Irritable bowel syndrome since childhood

Hello, IBS (especially mixed type) is a gut–brain interaction disorder, not just a stomach problem. When symptoms worsen with bloating, nausea, and inability to eat, it usually indicates heightened gut sensitivity + anxiety/autonomic overactivation, not damage to the intestine. Fludac (fluoxetine) can sometimes increase bloating, nausea, and appetite loss initially, especially in IBS patients. This does not mean psychiatric treatment is wrong- it means the choice or dose of medication may need adjustment.

- When IBS worsens and food intake reduces, a psychiatrist may: - Modify or change antidepressant choice (Some medicines worsen GI symptoms; others improve gut motility and pain) - Use gut-friendly psychotropics, such as: - Low-dose TCAs (e.g., amitriptyline/nortriptyline at night) - Certain SNRIs or SSRIs with better GI tolerance - Short-term anxiolytics only if needed - Coordinate with a gastroenterologist for combined management - Start psychological therapies (CBT, gut-directed hypnotherapy), which have strong evidence in IBS - Address eating fear, nausea-related anxiety, and symptom hypervigilance

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I can understand your distress, gastric upset problems are very very common, you have visited a gastroenterologist and psychiatrist subsequently * Your gastric problems get worse on fluoxetine 10, in such cases, you must discuss and update your treating doctor so that medications which have no GI associated effects can be planned " Other important thing is to follow certain life style modifications for keeping your GIT in a sound condition: Must have 6-8 hours of sleep at night, avoid nap during day, not more than 30 minutes * Avoid alcohol, smoking strictly, it cause acidity and indigestion * Try to reduce caffeine intake as tea coffee colddrink, cause acidity,aids indigestion belching, reflux of acidity, (if crave for tea you can take black tea or coffee ), after 5-6 in evening do not take tea it distrubs sleep , worsen digestion *Most important try to take dinner before 8 , it should be light, not oily spicy or junk) /* You can have your choice of food in breakfast or lunch, cheat diet during day time * Never lie down in bed just after meal, *you must have some form of physical activity as per your interest as walk, sports, gym, relaxation exercises When a person follow certain lifestyles modifications with medications, dose and number of medications decrease and response is better

Not necessarily mean the treatment is wrong it means the dose or the medicine may not be matching your sensitivity, and your psychiatrist needs to adjust it rather than asking you to continue suffering through the side effects. In such situations, the psychiatrist usually either reduces the dose, switches to a medicine with fewer gastric effects, or uses short-term supportive medication to reduce nausea and bloating until the body adjusts. You don’t need to panic you need a re-evaluation so that they can tailor the treatment to your system instead of expecting you to tolerate such intense discomfort. Take therapy. You can connect with me on nine two six six seven two six zero six five.

Such symptoms can happen in some patients when starting antidepressants. IBS often worsens with stress and anxiety, and psychiatric medicines can help, but not every medicine suits everyone. If symptoms become severe, the medication should be stopped or changed, and the patient should be reviewed again. A milder SSRI, slower dose titration, or alternative treatment plan may be required. IBS requires a combined approach—diet, stress management, and medicines tailored to tolerance.

Sometime , in initial days after starting with Fludac some patients have symptoms like you. We may need to change or stop this medicine and shift to some other medicine. Psychiatric medicine take some time for response. IBS gets worse with stress, so we treat both the stomach and the mind together. Kindly meet your psychiatrist soon so they can adjust your treatment and help you eat comfortably again.

Try to manage your stress Breathing excercise Walk