instruction: hello doctor I have been suffering from digestive problems for the past 10 years I have alternative bowel habits diarrhea loose stools or constipation gas and bloating some days I have to go for even three times a day and it always feels like the food is not properly digested I was at first misdiagnosed for having intestinal to and given strong antibiotics but at last it ended up with the diagnosis of is 10 years before I was stressed and stopped taking prescribed medicines and have been seeking natural treatments like siddha and ayurveda now and then and I found it to be somewhat helpful I need a complete treatment for this now as it affects my day to day lifestyle please suggest
output: hello welcome to icliniq com I understand that you know very well about your disorder as of now the basic problem with the is irritable bowel syndrome with diarrhea is the spastic contraction of bowel and increased secretion of various gut hormones leading to abdominal pain and diarrhea since you have tried many medications so far I see there is still a role of low dose antidepressant medication which help normalize the gut hormones in balance but unfortunately these drugs have some side effects not necessarily mental wise but some physical adverse effects such as dry mouth dry eyes and can sometimes lead to constipation and also could cause increased sleep but since we recommend the patient to start with a low dose and then gradually step up if tolerated well you can take tablet amitryptline to 10 my once daily at night time and your mind will take sometime before actual improvement like it can give you relief in two to four weeks time try it for four weeks and come back to me to discuss if we need to increase the dose or add some add on medication uncontrollable is follow up after weeks