I hope you can share this with your readers and perhaps improve the quality of life of someone out there. It has been wonderful for me.

DEAR READER: IBS is a malfunction of motility of the colon. Stress, medications, specific foods, caffeine, alcohol and gas contribute to symptoms that include abdominal pain, flatulence and diarrhea/constipation. The medication you have been prescribed can cause identical symptoms.

Colesevelam (WelChol) reduces the amount of cholesterol and specific fatty substances in the blood. It is sometimes prescribed with other cholesterol-lowering statin drugs toward this goal. This drug binds bile acids in the intestines to form a product that is ultimately released from the body. It is also prescribed for some type 2 diabetics to control blood-sugar levels. Drugs that have been manufactured and marketed for one purpose are often used for other, seemingly unrelated conditions and work well. My guess is that the reduction of fatty substances in your colon curbed your diarrhea and related symptoms. Or you are less stressed, have modified your diet or medications, and have taken other steps without realizing the positive impact they have had.

To provide related information, I am sending you a copy of my Health Report “Irritable Bowel Syndrome.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

The mascot for these patients is the zebra because the disease is often misdiagnosed as irritable bowel syndrome, Crohn’s disease, and other bowel ailments. Because of the difficulty in getting a proper diagnosis, the motto is “If you think it’s a horse, think again”.

My husband’s case is unusual because his primary tumor was located around the descending aorta, not the liver, as is typical. The cancer has since spread to his lungs and bones. He is a valiant warrior and tries to live a normal life in spite of the devastating side effects. As far as we know there is no cure. Treatment is usually surgery to reduce the tumors or a drug called Sandostatin. My husband was given Interferon but had to stop because Medicare refused to pay since it is not an approved carcinoid cancer treatment.

We are fortunate to have a support group for this disease only 30 miles away. It has been a lifeline for both us as. Your readers may be interested in more information which can be found online at www.carcinoid.org.

DEAR READER:
Carcinoid cancer is a relatively complex condition. It involves slow growing tumors that can present in nearly any part of the body. The most common sites are the small intestine, appendix, rectum, and more.

Some tumors may even produce hormones that can cause a condition known as Carcinoid Syndrome. The primary symptom is carcinoid crisis that may involve flushing of the face and upper body, diarrhea and asthma-like wheezing.

Early detection and removal of all the tumor tissue may lead to a complete and permanent cure. However, because the tumors are so slow-growing, the onset of symptoms can precede diagnosis by several years. Some tumors may not even be noticed until they have spread and multiplied to painful levels.

There are a few treatment options including surgery, chemotherapy and cancer-specific medication known as somatostatin analogues given by injection. Radiotherapy is used only for tumors that have spread within the skeletal system.

Nutritious high protein diets, vitamin and mineral supplements, anti-diarrheal drugs and more can be used in conjunction with the above treatments, primarily as a means to reduce the severity and frequency of diarrhea.

The Carcinoid Cancer Foundation website has several helpful links as well as information about specialists who are diagnosing and treating Carcinoid patients. I recommend anyone interested in learning more about this condition or who thinks their prior diagnoses (of IBS, Crohn’s, etc.) may be incorrect (because of failure to respond to appropriate treatment), to speak with their physician or gastroenterologist.

Because you mentioned that Carcinoid cancer is often misdiagnosed as benign bowel conditions such as IBS, I am sending you copies of my Health Reports “Constipation and Diarrhea” and “Irritable Bowel Syndrome”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 per report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

I suffered for many years before accidentally discovering this. I don’t know why it works, but it does. I would also like to point out that I have no interest in this company. In fact, I had never even heard of it before purchasing the cereal on a whim one day! It’s inexpensive and tastes good.

DEAR READER:
I am printing your letter for reader interest. I, like you, had never heard of this cereal before but felt it was worth printing since it is harmless and as you say, inexpensive and tasty.

If any of my readers have experience with this cereal, please let me know your thoughts.

Over the last eight years I have had numerous expensive medical tests, some two or three times, and all were negative. I am female, 5’ 8” and weight 115 pounds, that is 50 pounds less than what I used to be. When I mentioned to my primary care physician that I thought this problem may be related to a food allergy, he shrugged it off and continued to set me up for tests. I was labeled with IBS, given prescriptions and shunted to the side. It didn’t matter that I still had stomach problems and the prescriptions were not helping.

After eight years of this, I had had enough and went “out of network” to a doctor. I was asked to keep a food log for five days but kept one for a month. This doctor, after seeing the food log and examining, all in one visit, told me I had a classic case of gluten/wheat sensitivity.

I followed a somewhat strict gluten/wheat free diet for one week and noticed a difference. After receiving my proper diagnosis, I started doing some of my own research. I found that skin conditions, such as psoriasis and eczema (which I had had for eight years also) may be directly caused by a food allergy, as are excessive diarrhea, unexplained weight loss and IBS.

I knew there was something wrong with other than IBS but I couldn’t get my primary care doctor or the numerous specialists I had seen to acknowledge this. No one every asked me what my regular diet was. I don’t expect you to print this letter but hope you will because I know it will help others who have been labeled as having IBS but don’t get better on appropriate medication.

DEAR READER:
When I received your letter, I was dismayed that you had had to suffer for eight years because your physicians simply wouldn’t listen. I was also incredibly pleased to hear that you decided enough was enough and took your care into your own hands. In this way, you not only received an appropriate diagnosis but you also found a caring, attentive physician.

I have said this before, but based on the increasing number of letters I receive from disgruntled patients, I feel it is necessary to say again. Physicians need patients; they are their livelihoods. It is therefore in the physician’s best interests to treat every patient with kindness and respect. Patients also need to take responsibility for their health and stand up for themselves. Most common ailments, such as high blood pressure, high cholesterol, arthritis and others can be improved by taking simple steps to modify weight, diet and exercise.

I stopped the bars hoping things would return to normal. They didn’t. My movements are inconsistent and I’m having to strain. I tried a laxative. Big, violent mistake. I didn’t like it, nor did it help. A stool softener helped a little, but I’m still not happy. I’m concerned there may be a blockage.

DEAR READER:
You don’t indicate your gender, age, or medical conditions that might play a role. Therefore, it is rather difficult for me to provide a meaningful response.

There are several reasons for a change in bowel habits. A change in diet other than the Fiber One bar, medication, or an increased stress level in your daily living may be to blame. You could have irritable bowel syndrome or a blockage from yet another undiagnosed condition.

Any change in bowel habits should be followed up on and you need to get to the bottom of the problem (no pun intended). Begin with your primary care physician for testing. If any question of diagnosis remains, he or she can recommend you make an appointment with a gastroenterologist, a digestive tract specialist.

To give you related information, I am sending you a copy of my Health Report “Irritable Bowel Syndrome”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

A year ago I was having lots of trouble with irritable bowel syndrome and got no help from local doctors. Perhaps that was because it was going to take months to get an appointment with a specialist.

One of your articles mentioned drinking a glass of warm apple juice in the morning. It has worked great for me.

DEAR READER:
Irritable bowel syndrome (IBS) is a common disorder of the intestines. Symptoms include lower abdominal pain, gas, bloating, constipation, diarrhea, or a combination of constipation and diarrhea.

Improper diet and stress can worsen symptoms. While the condition can be a mild annoyance for some people, it can be completely disabling for others. Criteria for diagnosis of IBS include at least 12 weeks of abdominal pain or discomfort (not necessarily consecutive weeks) and at least two of three other features — change in stool appearance with onset of symptoms, change in stool frequency with onset of symptoms, or relief on defecation.

Adding fiber to a diet through fruits and vegetables, beans and bran will be helpful for those suffering from constipation. Learn which foods to avoid, such as alcohol, chocolate, caffeine, and deep-fried, fatty foods that can trigger symptoms. Eat smaller meals, since over-eating can cause cramps and diarrhea.

Take the necessary steps to reduce stress levels. Perhaps this will be through exercise, counseling, or listening to music.

If one of your major symptoms is constipation, the warm apple juice you mentioned might be just the ticket. I am pleased you found such a simple solution to this very complex condition. Thank you for sharing your success story.

Other readers who wish additional information can send for my Health Report “Irritable Bowel Syndrome”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

I want to share my own sickness with you in the hopes that my experience can help someone else. I have Celiac Sprue and went through years of not feeling well and seeing many doctors before I got any answers. I learned that it is an allergy to the gluten in grains such as wheat, rye, oats and barley. I love baked goods and bread and baking was a family activity. I had to stop and learn how to use new ingredients.

In my town there is a “Sprue Club”. Many hospitals and libraries also have a lot of information for sufferers. I have found several excellent cookbooks written by Betty Hagman. I have also learned to read every label on store bought foods since I never know where I might find products with grains, flours and gluten.

DEAR READER:
Celiac Sprue can be a difficult condition to diagnosis, especially because symptoms are often embarrassing for patients to discuss with their doctors. Gas, bloating, abdominal pain, and diarrhea are common symptoms for many disorders. Therefore it is important to get a diagnosis.

You were right to continue looking for the answer despite several failed tries. Your persistence paid off and now you appear to be leading a healthful, productive life. I have published your letter to show other readers that help can be found and a normal life can be had, despite having this troublesome condition. I am also glad you mentioned reading labels because, in today’s society, gluten can be found in several unusual places such as soy sauce.

Any person who suffers similar symptoms should see his or her primary care physician for an exam and testing. These same symptoms can be the result of benign conditions such as irritable bowel syndrome or the result of more serious conditions such as ulcerative colitis or cancer. Knowing the cause and finding it early can make the difference between minimal or aggressive treatment, especially for potentially severe conditions.

Thank you for writing to share your experience and providing possible resources for help. For those with computers and internet connections, resources abound. Simply “googling” a medical condition can provide several reliable information websites and even link you with support groups, both virtual and in real life.

To give you related information, I am sending you copies of my Health Reports “Irritable Bowel Syndrome” and “Diverticular Disease”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 per report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

I had suffered for a while with gas, bloating and other symptoms. My internist thought that I was lactose intolerant despite my claims that many milk products did not cause my symptoms. He ordered a colonoscopy which showed I had irritable bowel syndrome.

Shortly after the diagnosis I was reading an article in Prevention magazine that claimed there was an epidemic of IBS and that an additive found in many dairy products might be the cause. The additive is a seaweed product called carrageen.

Interested by this, I decided to check my refrigerator and found that the additive was in many products I had on hand including soy milk, ice cream, sherbet and more. I threw all these items away and started checking labels when I went to get replacements. I have found only two ice creams (Breyers and Hagen-Daaz) that don’t have it. It is also in Popsicles, sour cream, most yogurts, creamy dressings, eggnog, some brands of buttermilk and more.

I feel that our food industry’s additives have impaired the health of many people, especially young children. I hope that this information can help others as it has helped me.

DEAR READER:
I was unfamiliar with the additive but upon research found that is a dried and bleached red marine algae harvested for its valuable polysaccharide which is widely used as a gel, emulsifier and thickening agent. It is primarily used for foods, pharmaceuticals and cosmetics.

I am unaware of a link between carrageen and IBS but that is not to say it is not possible. If eliminating the additive from your diet has improved your symptoms, stick with it. If not, I recommend you try an over-the-counter product called Digestive Advantage IBS. It has helped many of my readers who also suffer from irritable bowel syndrome. IBS with constipation can often be helped by increasing fluid and fiber intakes. Occasional treatment with laxatives and stool softeners is acceptable but should not be used daily to prevent dependence. IBS with diarrhea can usually be controlled by increasing fiber and roughage intakes and using OTCs such as Imodium or Pepto-Bismol.

If you truly have IBS, I recommend you see a gastroenterologist who can give you up-to-date information about available treatments appropriate for you. If you feel you do not have IBS but are simply suffering from a food allergy to carrageen, you should see an allergist. This specialist can test you for various allergies to help pin-point the cause of your symptoms, including any possible lactose intolerance. He or she can also provide appropriate treatment.

To give you related information, I am sending you copies of my Health Reports “Irritable Bowel Syndrome” and “Constipation and Diarrhea”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 per report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
Irritable bowel syndrome (IBS) is a common disorder of the large and small intestines. It affects up to 15% of North Americans, with a predominance in females. Symptoms include gas, bloating, diarrhea, constipation, or a combination thereof. It can appear at any age, but is often found in younger individuals. Previous studies indicated IBS was caused by stress, but the condition is now thought to be a malfunction of the movement of the colon. Whatever the cause, it is uncomfortable for those who suffer from the condition.

For starters, your husband might modify his diet. It should include high fiber foods such as bran, whole grain bread, beans, fruits and vegetables. Remember to add the fiber gradually, since a major change to the dietary intake can cause gas that, in turn, will trigger symptoms — the very thing he wants to avoid.

Perhaps he already knows what brings on an attack, but generally speaking he should avoid fried foods, caffeine, alcohol, chocolate and some dairy products. If he is unaware what initiates symptoms, he might keep a diary of what he eats (and when) so when symptoms occur he can narrow down the list to certain foods which trigger an attack. If he takes the list of trigger foods to his physician, they can work out a diet together. In any event, his meals should not be large. He might consider four or five smaller meals throughout the day.

While I indicated stress was previously thought to be the cause of IBS but later found not to be, it can trigger an attack. He should find ways to reduce his stress level as an additional means of control.

Between diet modification, a reduction in stress levels and medication (such as over-the-counter Digestive Advantage IBS or prescription), if appropriate, he should be on the road to recovery.

To give you related information, I am sending you a copy of my Health Report, “Irritable Bowel Syndrome”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 176, Wickliffe, OH 44092. Be sure to mention the title.

I am now in my 60s, and retirement is hopefully not far away. I don’t want the rest of my life to be dictated by this condition and the availability of a bathroom.

DEAR READER:
Irritable bowel syndrome is still a condition of unknown cause. We often have ways to treat it and we know the symptoms and how to diagnose it; however, what causes it and how to stop it, or at least treat it more successfully is information that evades the medical community.

Early treatments, popular when you were first diagnosed, primarily consisted of unseasoned, bland foods which often were of little or no help. Most of today’s treatments are for IBS with constipation, such as Zelnorm, which is off the market for most sufferers unless no other treatment works and it is approved by the physician. However, the diarrhea type is usually treated with over-the-counter products such as fiber bulking agents (Metamucil and others) or anti-diarrheals (Imodium and others).

One over-the-counter drug that appears to work for either type of IBS, and better still, for most sufferers who try it, is Digestive Advantage IBS. This product seems to have responded in a way that pharmaceutical companies haven’t. It is even affordably priced and available nearly everywhere. I suggest you try this product with the approval of your gastroenterologist. Let me know how it works.

To give you related information, I am sending you a copy of my Health Report “Irritable Bowel Syndrome”. Other readers who would like a copy should send a self, addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.