Ibs?

[dairyking469]

Hi, I’m so embarrassed. I have IBS-D. I have had two colonoscopies and showed no colitis, crohns, or celiacs. I’ve eliminated dairy (90% of the time). I’ve been exercising and running. I eat better. But I have a problem in the bathroom. I poop in the morning and it takes like an hour to clean up. Sometimes I poop again midway through cleaning. Then it happens at work. There goes my lunch break. I even use a squatty potty. My gastric put me on xifaxan. No results. If I have fiber, I just go more and more. Does anyone else have this issue? I feel like I’m alone. I don’t have a normal life. Thanks. Sorry if it’s TMI.

 

[KaraBulut]

Well, backing up a bit. When you say, "fiber"- what fiber were you using?

Irritable bowel syndrome is a diagnosis of exclusion. Basically, when they've eliminated common disorders like ulcerative colitis, Crohn's and other things that can cause problems with the GI system, what is left is a broad diagnosis of "IBS". From there, IBS is broken down into three subtypes based upon whether it manifests as diarrhea (IBS-D), constipation (IBS-C) or mixed (IBS-M).

Because IBS is basically a "we're not sure what causes this" diagnosis, treating it is a challenge. You should get a referral to a GI specialist whose practice is subspecialized to treating patients with IBS. It can take months to figure out the triggers and get a patient with IBS into the right drugs and the right diet that makes their IBS manageable.

There's a new drug on the market- Eluxadoline (brand name: Viberzi)- that is pretty effective for treating intermittent IBS-D. It's really expensive, so the copays can be brutal if you don't have good insurance. The manufacturer offers a copay assistance program that can make it affordable.

There's older drugs like dicyclomine that also help slow the colon down to the point that the patient has better control, although it doesn't completely eliminate the diarrhea.

There's also some research connecting IBS and UC to a neurotransmitter abnormality. Some patients with IBS and UC respond to antidepressants- like SSRIs or Bupropion (Welbutrin).

A GI specialist who focuses on IBS can also refer you to a nutritionist/dietician that can help you with a rotational diet to isolate the foods that make it worse. They may also have you try a FODMAP diet which eliminates foods that produce gas and worsen IBS symptoms.

The most frustrating thing with IBS is that there's no one single cause and it takes trying different things until you find the things that work for you. Unfortunately, in the meantime the day to day symptoms can be miserable. I'm constantly surprised how many patients have IBS and aren't getting the appropriate treatment.

 

[dairyking469]

Well, backing up a bit. When you say, "fiber"- what fiber were you using?

Irritable bowel syndrome is a diagnosis of exclusion. Basically, when they've eliminated common disorders like ulcerative colitis, Crohn's and other things that can cause problems with the GI system, what is left is a broad diagnosis of "IBS". From there, IBS is broken down into three subtypes based upon whether it manifests as diarrhea (IBS-D), constipation (IBS-C) or mixed (IBS-M).

Because IBS is basically a "we're not sure what causes this" diagnosis, treating it is a challenge. You should get a referral to a GI specialist whose practice is subspecialized to treating patients with IBS. It can take months to figure out the triggers and get a patient with IBS into the right drugs and the right diet that makes their IBS manageable.

There's a new drug on the market- Eluxadoline (brand name: Viberzi)- that is pretty effective for treating intermittent IBS-D. It's really expensive, so the copays can be brutal if you don't have good insurance. The manufacturer offers a copay assistance program that can make it affordable.

There's older drugs like dicyclomine that also help slow the colon down to the point that the patient has better control, although it doesn't completely eliminate the diarrhea.

There's also some research connecting IBS and UC to a neurotransmitter abnormality. Some patients with IBS and UC respond to antidepressants- like SSRIs or Bupropion (Welbutrin).

A GI specialist who focuses on IBS can also refer you to a nutritionist/dietician that can help you with a rotational diet to isolate the foods that make it worse. They may also have you try a FODMAP diet which eliminates foods that produce gas and worsen IBS symptoms.

The most frustrating thing with IBS is that there's no one single cause and it takes trying different things until you find the things that work for you. Unfortunately, in the meantime the day to day symptoms can be miserable. I'm constantly surprised how many patients have IBS and aren't getting the appropriate treatment.

Hi, thanks for responding. I was using the Costco fiber (benefiber) and then tried one day of Psyllium....omg I was in the bathroom all day. My gastro recommended viburzi as a course, but I don’t like the risks of that pill. I’m not perfectly following the FODMAP he gave me, as certain foods on the low bother me and certain foods on the high are fine. I don’t want to try antidepressants for my stomach. I just feel it’s not all coming out when I go. The cleanup is what kills me.

 

[dairyking469]

Hi, thanks for responding. I was using the Costco fiber (benefiber) and then tried one day of Psyllium....omg I was in the bathroom all day. My gastro recommended viburzi as a course, but I don’t like the risks of that pill. I’m not perfectly following the FODMAP he gave me, as certain foods on the low bother me and certain foods on the high are fine. I don’t want to try antidepressants for my stomach. I just feel it’s not all coming out when I go. The cleanup is what kills me.

I feel like I only get clean when I finger myself. But then the hemorrhoids hurt me.

 

[CentFLGuyhere]

I have IBS-D as well and go through spells where it really flares up. My doctor prescribed Levsin which dissolves under the tongue. It works pretty quickly and other than having a bit of a dry mouth I've not had any side effects. Ot is a tropane alkaloid, I believe from the belladonna/deadly nightshade family. It works by reducing muscle spasms in the gi tract and reduces secretions. When I have flareups I take one every 6 hours. You have to be careful to take it only as directed.
I've started a diet and reducing fat intake and increasing salads, etc. Eating leaner proteins such as grilled or air fried chicken, fish etc. I've not had to take anything for my ibs in over 2 weeks. I have social anxiety and taking something for that which is also helping.

 

[dairyking469]

Hi, soooooo sorry I never saw this response! I’ll look into Levsin. Thank you!

 

[Abby509]

I've suffered a lot in my early 20s with what sounds pretty similar. Some things I've learnt about myself that may help you-
-Fiber is important, but the type of fibre is even more important. Soluble fibre for me is what helps. Pure for Men capsules (whilst expensive) do really help me.
-Douching is a vicious cycle. The more you douche the more you upset the bacterial balance in your gut, which knocks everything out. I cannot have sex without douching as it gives me peace of mind, but it takes me about 90mins to feel clean enough. Then for a few days after my stomach is very angry. Probiotics are absolutely crucial to gut health. Try things like fresh kimchi (not canned), Kefir drinks, Kombucha tea, probiotic yogurts, and do them DAILY. If you help get your bacterial levels to where they need to be then it may change things for you.
After many colonoscopies in my 20s, they never found anything. But I do sometimes find that if I take a course of Metronidazole for me personally it seems to 'reset' things and I can start again. Lots of probiotics again.
Much of it is linked to anxiety and the mind-gut connection. The more I stress about it the worse my stomach is. If you're mindful of that it may help.

I hope at least some of that is helpful to you. I am surprised if everyone has perfectly normal healthy bowels as you may believe everyone else is fine. People just don't talk about it!

 

[SC6201]

Are you 100% sure it is not food triggered? EVERYONE responds to food differently, it is not just diary.

Would take a reverse elimination diet and start with a VERY bland diet of something like only rice for a few days then add items day at a time to see how you digestive system reacts.

I have a few sensitivities that would not warrant an "allergy" but took quite a few months to pinpoint with all the other garbage I was eating.

Unrelated I recently had surgery that left me with a colostomy bag for a few months and became intimately familiar with how different foods affect your digestive system. Everything was amplified regarding sensitivities and symptoms that most would overlook and was amazed on how sensitive the system can be.