alternating loose stools and constipation

[anndewar]

Hi All

I have had IBS for a number of years now which seems to have settled into a pattern. For roughly 2 days I find it hard to go to toilet then 2 days going to the toilet with loose stools and sore stomach with going to toilet too many times. By the evening everything settles down and its as though I don't have IBS but the next morning, after toilet it starts all over again. I am a worrier, always have been. Does anyone else suffer this way

[Fruitandnutcase]

I find that all of a sudden I become constipated for no reason I can think of. I don’t even need to go to the loo to know that something has ‘switched’ within my body and that when I do go I’ll be constipated. It’s odd really.

Like you I can worry for England. I’m a multiple ‘good medalist’ in worrying and I don’t think that does your gut any good at all but try telling that to a worrier. I’m not great at it but on the whole I’ve found meditation is good for stopping worrying and getting to sleep if I can’t switch off.

[anndewar in reply to Fruitandnutcase]

Just the same as me, am going to look into yoga as that is supposed to be good for calming you. Thank you for your reply

[Stuart24]

Hello, this is my general response to help people find a baseline. First, go to the doctors and get yourself checked for intestinal infections, and whatever other tests they want to do. Most people find they are all clear, and that IBS is a condition brought on by our modern diet, freely accessibility food, sedentary lifestyles and a trigger of an earlier infection. After 27 years of suffering with IBS I have found that the long-term solution that actually works is all about vitamins and fasting and both are equally important. You are effectively the manager of a “food nutrient extraction factory”, I know that is obvious, but I have found that IBS is not about medicines, but about changing the way you run the factory, and thinking about it in that way.

This is based on some excellent publications, and also by observing how healthy people live. But, if you are all clear from the Doctor’s, then the first thing to sort out is your vitamins and the timing of your eating and fasting periods. An incident of food poisoning or infection can start you on a cycle that you need to make a really concerted effort to break out of. IBS causes vitamin deficiencies which are very difficult to overcome in most people’s diets, especially because you are probably eating selectively to manage your symptoms. Your vitamin levels affect the health of your intestines, and the health of your intestines affects your vitamin absorption, so it is a vicious circle that you have to break. Get some really good, expensive, multi-vitamins (ideally constituted for your age) and take them without fail every day before your breakfast. Get a blood test for Vitamin D and get you doctor to judge your supplement level required in IU’s. Do not get the ones with high calcium and magnesium content initially as certainly in large doses these minerals can mess you up as they consume your stomach acid, and you should get enough of these minerals from your diet. If you are on low FODMAPs, go for all lactose free dairy products to boost your calcium. At the same time, sort out your fasting periods immediately. This is normally completely overlooked by GP’s, but is critical. Your small intestine should be practically sterile, and your stomach acid along with bowel cleaning during fasting (called MMC) will usually do this. You need to fast for this to be effective, and by that I mean, ABSOLUTELY NO eating in between meals, only water, or zero-sugar drinks. Imagine that you never washed your dinner plates and just kept putting food on them all the time!, they would be permanently loaded with bacteria. You need to give your small intestine plenty of time free of food for cleaning and maintaining the factory. The modern scenario of have cupboards full of rich foods permanently available day and night is a modern luxury outside of the original design of the human being. Your stomach will sort itself out when you have got control of your small intestine (although if you've got gastritis you'll need to finish a course of omeprazole first), and then your large intestine will improve later as nutrients are more efficiently absorbed from your small intestine. To do this, eat a good breakfast at say 7am (porridge with 50% lactose free milk) or what suits you and then a good lunch at 12 o'clock - absolutely no food in between. After lunch, no food again for at least 5 hours, and eat well again for your evening meal because it has got to get you through the night. No supper or snacks, no food or milk at all until breakfast the next day.

Seek out and try to eliminate “trans-fats”. These cause inflammation of the colon, separately to bacterial overgrowth and you will be more sensitive than most because of SIBO and this confuses what is causing you trouble. Chips, hash browns, butter, popcorn and things cooked in cheap or old frying oil as you find in many restaurants can give you colon pain directly through inflammation. It usually passes in a day or so, but trans-fats are bad for you in a miriad of ways, not only by inflammation of the colon. Ideally, starches should only be boiled, and this is enough. Red meats take a long time to digest, and also contain some trans-fats, only have them once a day, and just a light salad to go with them, not a load of starchy food or grains, as they have long digestion times. You don’t want carbohydrates being held up with these in your digestion by heavy meats.

You will feel hunger in the fasting periods, this is doing you good, and you must NOT respond to it - only with water or no-sugar drinks. This is critical. Importantly, when you are feeling better, do not resort to your old ways, you are still recovering, and you need to make a life-style change to have this level of discipline in your eating and continue with it. Do start doing some exercise if you don’t already, as this will really help with your gut motility, and your general health. It takes a few weeks at least, and you need to persevere. You then need to maintain a healthy and consistent way of eating and always keep the vitamins topped to prevent you from relapsing. In a couple of weeks, you should be able to be getting off the low FODMAP diet, and mixing back in the higher FODMAPs.

There is a lot of support for L-glutamine to help with repair of your intestinal lining; this means buying 500g of the bodybuilder powder type and having a couple of tea-spoons of this a day, one before breakfast and one just before you go to bed, and you can have this in a light cordial drink. A lot of this was taken from this excellent paper below, but it does fit exactly with what I have experienced. For the first time I really feel in control of the IBS mystery that has been a burden for years. Good luck.

Treatment and Management of SIBO — Taking a Dietary Approach Can Control Intestinal Fermentation and Inflammation

By Aglaée Jacob, MS, RD

Today’s Dietitian

December 2012, Vol. 14 No. 12 P. 16