Case | Age (yrs) | Race | Sex (M/F) | Case History | Gastrointestinal Symptoms | Attempted Treatments without Resolution of Symptoms |
1 | 71 | C | F | History of ischemic colitis, IBS-D esophageal spasms/hypersensitivity, Schatzki’s ring, anxiety, and chronic atypical chest pains, complaints of hemorrhoids and irritation, rare rectal bleeding from hemorrhoids, rheumatoid arthritis | Worsening epigastric pain, general abdominal pain, bloating/distension, diarrhea | Pantoprazole, omeprazole, sildenafil, atropine/ hyoscyamine/scopolamine/ phenobarbital, pantoprazole, hyoscyamine, ondansetron, promethazine, topical hydrocortisone acetate (2.5%) |
2 | 53 | C | F | History of IBS-U, nausea, acid indigestion, foul smelling flatus, anemia, multiple somatic complaints | Chronic abdominal pain, bloating/distention, flatus, epigastric pain, nausea | Dicyclomine, omeprazole |
3 | 37 | H | F | Lactose intolerance, small intestinal bacterial overgrowth, IBS-U symptoms | Chronic abdominal pain, bloating/distention, diarrhea, positive H2 breath test | Pantoprazole, hyoscyamine, polyethylene glycol 3350 NF, probiotic, flaxseed, subsequent monthly courses of rifaximin followed by dicyclomine |
4 | 62 | C | F | History lactose intolerance, IBS-U, dyspesia/tachygastria, GERD, reflux esophagitis, recurrent polycythemia vera | Chronic and severe abdominal pain, bloating/distention, with occasional dyspepsia | Aluminum hydroxide, magnesium hydroxide and simethicone, milk supplemented with lactase, dicyclomine (discontinued due to blurred vision) |
5 | 59 | B | F | History of IBS-D, GERD, insomnia, sleep apnea | Watery BMs with urgency, abdominal pain and distention relieved by defecation, “bubbling” followed by nausea/ vomiting | Escitalopram, amitriptyline, alosetron caused nausea |
6 | 63 | C | M | Long history of IBS-D, GERD, dyspesia/tachgastria, gastritis, gastroparesis, anal fissure, hiatal hernia, renal cell carcinoma | Abdominal pain, bloating/distention, diarrhea | Omeprazole (discontinued), diphenoxylate/atropine, dicyclomine (discontinued), tamsulosin, simvastatin, losartan, simethicone |
7 | 54 | H | F | History of IBS-U, gastritis, GERD, reflux esophagitis, hemorrhoids | Chronic abdominal pain, bloating/ distention, nonulcer dyspepsia, moderate epigastric pain after meals | Dicyclomine, hyoscyamine, omeprazole, bisacodyl, phenobarbital, PEG-3350 |
8 | 52 | C | F | History of gastroparesis and IBS-D multiple somatic and joint complaints | Generalized abdominal pain, bloating, early satiety, chronic diarrhea, foul smelling gas and flatulence, bloating/distention, nausea, vomiting | Pantoprazole, ondansetron, propranolol, chlordiazepoxide/clidinium, topiramate, quetiapine, lamotrigine, sumatriptan, trazodone |
9 | 66 | H | F | Long history of IBS-D, GERD, gastritis, fundic gland gastric polyps, avoids dairy | Quit her part time job due to symptoms, urgent exploding diarrhea mainly in morning with abdominal cramping, fecal incontinence | Citalopram, bismuth subsalicylate |
10 | 63 | H | F | Long history of IBS-D, GERD, gastritis | Chronic watery, non-bloody diarrhea with urgency occurring 2 - 3 times a day | Mesalamine (resulted in rash), sulfasalazine, metronidazole, methylprednisolone |