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Is this really diarrhoea or constipation?

I need to go to the loo at least 3 times a day - yesterday it was 8 times! The bms are usually soft but not watery and I often have to strain to pass them and I never feel like I have finished. After reading Prof Whorwell`s book I`ve been following a low fibre diet for 3 weeks but it`s made no difference. The next step is to try taking a low dose of loperamide on a daily basis - but I`m worried that might make me strain even more (I already have constant discomfort round the back passage from going so often and think straining more would make that worse).

Does anyone have experience of taking loperamide like this? Or should I be treating this more like constipation and taking a regular laxative (I`m very nervous of doing that as it likely to increase the stomach ache and urgency)

Please don`t tell me anything about diet or stuff like fybogel - I`ve done all of that and had all the tests to rule out anything else and nothing has worked

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Hi Janke,

Sorry I don't have any answers, as I'm exactly the same as you, having to use the loo many times in the morning. I'm also following a low fibre diet.

I use immodium on 3 consecutive days in the week as I work 3 afternoon shifts. I 'go' as much as I can before I take the immodium. The mornings after I still have to go but things seem to take longer and do involve more straining. Have to do this though as I can't use a loo in work.

I'm going to prof whorwell's clinic in a couple of weeks so I will let you know what his advice is as you have similar symptoms to mine. I too have tried everything and am very wary of laxatives. I hope we find a solution soon!

Best wishes

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I`m very envious of you going to his clinic - I`m finding his book helpful but symptoms like your`s and mine don`t seem to fall exactly into either category! I`d love to be able to ask him which way I should be going. I have found a factsheet from Birmingham Hospital which confirms that it is safe to take loperamide regularly and says that morning frequency can improve by taking a dose last thing at night so I might try that. I can`t face another day like yesterday as I was in and out of the loo all day and feel rubbish today.

Please do keep in touch if you find out anything helpful

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Yes it's a total pain isn't it. I waste so much time in and out of my bathroom!

One thing I've never tried is to take the immodium at night as I worry I won't be able to 'get things out' before work. If you try it please let me know how things go.

Yes I will definitely let you know what prof whorwell says. Hopefully he'll suggest something I haven't thought of.

Best wishes

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I have wondered if it it might worth combining loperamide at night and using a glycerine suppository in the morning to help clear everything out! In his book he seems to be happy to combine different approaches. If you haven`t read it, you might find it useful before your appointment "Take Control of your IBS"

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@Chocoholicww can you please write his advice (Dr.Whorwell ) as a public post here so that we can all benefit from this ..as i also suffer exactly like janke and you ( I even give it a name " Constipated Diahrrea " ) tried different meds that gave me more troubles with horrible side effects ..would love to travel abroad to meet new doctors to see if they have different approaches or newer drugs to this Dilemma but unfortunately I can't get into an airplane and go through the whole travelling process while suffering from ibs /D .

Wish you Best of luck in your upcoming appointment 🌸

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Hi eternity,

Yes I will definitely make a post on here when I have visited the clinic. I have had so much good advice on this forum that I am more than happy to share my findings with everyone. 🙂

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Thank you so much ..really appreciate it 🌸🌸

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Yes I did read about the suppository. It does sound like a good idea. I've not been brave enough to try it yet though. I'm always scared I'll make things worse.

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Hi there

I don't exactly have the same symptoms but I did used to get the urge to go alot of times a day.

I use loperamide everyday. In the morning I take a loperamide along with a vitamin D tablet and a psyllium husk tablet.

I find taking those things help improve my tummy but the loperamide helps by making the loo trips less frequent. I normally now have 1 or 2 bowel movements a day and hardly ever feel like I've not finished.

Also the past couple of months I've been on an antidepressant called amitriptyline (prescribed for migraines) but it has hugely helped my tummy. Since taking it I have pretty much had normal bowel movements and most pain/discomfort has gone. Even on days where I've eaten badly it's been okay!

Lyn

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Thanks. I`m afraid I am currently coming off amitriptyline. I`ve been on it for about 20 years for various things and decided I need to stop. As I get older I am concerned about the links to increased risk of dementia from taking drugs like amitriptyline - and I don`t feel it made any improvement to my IBS. I must admit I have wondered if my long term use of it has actually made my bowel more sluggish

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Your symptoms are quite like mine too. I often go many times a day and don’t feel empty. When I saw a colorectal consultant he said he had many patients who take Imodium every day & it was quite safe to do so.

It worries me though so I only take it if I really need to. For me taking a bulk forming laxative has helped but it hasn’t solved the problem. I struggle with fruit & can only have small amounts of veg so I do need something to make me go.

Straining is never good, I have been advised not to at all as I have had prolapse surgery twice so have weak pelvic floor muscles - I really don’t want any more surgery! I also take amitriptyline and like you am coming off it, I have 10mg at the moment (I was taking 25mg). Do you get back pain following a BM? Neither the colorectal consultant or urogynaecologist had an answer for that unfortunately.

Perhaps you could start with half a tablet daily & see how you feel?

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Yes - lots of back pain! Gastroenterologist just said it is very common with IBS - otherwise no help. My gp`s only solution was some powerful nerve pain medication which has lots of side effects so I`m not doing that. I`m actually going to see an osteopath tomorrow to see if he has any ideas. Will let you know if it is helpful

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Thanks, I would be interested to hear how you get on. I have tried acupuncture with no success. I haven’t actually seen a gastroenterologist yet. What tests have you had? If you don’t mind me asking.

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I`ve had coloscopy and sigmoidoscopy - under the care of colorectal surgeons but they lose interest if they can`t find anything they can operate on! Have also had bloodtests for celiac disease etc. Have also seen 2 gastroenterologists who couldn`t offer anything I hadn`t tried before and an NHS dietician who also couldn`t suggest anything I wasn`t already doing. I`ve also had bowel irrigation under the direction of a specialist physiotherapist (no help). I`m currently seeing a hypnotherapist - which is nice and relaxing but hasn`t had any effect on the IBS. It was she who suggested I talk to the osteopath

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I’ve had the sigmoidoscopy & coeliac tests. I saw a dietician who suggested cutting out cows milk & soft cheese. This has helped a bit. I also take acidophilus but I’m not sure if it actually does anything. I kept a food diary for months but that didn’t show up anything helpful.

My GP says it’s probably IBS but of course that’s no help at all as that just means “we don’t know what to do with you”. I also have sore, watery eyes (not red), aching joints & dermatitis (?) on my hands. All this has happened at the same time as becoming menopausal so I wonder if it’s hormone related? Good luck tomorrow.

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I have definitely been worse since hitting the menopause. I have mentioned this to doctors and they nod but don`t seem to want to persue this. To be honest I wouldn`t want to go onto HRT anyway so perhaps there isn`t much they could do

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I had an unpleasant reaction to Loperamide I was on the loo for weeks with diarrhea! I can sympathize with you when there seems to be no simple solution.

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I saw your post this morning not too long after I had spent about 30 minutes in the bathroom trying to empty my bowels! My first bowel movement seems to be ok but by the time I've sorted myself out and washed my hands I feel like I have to go again ..then again.. and again ( the poo getting smaller in amount and softer each time) 5 times this morning! Even after this I feel like there is still a fullness in my rectum but not sure if there is more poo or if it is haemorrhoids as I do suffer from them( no surprise there!) This happened to me quite regularly over the past few years then seemed to improve a bit on the FODMAP diet but that is a bit difficult to sustain and I've lapsed a bit recently and I'm still not sure which foods upset me - possibly onions. I haven't actually been properly diagnosed with IBS but everything I am reading is familiar to me and it's actually quite reassuring to know that my symptoms are fairly common. I hope you find something to help with your symptoms - please keep us updated.

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Prof Whorwell says that the entire bowel including the rectum becomes hypersensitive and that people like us are aware of tiny amounts in the rectum that other people wouldn`t be. He says that straining to get rid of these tiny amounts stretches the rectum and makes it more sensitive and recommends that if you feel you have done a reasonable amount you should try to ignore the urge to get rid of everything. He does admit that this is easier said than done (I find it pretty well impossible!)

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Hi yes this is me. Straining to empty every last little stool until I bleed as I have haemorrhoids. I know my bowel is over sensitive as I’ve had ibs for 30 years I’ve also gone through the menopause. Can’t go on HRT as I’ve had breast cancer. Anti depressants help but have side effects so may try Imodium soon. It helps just knowing others have similar problems as I feel I’m a bit of a freak. What a pain it all is! Hope you get some answers soon :)

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Hi there Janke,

This is me to a tee and sometimes I seem to go often but never feel like I have emptied my bowels. What I do, and this works for me, is put approximately a rounded dessertspoon of linseeds in a mug with about a half a mug of water and leave to soak for an hour or more then drink. This works gently on my bowels and does make it easier to go. I don't get diarrhoea but am sometimes constipated but I would class myself as more IBS C than D.

It's such a menace and drives me nuts as sometimes I think am I going to finish a walk (I love walking) and not need to go whilst walking.

All the very best to you.

Take care x

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Hi Janke and everyone else. This is me too. I get up and as soon as I start to go to toilet, I just want to keep going. I am sure I could just continue to go all day if I didn't force myself to stop going. Alternatively, if I force this stop to early (like today) I just feel sick and awful all day and like I should have gone back to the toilet. I have tried staying in the toilet, going back and forth and just trying to hold it but nothing really works. If you keep going you just keep wanting to go more and if you stop you feel like you should have carried on going. I have just turned 60 and had IBS for more than 30 years now and have more or less run out of ideas.

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Oh that’s exactly me too! The toilet dilemma- if I don’t keep going I get a headache and feel sick. Feels like I live my life on the loo (aka my office) !!

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Yes, I feel the same (and also a bit of a freak as you said further up).

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this all describes me exactly. I've been like this, on and off, for over 30 years. 3 years ago my GP prescribed Imodium every day. this didn't cure things but helped a bit to control it. I've seen an enterologist who says it is OK to take daily. before Christmas I was desperate and spent a fortune on symprove which unfortunately did not help me. I had got to the stage that at least 2 days a week I was unable to leave the house because of needing the loo, and was totally unreliable in keeping appointments. now heres a thing ( as they say) on 12th February this year I started to drink Kefir daily and have only had 2 bad days since. I know that IBS comes and goes, but it does feel like more than co incidence. has anyone else found Kefir useful? ps I only need approx one Imodium a week now - fingers crossed

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As an update - I`ve been to the osteopath today who couldn`t find anything he could help me with regarding the backpain - he thinks it is visceral referred pain stemming from the gut. He did say he had seen some good scientific evidence about Yakult being used at Great Ormond Street to treat motility problems in children - so I`ve been and bought myself some of that!

I had just half an imodium last night and it made no difference at all!

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Sorry the osteopath couldn’t help. Have you read anything by Dr Michael Mosley? The Clever Guts Diet is an interesting read. He is very into the gut microbiome which is a fascinating subject. As for the half tablet of Imodium I would think it will take a few days to build up in your system so maybe keep trying? Good luck.

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Have been meaning to try Yakult for a while now. Let us know how you get on with it.

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Hi.

I have the same problems..many loo trips in the morning.urgent..not D but like incomplete evacuation ...along with mucous cramps and lots of wind.

When I got ibs at 40 it was from food poisoning and was D in the mornings .

Like everyone else I have no answers.

If I need to be somewhere for a while I take immodium....that works on the day but then the whole cycle starts again.maybe two days later.

I had a scan two years ago but nothing sinister showed so no treatment.

I take colofac the odd time...also Deflatine and even 5mg of a benzo really helps to calm things down.

It was good to hear of others with almost identical problems.

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