Q: I am a 45 years old man having bowel problem from seven years. Before that I had a very mild form of irritable bowel syndrome (IBS) manifesting as two bowel movements in the morning. I have third degree haemorrhoids for the past 8 years. I had colonoscopy done to rule out any other pathology for the rectal bleeding - later confirmed that it was due to haemorrhoids. Colonoscopy was normal and no biopsy was taken. I later took raw vegetables (in high quantities) for four days during the same period (seven years back) and following, which I started developing frequent belching, flatulence, passing excessive wind, intolerance to milk and milk products, semi-loose stools and frequent bowel movements apart from losing weight, around 5-6 kg. Tests like Upper GI endoscopy, colonoscopy, ultra-sonogram of the abdomen along with other blood tests like full blood count, ESR and so on was done. All were normal. My haemoglobin was 13.5 gm and had no other deficiencies. Now two weeks back, I had an upper GI endoscopy and colonoscopy with ileoscopy done and biopsies taken. Just before this, I had a full blood count done, which was normal. ESR and C-reactive protein were also normal. Stool for occult blood was negative. Immunological tests such as Anti-Endomysial antibodies; as well as Anti-gliadin antibodies were also negative. The same antibody tests were also done four years back and even then they were negative. But I couldn't do the Tissue-Transglutaminase test, as it is not available in our government hospital. The biopsy reports (of samples taken from third part of duodenum, terminal ileum and the colon) are: duodenal mucosa with retained crypt pattern and no significant inflammation, normal ileal mucosa and colonic mucosa with slight increase in the degree of inflammation - duodenal biopsy normal, terminal ileum biopsy normal and colon biopsy - ch. min. colitis. Please advise.

A:It appears you have irritable bowel syndrome, since all lab tests, endoscopic exams and biopsy results were normal. The mild increase in inflammatory cells in the colon biopsy is very non-specific. I suggest you do the following:

• Take isabgol husk (tablespoonful once or twice a day)
• Drink 6-7 glasses of water a day
• Regular exercise (1/2 hr of brisk walking 4-5 times a day).