAP Diet, discussed earlier, can be used to treat IBS and many of the gluten containing food are also high in FODMAP, so it is possible that a reduction of these foods has resulted in symptom improvement. | | seoach | 1 | | 0 | 4/4/2019 11:10 AM | 4/15/2019 10:36 AM | | | | | | 4/4/2019 11:10 AM | | | |
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Edited: 4/15/2019 10:35 AM | | | |
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| Hi Doctor! Jus a quick question. Im been diagnosed with IBS recently and currently on Meteospasmyl tabs adhoc. It doesnt seem to work that well too even though it was switched from Mebetin initially. I was also told to do a scope in the interim. Else, the discomfort comes suddenly and it doesnt go away even after 2/3 days. My mood gets low and though im hungry, i will refrain from filling my tummy so as not to upset it any futher. My stools too seems soft wz alot of gas after the episode. Appreciate your advise. Regards Haidon Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) Your symptoms are suggestive of IBS and the medications you are on are for IBS but, as with all IBS treatment, may not be effective for some. I would suggest you feedback your symptoms to your doctor to further adjust your treatment. |
Haidon
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| Hi Doctor! Jus a quick question. Im been diagnosed with IBS recently and currently on Meteospasmyl tabs adhoc. It doesnt seem to work that well too even though it was switched from Mebetin initially. I was also told to do a scope in the interim. Else, the discomfort comes suddenly and it doesnt go away even after 2/3 days. My mood gets low and though im hungry, i will refrain from filling my tummy so as not to upset it any futher. My stools too seems soft wz alot of gas after the episode. Appreciate your advise. Regards Haidon Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) Your symptoms are suggestive of IBS and the medications you are on are for IBS but, as with all IBS treatment, may not be effective for some. I would suggest you feedback your symptoms to your doctor to further adjust your treatment. | | seoach | 1 | | 0 | 4/4/2019 12:24 PM | 4/15/2019 10:35 AM | | | | | | | | 1 | Haidon |
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| Posted by Jason (Republished by Forum Admin) Hi Doctor, I don’t think I have IBS but I suffer frequently from loose stools. My stools are often not fully formed and while not watery like diarrhoea, is watery in a viscous way. It is also foul smelling. I have a fair amount of flatulence throughout the day and it does vary with somedays having a lot and some days little to none. I eat a balanced diet with everything in moderation and include a large amount of fruit and vegetables. I hydrate myself constant throughout the day but often feel dryness in my mouth and on lips. Wondering if my colon has some issues with water absorption? Seek your view on this, thanks! Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) Your symptoms may be due to IBS but it should first be formally evaluated by a doctor. I suggest you seek medical consult. |
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| Posted by Jason (Republished by Forum Admin) Hi Doctor, I don’t think I have IBS but I suffer frequently from loose stools. My stools are often not fully formed and while not watery like diarrhoea, is watery in a viscous way. It is also foul smelling. I have a fair amount of flatulence throughout the day and it does vary with somedays having a lot and some days little to none. I eat a balanced diet with everything in moderation and include a large amount of fruit and vegetables. I hydrate myself constant throughout the day but often feel dryness in my mouth and on lips. Wondering if my colon has some issues with water absorption? Seek your view on this, thanks! Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) Your symptoms may be due to IBS but it should first be formally evaluated by a doctor. I suggest you seek medical consult. | | seoach | 1 | | 0 | 4/4/2019 4:26 PM | 4/4/2019 4:40 PM | | | | | | 3/25/2019 2:55 PM | Forum Admin | | |
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| Posted by Kaushal (Republished by Forum Admin) Hello Dr Wang, I am 75 years old male. Some time, I get only 4-6 notice that I should run to toilet. But before, I could find a toilet, I let go as I couldn't hold it any longer and it is always very soft. Is there any cure for it?
Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) You may have a combination of IBS and weak anal muscles. There are treatments to manage both these problems. I suggest you seek medical consultation. |
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| Posted by Kaushal (Republished by Forum Admin) Hello Dr Wang, I am 75 years old male. Some time, I get only 4-6 notice that I should run to toilet. But before, I could find a toilet, I let go as I couldn't hold it any longer and it is always very soft. Is there any cure for it?
Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) You may have a combination of IBS and weak anal muscles. There are treatments to manage both these problems. I suggest you seek medical consultation. | | seoach | 1 | | 0 | 4/4/2019 4:27 PM | 4/4/2019 4:39 PM | | | | | | 3/25/2019 2:55 PM | Forum Admin | | |
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Posted by Steven (Republished by Forum Admin)
Dear Dr Wang,
I am writing this to denote the issue with medical diagnosis of IBS in our healthcare. Over the past 5 years, I have visited at least two gastrointestinal specialist who concluded that they were unable to help me further on my suspected IBS. The medications given are painkillers/muscle relaxant for my stomach cramps, and lactulose for constipation. While my IBS have been better over the years by itself, resources for IBS is extremely limited online; especially so in Singapore.
How is IBS diagnosed in our healthcare, and where are the information to treatments and management of IBS?
Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH)
Thanks for sharing your experience Steven, I agree with you that online resources are limited and often not tailored to Asian patients. To this end, we are planning to develop a mobile application to assist with IBS management (you can help by taking part in the online survey
here).
IBS is diagnosed through a combination of symptoms: abdominal pain or discomfort with altered bowel habit and, where necessary, tests to exclude other causes. You probably have severe IBS which may require multidisciplinary care. The SGH
Centre for Digestive and Liver Diseases (CDLD) provides multidisciplinary IBS care involving dieticians, psychiatrist, psychologist, gastroenterologists and surgeons.
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Posted by Steven (Republished by Forum Admin)
Dear Dr Wang,
I am writing this to denote the issue with medical diagnosis of IBS in our healthcare. Over the past 5 years, I have visited at least two gastrointestinal specialist who concluded that they were unable to help me further on my suspected IBS. The medications given are painkillers/muscle relaxant for my stomach cramps, and lactulose for constipation. While my IBS have been better over the years by itself, resources for IBS is extremely limited online; especially so in Singapore.
How is IBS diagnosed in our healthcare, and where are the information to treatments and management of IBS?
Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH)
Thanks for sharing your experience Steven, I agree with you that online resources are limited and often not tailored to Asian patients. To this end, we are planning to develop a mobile application to assist with IBS management (you can help by taking part in the online survey
here).
IBS is diagnosed through a combination of symptoms: abdominal pain or discomfort with altered bowel habit and, where necessary, tests to exclude other causes. You probably have severe IBS which may require multidisciplinary care. The SGH
Centre for Digestive and Liver Diseases (CDLD) provides multidisciplinary IBS care involving dieticians, psychiatrist, psychologist, gastroenterologists and surgeons.
| | seoach | 1 | | 0 | 4/4/2019 4:34 PM | 4/4/2019 4:39 PM | | | | | | 3/25/2019 2:55 PM | Forum Admin | | |
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| Posted by Popiah Ng (Republished by Forum Admin) I am feeling easily bloated and difficulty passing stools...How do i know if it is IBS or Gastritis or if due to other factors? Any main difference? Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) While these symptoms probably have a benign cause like IBS or chronic constipation, it is not always possible to distinguish from other more sinister causes through symptoms alone. The presence of “alarm features” such as old age, blood in stool, unintended weight loss, pain while sleeping at night, fever, personal or family history of gastrointestinal cancer would usually prompt further investigations. |
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| Posted by Popiah Ng (Republished by Forum Admin) I am feeling easily bloated and difficulty passing stools...How do i know if it is IBS or Gastritis or if due to other factors? Any main difference? Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) While these symptoms probably have a benign cause like IBS or chronic constipation, it is not always possible to distinguish from other more sinister causes through symptoms alone. The presence of “alarm features” such as old age, blood in stool, unintended weight loss, pain while sleeping at night, fever, personal or family history of gastrointestinal cancer would usually prompt further investigations. | | seoach | 1 | | 0 | 4/4/2019 4:36 PM | 4/4/2019 4:39 PM | | | | | | 3/25/2019 2:55 PM | Forum Admin | | |
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| Posted by Jacelyn (Republished by Forum Admin) Dear Dr Wang, When I was prescribed Metformin or normal or extended ones, I get intense stomach cramps and acute diarrhoea. However, GP does not quite buy my feedback. Just yesterday, during regular check up, the doctor wanted me to try taking again at a lower dosage. But I refused. Your advice, please. Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) Diabetes and some diabetes medications including Metformin are known to cause gastrointestinal discomfort like abdominal pain and diarrhoea. This is can be challenging because Metformin is a very important first line diabetes medication with many good qualities. The use of extended release and lower dose can reduce symptoms. I would advice you to continue discussing your treatment plans with your GP. |
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| Posted by Jacelyn (Republished by Forum Admin) Dear Dr Wang, When I was prescribed Metformin or normal or extended ones, I get intense stomach cramps and acute diarrhoea. However, GP does not quite buy my feedback. Just yesterday, during regular check up, the doctor wanted me to try taking again at a lower dosage. But I refused. Your advice, please. Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) Diabetes and some diabetes medications including Metformin are known to cause gastrointestinal discomfort like abdominal pain and diarrhoea. This is can be challenging because Metformin is a very important first line diabetes medication with many good qualities. The use of extended release and lower dose can reduce symptoms. I would advice you to continue discussing your treatment plans with your GP. | | seoach | 1 | | 0 | 4/4/2019 4:38 PM | 4/4/2019 4:39 PM | | | | | | 3/25/2019 2:55 PM | Forum Admin | | |
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Edited: 4/15/2019 10:34 AM | | | |
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| Dear Dr Wang
My mense has stopped for several months since March 2018. But in between months, I had spotting. I had premenopausal symptoms such as hot flashes and insomnia for a few years. 3 years ago, I started experiencing difficulty in pooping and I had to put in more effort like drinking lots of water and exercise daily in order to clear my bowel. i eat fruits and vegetable more than meat. But still, I feel that i don’t have full evacuation. 2 weeks ago, i started to bloat and felt a lot of trapped gas. My constipation has worsened. kimchi, natto beans, kefir milk don’t seem to help. I can jump on the rebounder for 45 mins till i can feel the waste in my rectum but I still don’t have the urge to poop. is this constipation IBS related to menopause and what can i take to relieve this IBS? Are there any enzymes, prebiotic or probiotic supplements that is suitable for my condition. Thanks and looking forward to your advice. Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) Hormonal changes during premenopausal periods can cause changes to intestinal movement and nerves which causes IBS symptoms. There are many treatment options including,medications, probiotics and diet interventions. The treatment choice would need to be individualised. |
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| Dear Dr Wang
My mense has stopped for several months since March 2018. But in between months, I had spotting. I had premenopausal symptoms such as hot flashes and insomnia for a few years. 3 years ago, I started experiencing difficulty in pooping and I had to put in more effort like drinking lots of water and exercise daily in order to clear my bowel. i eat fruits and vegetable more than meat. But still, I feel that i don’t have full evacuation. 2 weeks ago, i started to bloat and felt a lot of trapped gas. My constipation has worsened. kimchi, natto beans, kefir milk don’t seem to help. I can jump on the rebounder for 45 mins till i can feel the waste in my rectum but I still don’t have the urge to poop. is this constipation IBS related to menopause and what can i take to relieve this IBS? Are there any enzymes, prebiotic or probiotic supplements that is suitable for my condition. Thanks and looking forward to your advice. Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) Hormonal changes during premenopausal periods can cause changes to intestinal movement and nerves which causes IBS symptoms. There are many treatment options including,medications, probiotics and diet interventions. The treatment choice would need to be individualised. | | seoach | 1 | | 0 | 4/7/2019 12:27 PM | 4/15/2019 10:34 AM | | | | | | 4/7/2019 12:27 PM | | | |
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Edited: 4/15/2019 10:33 AM | | | |
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| My 6-year old daughter frequenty complaints of stomach pain after waking up. It sometimes persists toward the afternoon but subsides most of the time and is generally fine from evening onwards. She also coughs quite a lot (with accompanying mucus) in the morning. The stomach pain can come about before or after breakfast and so does not appear to be "hungry" pain. She eats yoghurt, cheese and drinks milk without problem. Her stools is normal although she farts a lot and is often bloated. She appears to contract gastroenteritis quite frequently (every couple of months). Does this sound like SIBO and/or IBS?
Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) She may have IBS and/or SIBO but the diagnosis should be made after assessment by her doctor.
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10XPD
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| My 6-year old daughter frequenty complaints of stomach pain after waking up. It sometimes persists toward the afternoon but subsides most of the time and is generally fine from evening onwards. She also coughs quite a lot (with accompanying mucus) in the morning. The stomach pain can come about before or after breakfast and so does not appear to be "hungry" pain. She eats yoghurt, cheese and drinks milk without problem. Her stools is normal although she farts a lot and is often bloated. She appears to contract gastroenteritis quite frequently (every couple of months). Does this sound like SIBO and/or IBS?
Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) She may have IBS and/or SIBO but the diagnosis should be made after assessment by her doctor.
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Edited: 4/15/2019 10:48 AM | | | |
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| Posted by Dr Rubini (Republished by Forum Admin) Hi Dr Wang, I’m asking these questions on behalf of a family member (non-medical): It takes trial and error to figure out which types of food affect the body, and in what way. What is the best approach to figuring this out? Is there a rule of thumb to avoid certain groups of food e.g. dairy/ deep fried? Some alternative medicine practitioners advise breathing exercises. What is your take? How can one help our body to produce a normal level of good gut bacteria? How can one reduce flatulence?
Grateful for your responses please. Thank you Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) Diet intervention like the “Low FODMAP” has been shown to improve symptoms in IBS. Research overseas and in SGH shows around 70% of IBS patients can have symptom improvement with this diet intervention which reduces fermentable carbohydrate consumption. This intervention is useful for management of gas related symptoms like bloating and flatulence. It has been shown to alter gut bacteria, but the long-term effect of these bacterial changes is not known. I would recommend that the diet intervention be guided by your healthcare provider to ensure it is sustainable and nutritionally balanced. The SGH CDLD dietician service provide the “Low FODMAP” diet intervention which has been shown improve IBS symptoms. Breathing exercises can be used to manage IBS in some situations. For example, It is known that anxiety may exacerbate IBS symptoms, and breathing exercises can be incorporated with psychological therapy such relaxational therapy and mindfulness-based therapy. |
seoach
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| Posted by Dr Rubini (Republished by Forum Admin) Hi Dr Wang, I’m asking these questions on behalf of a family member (non-medical): It takes trial and error to figure out which types of food affect the body, and in what way. What is the best approach to figuring this out? Is there a rule of thumb to avoid certain groups of food e.g. dairy/ deep fried? Some alternative medicine practitioners advise breathing exercises. What is your take? How can one help our body to produce a normal level of good gut bacteria? How can one reduce flatulence?
Grateful for your responses please. Thank you Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) Diet intervention like the “Low FODMAP” has been shown to improve symptoms in IBS. Research overseas and in SGH shows around 70% of IBS patients can have symptom improvement with this diet intervention which reduces fermentable carbohydrate consumption. This intervention is useful for management of gas related symptoms like bloating and flatulence. It has been shown to alter gut bacteria, but the long-term effect of these bacterial changes is not known. I would recommend that the diet intervention be guided by your healthcare provider to ensure it is sustainable and nutritionally balanced. The SGH CDLD dietician service provide the “Low FODMAP” diet intervention which has been shown improve IBS symptoms. Breathing exercises can be used to manage IBS in some situations. For example, It is known that anxiety may exacerbate IBS symptoms, and breathing exercises can be incorporated with psychological therapy such relaxational therapy and mindfulness-based therapy. | | seoach | 1 | | 0 | 4/15/2019 10:39 AM | 4/15/2019 10:48 AM | | | | | | 3/25/2019 2:55 PM | Forum Admin | | |
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Edited: 4/15/2019 10:48 AM | | | |
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| Posted by Just Dumpling (Republished by Forum Admin) Hi Dr Wang
What are the symptoms of IBS?
Like to understand more as it seems doctors I see are not very clear too. Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) IBS is defined by the presence of abdominal discomfort and change in bowel habit (diarrhoea or constipation) in the absence of a structural or biochemical abnormality which can cause these symptoms. |
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| Posted by Just Dumpling (Republished by Forum Admin) Hi Dr Wang
What are the symptoms of IBS?
Like to understand more as it seems doctors I see are not very clear too. Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) IBS is defined by the presence of abdominal discomfort and change in bowel habit (diarrhoea or constipation) in the absence of a structural or biochemical abnormality which can cause these symptoms. | | seoach | 1 | | 0 | 4/15/2019 10:40 AM | 4/15/2019 10:48 AM | | | | | | 3/25/2019 2:55 PM | Forum Admin | | |
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Edited: 4/15/2019 10:48 AM | | | |
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| Posted by HH (Republished by Forum Admin) Hi Dr Wang
The dietician recommended the low FODMAP diet, but it does not work on me. Is this diet really helpful for most people? Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) While research has shown the low FODMAP diet improves symptoms in around 70% of patients, like all IBS treatment, it may not work for some patients. This may be because the diet is not effective, or it is difficult to follow the diet adequately. I would suggest you check with your doctor and dietician on your treatment options. |
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| Posted by HH (Republished by Forum Admin) Hi Dr Wang
The dietician recommended the low FODMAP diet, but it does not work on me. Is this diet really helpful for most people? Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) While research has shown the low FODMAP diet improves symptoms in around 70% of patients, like all IBS treatment, it may not work for some patients. This may be because the diet is not effective, or it is difficult to follow the diet adequately. I would suggest you check with your doctor and dietician on your treatment options. | | seoach | 1 | | 0 | 4/15/2019 10:41 AM | 4/15/2019 10:48 AM | | | | | | 3/25/2019 2:55 PM | Forum Admin | | |
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Edited: 4/15/2019 10:48 AM | | | |
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| Posted by Leung WC (Republished by Forum Admin) Dear Dr Wang, I got Helicobacter Pylori Infection Disease in 2011 Dec & cleared off the bacteria in 2012 Jan by ST treatment in CGH. The UBT also passed to double confirm no bacteria any presence.
From since up to now; I've tried prescriptions in various stages like Omeprazole; Nexium ; Rabeprazole & Lanoprazole. Regrettably, they gave a bit relief of symptoms but with adverse side effects - joint pains & others. Gastritis Or Ulcer quite easily trigger after intake certain food.
From certain Research studies; up to 60% Pylori cleared patients by TT or ST also comes across with the same problems.
There is no full recovery wishes!! If chronic & prolong in this way; is there a high risk of developing to Cancer? Any better medical ways to tackle these problems for us?? Thanks! Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) If your main symptom is abdominal discomfort and your investigations have not shown any problem apart from Helicobacter pylori infection. The persistence of symptom after eradication of Helicobacter pylori infection suggest you may have functional dyspepsia, an IBS equivalent of the stomach. Acid reducing treatment like omeprazole and Nexium may not be effective in some patients. Other treatment options include psychological therapy and medications which reduced nerve sensitivity. I would suggest you discuss further with your doctor. |
seoach
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| Posted by Leung WC (Republished by Forum Admin) Dear Dr Wang, I got Helicobacter Pylori Infection Disease in 2011 Dec & cleared off the bacteria in 2012 Jan by ST treatment in CGH. The UBT also passed to double confirm no bacteria any presence.
From since up to now; I've tried prescriptions in various stages like Omeprazole; Nexium ; Rabeprazole & Lanoprazole. Regrettably, they gave a bit relief of symptoms but with adverse side effects - joint pains & others. Gastritis Or Ulcer quite easily trigger after intake certain food.
From certain Research studies; up to 60% Pylori cleared patients by TT or ST also comes across with the same problems.
There is no full recovery wishes!! If chronic & prolong in this way; is there a high risk of developing to Cancer? Any better medical ways to tackle these problems for us?? Thanks! Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) If your main symptom is abdominal discomfort and your investigations have not shown any problem apart from Helicobacter pylori infection. The persistence of symptom after eradication of Helicobacter pylori infection suggest you may have functional dyspepsia, an IBS equivalent of the stomach. Acid reducing treatment like omeprazole and Nexium may not be effective in some patients. Other treatment options include psychological therapy and medications which reduced nerve sensitivity. I would suggest you discuss further with your doctor. | | seoach | 1 | | 0 | 4/15/2019 10:43 AM | 4/15/2019 10:48 AM | | | | | | 3/25/2019 2:55 PM | Forum Admin | | |
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Edited: 4/15/2019 11:04 AM | | | |
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| Posted by Kaushal (Republished by Forum Admin) Dear Dr Wang, Sudden and uncontrolled bowel movement for me occurs only once in 1 to 2 months. When I let go, I feel that my bowel is near empty. It is quite soft but not watery. Meanwhile is there anything else which I can do? Is there any food to avoid for IBS? Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) Since your symptoms are infrequent, you can try to identify trigger to avoid. Some medications which reduces intestinal peristalsis may also help reduce the urgency of your bowel motion. |
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| Posted by Kaushal (Republished by Forum Admin) Dear Dr Wang, Sudden and uncontrolled bowel movement for me occurs only once in 1 to 2 months. When I let go, I feel that my bowel is near empty. It is quite soft but not watery. Meanwhile is there anything else which I can do? Is there any food to avoid for IBS? Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) Since your symptoms are infrequent, you can try to identify trigger to avoid. Some medications which reduces intestinal peristalsis may also help reduce the urgency of your bowel motion. | | seoach | 1 | | 0 | 4/15/2019 10:44 AM | 4/15/2019 11:04 AM | | | | | | 3/25/2019 2:55 PM | Forum Admin | | |
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Edited: 4/30/2019 10:38 AM | | | |
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| Posted by PL (Republished by Forum Admin) Hi Dr Wang, After severe bouts of stomach pain that started on July 2018, I was diagnosed as having IBS by a gastro specialist at TTSH after colonoscopy (on 28/01/2019) showed clear colon. This year, I seem to have severe pain during menses. After meals the pain is intensified & at times diarrhoea a few times a day. Lots of gasses, dull & sharp pain the whole day. Sometimes the pain left me rolling in bed crying in pain. The medicines (Meteospasmyl & Hyomide when necessary) seem to help lessen the pain & gradually the pain subsides as the menses stops. However, every cycle it happens again (now 3rd cycles). Interestingly, last year I didn’t experience this kind of pain during menses (I think it was quite random last year), it only happens this year. I take probiotic daily but it doesn’t seem to help. My questions: Why do I get stomach (colon?) pain during menses when colonoscopy showed clear colon? Is this really IBS? Are the medicines given the only way to lessen the pain? I’m concerned about taking them long term. Is there no cure at all? Is it possible that I have SINO (small intestines bacterial overgrowth)? Should I and how to test for it?
Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) Hormonal changes during menses is known to alter intestinal movement and nerves which can make IBS symptoms worse. Given that your IBS symptoms are not always related to menses, I would agree with your TTSH doctor that this is IBS. There is no definite cure for IBS but satisfactory symptom control can usually be achieved. Some of the other treatment options include diet, psychological therapy and medication have been discussed earlier but they need to be individualised. Yes, it is possible you may have small intestinal bacterial overgrowth(SIBO) and one way to test it is with breath test. But this may not be necessary for your treatment.
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seoach
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| Posted by PL (Republished by Forum Admin) Hi Dr Wang, After severe bouts of stomach pain that started on July 2018, I was diagnosed as having IBS by a gastro specialist at TTSH after colonoscopy (on 28/01/2019) showed clear colon. This year, I seem to have severe pain during menses. After meals the pain is intensified & at times diarrhoea a few times a day. Lots of gasses, dull & sharp pain the whole day. Sometimes the pain left me rolling in bed crying in pain. The medicines (Meteospasmyl & Hyomide when necessary) seem to help lessen the pain & gradually the pain subsides as the menses stops. However, every cycle it happens again (now 3rd cycles). Interestingly, last year I didn’t experience this kind of pain during menses (I think it was quite random last year), it only happens this year. I take probiotic daily but it doesn’t seem to help. My questions: Why do I get stomach (colon?) pain during menses when colonoscopy showed clear colon? Is this really IBS? Are the medicines given the only way to lessen the pain? I’m concerned about taking them long term. Is there no cure at all? Is it possible that I have SINO (small intestines bacterial overgrowth)? Should I and how to test for it?
Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) Hormonal changes during menses is known to alter intestinal movement and nerves which can make IBS symptoms worse. Given that your IBS symptoms are not always related to menses, I would agree with your TTSH doctor that this is IBS. There is no definite cure for IBS but satisfactory symptom control can usually be achieved. Some of the other treatment options include diet, psychological therapy and medication have been discussed earlier but they need to be individualised. Yes, it is possible you may have small intestinal bacterial overgrowth(SIBO) and one way to test it is with breath test. But this may not be necessary for your treatment.
| | seoach | 1 | | 0 | 4/15/2019 10:46 AM | 4/30/2019 10:38 AM | | | | | | 3/25/2019 2:55 PM | Forum Admin | | |
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Edited: 4/30/2019 10:38 AM | | | |
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| Posted by Mandy (Republished by Forum Admin) Dear Dr Wang, My son, 14 years old, has been told by KKH doctor that he has IBS. He always have stomach pain, diarrhoea and a lot of gas in his stomach which caused him to feel very full and has no appetite, thus he is very thin. He started to have this problem since he was 11 years old and he even missed his math exam because of the stomach pain. We were told by KKH doctor that there is no treatment for IBS and was only given debridat and was told to let him take it when he has stomach pain. Since beginning of this year, my son's condition became worse. He keeps having stomach pain, diarrhoea and bloatedness very often and had to miss school. He has been on medical leave for more than 12 days since January till now and when we had school teachers/parents meeting, the teachers expressed concern and said that he should not be missing school as he is lagging behind. We were told that he has to go to school even he has diarrhoea. Unless he has fever, he can stay at home. On 15 April, my son had stomach pain and diarrhoea 7 times in school. We brought him to see TCM this time (we usually bring him to our family doctor but because this doctor always prescribed him with antibotic, we were afraid he will do the same thing this time so we decided to see other medical help). In fact, on 14 April, he just finished the last dose of his antibotic (Zinnat) which he started 10 days ago. We were told that TCM medicines will take time to see results. We sent him to school on 16 April (as his form teacher had said that unless he has fever, he has to go to school). In school, he had stomach pain, kept burping and had diarrhoea 7 times and also vomitted. We had no choice but to bring him to our family doctor as this time he has fever. This time the doctor did not give him antibiotic but only lacteo fort and a green tablet (which I cannot remember the name) to stop the diarrhoea. Until today, my son has not recovered and his stomach is still very bloated and has frequent stomach pain. He still had diarrhoea once last night. Due to his bloatedness, he couldn't eat and drink. I am concern as I am afraid he might become dehydrated. To make the matter worse, the school teacher has been calling me to feedback that he is very forgetful and disorganised. He always forgets to submit his homework and when asked, he will search his bag for a long time. Teacher also said it is a vicious cycle (when he was asked to submit his homework, he become anxious and starts to have stomach pain). His form teacher also feedback that he has low self-esteem and also feels agitated easily. I informed the family doctor about his poor memory and other feedback the school teacher told me and he thinks my son might be having attention span issue and asked me to go to polyclinic to ask for referral letter to seek medical attention. I am currently waiting for appointment from IMH Outram. As this IBS is causing my son a lot of inconvenience and suffering, can I check with you a few things : - Can IBS be treated?
- Is there any relation between IBS and ADHD?
- Is there any medicine for getting rid of the gas So far no doctor has given me any medicine for this. Does charcoal pill helps to relieve gas?
- Moving forward, can you advise the right place for us to seek medical attention for his IBS as KKH has not done anything except giving us debridat.
Thank you for your time and patience to read this long email. I am very worry for my son and am desperate to give him the right treatment as this is affecting his health and studies. I will greatly appreciate if you could kindly reply me. Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) Thanks for sharing your experience Mandy. I would like to qualify that I am an adult gastroenterologist with limited experience managing children. IBS cannot be cured but symptoms can usually be controlled. There is clear association between psychological disorders with IBS. In these instances, concurrent and coordinated management of both psychological and gastrointestinal disorders is important for successful management. I would suggest you communicate with your KKH and IMH doctors for coordination of care. While IBS symptoms (including gas) can be managed in many ways including medications, diet and probiotics. Their response is variable and may not be suitable for your son. It is important for you to have a good working relationship with your physician so that a care plan can be developed to achieve sustainable symptom control.
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seoach
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| Posted by Mandy (Republished by Forum Admin) Dear Dr Wang, My son, 14 years old, has been told by KKH doctor that he has IBS. He always have stomach pain, diarrhoea and a lot of gas in his stomach which caused him to feel very full and has no appetite, thus he is very thin. He started to have this problem since he was 11 years old and he even missed his math exam because of the stomach pain. We were told by KKH doctor that there is no treatment for IBS and was only given debridat and was told to let him take it when he has stomach pain. Since beginning of this year, my son's condition became worse. He keeps having stomach pain, diarrhoea and bloatedness very often and had to miss school. He has been on medical leave for more than 12 days since January till now and when we had school teachers/parents meeting, the teachers expressed concern and said that he should not be missing school as he is lagging behind. We were told that he has to go to school even he has diarrhoea. Unless he has fever, he can stay at home. On 15 April, my son had stomach pain and diarrhoea 7 times in school. We brought him to see TCM this time (we usually bring him to our family doctor but because this doctor always prescribed him with antibotic, we were afraid he will do the same thing this time so we decided to see other medical help). In fact, on 14 April, he just finished the last dose of his antibotic (Zinnat) which he started 10 days ago. We were told that TCM medicines will take time to see results. We sent him to school on 16 April (as his form teacher had said that unless he has fever, he has to go to school). In school, he had stomach pain, kept burping and had diarrhoea 7 times and also vomitted. We had no choice but to bring him to our family doctor as this time he has fever. This time the doctor did not give him antibiotic but only lacteo fort and a green tablet (which I cannot remember the name) to stop the diarrhoea. Until today, my son has not recovered and his stomach is still very bloated and has frequent stomach pain. He still had diarrhoea once last night. Due to his bloatedness, he couldn't eat and drink. I am concern as I am afraid he might become dehydrated. To make the matter worse, the school teacher has been calling me to feedback that he is very forgetful and disorganised. He always forgets to submit his homework and when asked, he will search his bag for a long time. Teacher also said it is a vicious cycle (when he was asked to submit his homework, he become anxious and starts to have stomach pain). His form teacher also feedback that he has low self-esteem and also feels agitated easily. I informed the family doctor about his poor memory and other feedback the school teacher told me and he thinks my son might be having attention span issue and asked me to go to polyclinic to ask for referral letter to seek medical attention. I am currently waiting for appointment from IMH Outram. As this IBS is causing my son a lot of inconvenience and suffering, can I check with you a few things : - Can IBS be treated?
- Is there any relation between IBS and ADHD?
- Is there any medicine for getting rid of the gas So far no doctor has given me any medicine for this. Does charcoal pill helps to relieve gas?
- Moving forward, can you advise the right place for us to seek medical attention for his IBS as KKH has not done anything except giving us debridat.
Thank you for your time and patience to read this long email. I am very worry for my son and am desperate to give him the right treatment as this is affecting his health and studies. I will greatly appreciate if you could kindly reply me. Answered by Dr Wang Yu Tien, Senior Consultant from the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH) Thanks for sharing your experience Mandy. I would like to qualify that I am an adult gastroenterologist with limited experience managing children. IBS cannot be cured but symptoms can usually be controlled. There is clear association between psychological disorders with IBS. In these instances, concurrent and coordinated management of both psychological and gastrointestinal disorders is important for successful management. I would suggest you communicate with your KKH and IMH doctors for coordination of care. While IBS symptoms (including gas) can be managed in many ways including medications, diet and probiotics. Their response is variable and may not be suitable for your son. It is important for you to have a good working relationship with your physician so that a care plan can be developed to achieve sustainable symptom control.
| | seoach | 1 | | 0 | 4/22/2019 3:20 PM | 4/30/2019 10:38 AM | | | | | | 3/25/2019 2:55 PM | Forum Admin | | |
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