Severe Daily IBS?!


Question:

Severe Daily IBS?

I've had IBS symptoms for over 8 years. I got a colonoscopy and an ultrasound and everything was normal minus a large ammount of gas. I have tried a few pills and am taking Nexium now, but it doesn't work. I can eat a piece of toast and then 10 minutes later it's diarreha time, but it happens when I don't eat too. I have diarrhea about 3x a week (sometimes every day). I go #2 more than 6x a day. I've heard that most people go maybe 2-3 times a day. I've tried meds (as I said), fiber, changing my diet, excersizing more, etc. I'm about to go back to the doc and need some ideas on what to ask him this time!!!


Answers:

First off, I too suffered from your symptoms for many years. It was really a combination of nausea, cramping, and irregular bowel habits. Before I offer my advice, here is the caveat: IBS is merely an absence of a true diagnosis. People can you advice, but because there are multiple causes, potential remedies often conflict, leaving you with no real solution. In the process of jumping from solution to solution, you can easily exacerbate the underlying problem. This is clearly evident from the above advice - people are so certain that they can solve your problem without possibly knowing enough about your symptoms to do so!

Speaking from experience - you need to do everything you can to find the actual cause of your symptoms. Don't settle for an "IBS" diagnosis. In my case, I found, after three years of misery, that I have "fructose malabsorption." This can be detected with a simple and inexpensive hydrogen breath test.

Thus, in my case, I needed to cut out sources of fructose - especially fruit juices and anything sweetened with high fructose corn syrup. I also need to avoid fructans, which are found in wheat and nuts.

Unfortunately, because I had initially been "diagnosed" with IBS, I was told to replace sugary, fatty snacks with fruit. I also was told to eat lots of fiber, often from whole grain wheat. Over time, my condition worsened to the point that I developed a plethora of other problems. Once I cut the fructose, I started to do better, but I am still recovering after three years. Also, I am on a low dose of Nortriptyline, which greatly controls my nausea.

I had to seriously fight to get a doctor to look past the IBS diagnosis. It took too much time and too much money, but the alternative is far worse. Sorry for being "preachy," but people need to know to keep digging for a solution - an IBS diagnosis just isn't enough.

Best of luck!

In response to the above comments:

1. Loperamide is merely Imodium, which, in my case, GREATLY exacerbated intestinal cramping. If it works for you, that is great. However, consider that you are not really treating the underlying cause and could be missing something potentially problematic.

2. Tricyclic antidepressants can be helpful, but not for the reasons stated above. Nortriptyline, which I am on, is very benefical to me at a very low dose, 20mg/day (far lower than is used to treat depression). Tricyclic antidepressants are frequently used IBS because these drugs are affect the uptake of serotonin (95% of the setotonin in the human body is found in the gut). Thus, the effect of antidepressants on the brain is felt as a peripheral result in the gut.

3. Alosetron is available as the prescription Lotronex. I had asked my doctor about this and was told that it had been removed from the market a few years back because of serious side effects, including life-threatening constipation. After checking the internet, I now see that it has returned, but has only been approved for women.

4. Celiac sprue is something that you should be tested for - my doctor tested me within a month of symptom onset. If your doctor hasn't yet tested you, that is probably a good sign you need a different doctor.




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