IBSd since 7 years after completion of my TB treatment - #11495

Patient: Male, 22 years in November 2025 Presenting Complaints: I have two chronic health issues: nasal/allergy problem and digestive/IBS-D problem, which I would like to discuss in detail for proper evaluation and management. 1️⃣ Nasal / Allergy Symptoms I experience persistent blockage in one nostril almost all day. Occasionally, the blocked nostril opens for a short period, such as when I take water in it or exert pressure while inhaling or exhaling. I often have mild burning sensation in my head, which seems to be related to the nasal congestion. Early morning sneezing fits: when I wake up and air passes through my nose, I sneeze 5–7 times in a row. Symptoms worsen in certain environments, such as dusty rooms, exposure to smoke, or strong odors, and improve temporarily with nasal irrigation or Mometasone nasal spray (Metaspray, Cipla) prescribed by an ENT doctor. ENT evaluation suggested allergic rhinitis, and I was advised to use a mask in dusty areas. My CBC report shows: (CBC done on 1st September 2025) WBC 5.0 ×10³/µl (normal) Lymphocytes 47.8% (slightly high) Monocytes 24.4% (high) Granulocytes 28.1% (low) RBC, Hb, platelets all normal Interpretation: No bacterial infection; pattern consistent with chronic allergic inflammation. I want evaluation to rule out deviated nasal septum, turbinate hypertrophy, or nasal polyps, and to identify specific allergens causing these symptoms, both environmental and food-related. 2️⃣ Digestive / Gut Symptoms (IBS-D) I experience frequent loose stools, sometimes urgent, along with mild abdominal discomfort. Symptoms are triggered by certain foods, but I do not have weight loss, bleeding, or major systemic symptoms. Colonoscopy, Endoscopy, gastroscopy and routine blood tests have been normal. Which was done 6 years ago I have a history of mild fatty liver, IBS-D symptoms, excessive sweating after post-TB period, and occasional low blood pressure episodes. And dehydration , dizziness, excessive thirst, higher frequency of urination are also present every in 1 out of 3 day ,Sour and vinegar smelly stools , mostly black coloured stools but yellow when I eat dal rice only. I am seeking guidance to identify root causes (dietary, gut dysbiosis, infections, or other GI disorders) and long-term management strategies. 3️⃣ Medications / Past Treatments Nasal: Metaspray (mometasone nasal spray) – some improvement but not fully effective. I stopped it , doc says to use it for 2 years but I used it for 8 months and stopped. No ct PNS, endoscopy is done in past Gut: Occasional supplements for gut health; no recent antibiotic treatment., Colonoscopy, gastroscopy & endoscopy is done before 6 years both are normal, my TB specialist dr said I have to do probiotic course, but I didn't allow, due to past blind treatment from psychologist doctor for ibs d by nexeto tablet (10 mg 1 x day) which increases my thirst and urgency of loose stools . That's why I want to find root cause of my diarrhea before starting any medication Previously prescribed Nexito (escitalopram) for stress/anxiety, which I discontinued. 4️⃣ Questions for the Doctor 1. For nasal symptoms: Confirm if this is allergic rhinitis alone or combined with structural issues (DNS / polyps / turbinate hypertrophy). Identify specific environmental and food allergens. Recommend long-term management and whether further testing (nasal endoscopy, CT PNS, IgE/skin prick tests) is necessary. 2. For digestive symptoms: Investigate root causes of IBS-D: gut dysbiosis, SIBO, bile acid malabsorption, FODMAP sensitivity, or other functional disorders. Suggest any tests required to identify root cause of my IBS d and suggest diet, supplements, and lifestyle modifications to control symptoms and improve gut health. 3. Overall: Advice on safe and effective treatments for both conditions simultaneously. Clarify whether stress, diet, or allergy triggers could be contributing to both nasal and gut symptoms.