AF and IBS

[ruskin10]

Hi everyone, as a long time with AF lady it has over the past year progressed and flecainide no longer helped so was stopped. Had various tests....... Stress test, heart monitor for 2 weeks, BP monitor 2 days, many ecg's. Waiting to see if a pacemaker will help and new meds. I've suffered with IBS for over 10 years, recently had endoscopic tests because of weight loss..... all clear. I'm posting to ask if any of you with AF and IBS have been offered amatripoline. Has it affected your AF as pharmacist says it can. Hence I am unsure. Thank you.Pat

[jeanjeannie50]

Hi Ruskin 10

I take 6.25mg of Amitriptyline at night for pain. I wouldn't be happy taking more than that as one of the side effects can certainly be a heart arrhythmia.

Jean

[ruskin10 in reply to jeanjeannie50]

Thank you Jean

[Hidden]

Hi Pat,

I was originally diagnosed with paroxysmal AF in January 2010 by September 2011 I was sure beyond doubt that the trigger was food. Back in the day I also had the following symptoms diahorrea, burping, loud intestinal gurgling and massive, massive and painful bloating. These would all occur at random, never together and the one that would trip me into AF was bloating !

My GP had blood tests done for IBS and Coealiac Disease which came back all clear. He offered more tests but I declined. I then consulted a Nutritionist who got me going Gluten Free, Wheat Free and Oats Free .......... and guided me onto the wisdom of diet and food observation and food planning. Following this advice since those days I had one full blown AF event in April 2015 and another in February 2018, I had two other minor AF events since 2018 but only lasting a few hours and all driven by food. These free from cereals I've mentioned were the start and the list of don't have foods has widened over the years, particularly, roast Duck, Pork with crackling or other fatty content and Turkey is a bit suspect. Some veggies can also do it. Sometimes a range of other foods can do it - hard cheese is OK soft cheese not so..... and it goes on and on.

Thanks to previous AF forum members (hosted by Yahoo back in the day) I learned about the vagal nerve and how if upset, aggravated, inflamed .... whatever ... was the catalyst, following food which would trigger an AF event.

Whilst I was enjoying life with AF (so to speak) my body was aging and with it came the onset of osteoarthritis in various joints, particularly both shoulders. I had already been prescribed CoCodomol 30/500 tablets to deal with knee pain. In Sept 2020 my GP then prescribed 10mg tablets of Amitriptyline to be taken at night. Well that didn't last long as that started me with night time ( early morning hours) severe diahorrea. Seems that this was her additional prescription for pain relief. Now totally abandoned and I'm just left with CoCodomol. I don't take anti inflammatories due to Warfarin which I'm also scoffing. In the short time I took it I felt crap. On reading in detail the bit of paper in the packet I began to wonder why I was prescribed the damn stuff at all. One of the DO NOTS is " do not take this if you have heart problems such as irregular heart beats, heart block or have recently had a heart attack". AND THEN YA WANNA READ THE LIST OF POSSIBLE SIDE EFFECTS ON THE SAME BIT OF PAPER.

Fer goodness sake !!

So there we are, apologies for the length of this but now you have my experience in context. Hope it all helps.

John

[ruskin10 in reply to Hidden]

It's a minefield of shall I shan't IThanks for your reply

[RoyMacDonald in reply to Hidden]

I'd never heard of a blood test for IBS so I searched the web and the NHS said this... "There's no test for IBS,"

I'm a long term (50 years) sufferer from IBS so was very interested to see if there was now a blood test.

All the best.

Roy

[Hidden in reply to RoyMacDonald]

Hi Roy,

When these tests were done I was living in Surrey and the year was mid 2010 or early 2011. Since I've been in Cornwall and also since I've been under the care of a nutritionist I've never needed to revisit these tests, just stick to a diet/food plan. So what you say in the current era may well be correct.

John

[RoyMacDonald in reply to Hidden]

Hi John.

My knowledge is from 1972 when I was diagnosed, and it has not changed up to the present day according to the NHS. All that has changed is the introduction of the low FODMAP diet. Which works for me.

All the best.

Roy

[Megams in reply to RoyMacDonald]

~Indeed following FODMAP + remaining gluten free, additive free in foods, supplements etc has helped me too. Organic veg/herbs/fruit important which I grow in small garden.

Must be remembered that genetics can play its part in IBS along with stress which was always my main trigger. I take a quality probiotic+prebiotic morning & evening along with Keifer cocoanut yoghurt & no dairy if possible.

[Autumn_Leaves in reply to RoyMacDonald]

No, I’ve never heard of a blood test or any kind of test for IBS as it’s a diagnosis of elimination after you’ve had the more serious conditions ruled out. Anyone offering a blood test for IBS sounds bogus to me. Likewise those “food sensitivity” blood tests are pretty much a waste of money but if someone shells out hundreds of pounds for them they’re already invested in whatever they’re going to be told, financially and emotionally. I’ve had excellent treatment on the NHS dietetics but I appreciate not everyone has access to these services.

[Hidden in reply to Autumn_Leaves]

Hi, at the end of the day the only thing that worked for me was paying for privately and consulting a Nutritionist and following her advice. Anything the NHS offered was irrelevant.

[Autumn_Leaves in reply to Hidden]

We all have different experiences with the NHS. I was referred to an excellent dietitian and it was very helpful. There are some excellent private practitioners but there’s also plenty of underqualified peddlers of dietary nonsense too. Anyone can call themselves a “nutritionist”. It’s not a protected title in the UK, although people with the RNutr and ANutr accreditation have had to had sufficient training and education and are held to high professional standards. It is a minefield out there and it’s a case of buyer beware. I’ve seen a few people whose health has been damaged by the bogus type, dangerously underweight because of cutting out this, then that, then the next thing because of “allergies” or whatever. It’s an awful thing to witness. I know another one who has gone down that path right now, it’s like history repeating. But as I said, there are some very good practitioners too and if you’ve found someone who gives helpful advice and you feel better, then that’s all good.

[Hidden in reply to Autumn_Leaves]

I used BANT to guide me to a practioner who met specific professional standards. Sadly, where I am the NHS does not offer a common set of professional standards, whether we talk of GP Surgeries or NHS Hospital Trusts. Local CCG's are as much use as chocolate fireguards. I always thought the emphasis was on NATIONAL and SERVICE ....in that context it doesn't exist.

[Autumn_Leaves in reply to Hidden]

Yes, there are some very good BANT nutritionists too. I follow a BANT registered person on Instagram, mostly for the recipes, but I imagine she’d be a very good practitioner to see in real life. Sometimes seeing a private practitioner is the only option for many people. So much depends on where you live. My sister has a pretty awful service where she lives yet I’ve had seen some excellent consultants at prestigious NHS flagship hospitals in my catchment area. In some respects I’m reluctant to move out of the area as we *should* be able to access a good standard of care wherever we are but I know that’s not reality.

[Autumn_Leaves in reply to Hidden]

I considered doing an online nutrition course just for the bogus qualification, because I was curious and because it didn’t cost all that much. I’d never attempt to advise anyone about their diet based on this “wellness and nutrition coach” certificate. No way would is it a qualification in anything. It’s really a business that sells online courses and issues it’s own certificate - at a price of course - but there isn’t a law in the land that would stop me from calling myself a “nutrition coach” or even a “nutritionist” and offering my services to anyone. Personally, I think it would be immoral of me to do that. I am curious about what the course actually covers and I may just do it just to see how easy it is to “qualify” but that’s as far as I’m prepared to go.

[Mugsy15 in reply to RoyMacDonald]

You're correct, there is no blood test designed to identify IBS. IBS is not a single specific condition, it is a catch-all diagnosis arrived at by eliminating all other potential causes of the patient's symptoms.

Whilst anecdotally some medics seem to doubt the link between AF and IBS and the role of the Vagus nerve, I know from my own experience, that of a friend and from years of reading this forum, that the two conditions go hand in hand in many sufferers.

[RoyMacDonald in reply to Mugsy15]

Yes, I agree. I have a pain killer prescribed by my doctor and as a side effect it stops my IBS symptoms and once they go so does my AF. Unfortunately for some people it makes their IBS worse depending what type of IBS you have. IBS-D or IBS-C. I have IBS-D.

All the best.

Roy

[Tommyboy21]

Lots of people with ibs are on a low dose of it I once was pescribed it but never took it. Personally I've found my diet change has helped my ibs more than medication. Even though I've been tested for coeliac disease ect and came out negative. Giving up bread products has been a game changer for me.. And I've suffered ibs symptoms for all my life.Also stopped my buscopan as so many different opinions regarding affects on AF.

[ruskin10 in reply to Tommyboy21]

I've been thinking about stopping bread and biscuits.Thanks for your reply

[Tommyboy21 in reply to ruskin10]

I buy gluten free biscuits as a treat. And sourdough bread if I fancy a bit of toast. But generally eat corn wraps ect as a bread alternative.

[Autumn_Leaves in reply to ruskin10]

Many people with IBS are sensitive to Fructans which is found in wheat, barley and rye but also various fruits and vegetables. It’s also a FODMAP. But other people are sensitive to other FODMAPS too. But the good news is that after some time of having minimal symptoms eating the foods that don’t create symptoms for you, it is possible to reintroduce limited quantities of foods that previously triggered you. Eliminating food groups long term reduces dietary diversity which can in turn have a detrimental effect on the gut microbiome. Your microbes need a variety of plant fibres to thrive. People who follow a gluten free diet have been shown to have reduced gut microbe diversity, so it’s not a good thing to do for your overall health if you can avoid it. The gut microbiome is believed to play a significant role in our overall long term health so we need to “feed” it as best we can. Some fermented foods in the diet are good too.

[ruskin10 in reply to Autumn_Leaves]

Thankyou

[Autumn_Leaves]

I have had IBS for many years and AF only for the past year so I’m no expert on AF as I’m only just about to have my first appointment at the Arrhythmia Clinic since developing AF.

I tried amitriptyline years ago for insomnia but I didn’t get on well with it. I felt like a zombie so I stopped them. These drugs also can cause constipation so it’s not going to help your colon function as well as it should. I didn’t even have much of a problem with ectopics back then (I do now) so there was no concerns about cardiac symptoms although I’d be more cautious now.

I can’t work out why you’ve been offered amitriptyline. It’s not a standard treatment for IBS and I’ve never heard of it being prescribed for AF, but as I said, I’m a newbie to AF so what would I know?

I found the FODMAP process of elimination and (very importantly) reintroduction was the most helpful thing for IBS, but I must emphasise that it should always be done under the supervision of a trained dietitian. This is available on the NHS and it’s well worth asking your gastroenterologist for a referral or if you don’t have a consultant you can ask your GP. Don’t do it without supervision of a qualified dietitian. I’m more or less symptom free now, as far as abdominal symptoms go, plus I’ve been able to gradually increase my tolerance to foods that used to cause symptoms. I advise everyone to steer clear of “nutritionists” with Micky mouse certificates. If you do go private, please see either a registered dietitian (RD) or a registered nutritionist (RNutr or ANutr).

I have lived a too-good-to-be-true lifestyle for decades, and I’ve done all the right things, and avoided all the wrong things. I still developed AF. Personally, I’m doubtful of the vagal/digestive theories. That’s not to deny that there maybe a connection for some people but I think it’s somewhat overstated. I rarely drink alcohol, eat a whole food plant based diet with limited amounts of animal protein, exercise within sensible limits and I’ve never been anywhere near overweight in my life, low BP, low cholesterol. On paper, my NHS health checks are exemplary. I still developed AF. So who knows why these things develop? I’m certainly not going to blame myself for anything I did “wrong”.

Only you can make the decision to take a medication. As long as you know why and can weigh up the benefits versus the risks. If you do, you might need something like Fybogel on prescription to keep yourself “regular” though if you can find a way that works for you, that’s the main thing. You also need to be wary of drug interactions and the risks of “polypharmacy” if you are prescribed more cardiac drugs later on, but that’s really something you need to raise with your consultants when the time comes.

[ruskin10 in reply to Autumn_Leaves]

Thank you. Gastro consultant's offered it to me as the next step to get me some relief. I have NHS dietitian phone or clinic appointments 6 weekly, eliminating foods causing gas/cramps, constipation med, buscapan etc without any joy yet. I'm under LHCH (Liverpool) who I'm due to see January. First prescription ready tomorrow so after a rough week I think I will be giving it a try. AF behaved quite well for some weeks except for short bursts. Thanks for you reply

[Autumn_Leaves in reply to ruskin10]

That sounds promising. I hope it all goes well for you.