### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I have started having panic attacks and when I have them, it s hard to breathe. I have always been a constant worrier and have always been stressed. I get knots in my stomach that make me miserable and nauseated badly. sometimes I throw up. I can t eat like this and I lay awake most nights when this happens until 3:00 to 4:00 am. I do this at least once a week and this whole mess of problems may last up to 4 days and sometimes longer. I have gone to several physicians asking for help because I make the mistake of asking for Xanax. I took that medicine for several years and it took the problem away, then the doctor who prescribed them retired. I don t know where to turn. I had it so bad the other day, that the knots in my stomach were real high up in my stomach (right where I hurt when I had a gallbladder), but when my stomach was like that it felt like my throat was swelling shut or it had a big knot in it one. My mom gave me a Xanax and after it started working, my stomach settled down and my throat wasn t swollen any more. that was the only relief I had for 3 days of living with my stomach and throat like it was. I am 60 years old, and I m not trying to get a buzz like I have heard some younger people do, I just need one for my nerves, not to abuse, just for relief. When I had them prescribed before, the doctor gave me too many, I thought because he gave me enough to take 6 per day. I can truthfully say, if I took one it was usually one about mid-day and one at bed time. If my stomach wasn t bothering me, I took one only when I was nervous and got the shakes real bad, or at bedtime if I couldn t sleep. Why is it so hard for someone to get a prescription when they need one, that s what they are manufactured for.

### output:

Hi.thanks for your query and an elucidated history. After reading and re-reading your history I could get is that you need Xanax. You should consult another Doctor For a second opinion and any good Doctor would certainly after going through your history would prescribe you this. As a precaution due to your age of 60, you should get yourself investigated at least once, and I would advise you the following:Investigations:*Routine blood investigations like Complete blood picture, blood sugar, urea, creatinine, liver function tests, thyroid function tests.*Urine -routine and microscopy*Stool: routine, microscopy, occult blood, culture and sensitivity.*Ultrasonography of abdomen, *Colonoscopy All these investigations should be within normal limits for one to say you have IBS. Treatment:STRESS = stress is the most important cause of IBS. Please remember, and you must have observed that when you do not have stress your problem with IBS is reducedChange of lifestyle. I think maybe you are not coping with something. Vacation outside your area, mobiles phones to be off. You must have noticed already that these changes help a lot. Try to avoid anything which you are / have to do against your will and wish. Get into the hobbies which make you forget the world around you. Life comes only once,