IBS-C

[Alikatte123]

Hi All, I'm new to this forum and hoping some of you might be able to help me. Before lockdown I was under a gastro dietician trying to sort out the reason for my constipation and acid reflux. Unfortunately, the gastro dietician has had to sign me off since we've gone into lockdown. I had been trying a dairy free diet, which has helped my eczema but not my constipation. I have also noticed that eating processed sugar makes me extreamly tired to the point of knocking me out. Since lockdown I have now been getting bright red blood in my stools and feel really dehydrated. I was given a dose of 200mg omeprazole and 10ml of lactulose for my acid reflux and constipation by my GP. I took this on Saturday and woke in the night with palpitations, shaking, horrid tasting reflux and anxiety, I then passed a couple of large pale stools. I am wondering if I am intolerent to lactose, fructose and other types of sugars. I wake every night to wee, and notice I have a very dry mouth and dry eyes, on waking. I am following an alkaline diet and this has helped with the acid reflux, but has not helped the constipation or feeling dehydrated. Does any one know of a list of does and don't eats for IBS-C? Or of a stool softener/laxative that will not dehydrate me further? I'd be grateful for any help with this. Thanks.

[xjrs]

I have IBS-C and have been prescribed Linaclotide for it and I am also taking Alflorex probiotic which has been scientifically studied for IBS and is available on a free 2 month trial on joining theibsnetwork.org. These in combination have reduced the pain I am in considerably and I have been able to tolerate more foods so that I am able to consume the extra fibre I need to have a BM without laxatives including 4 tablespoon oatbran, 1 tablespoon of ground flaxseed, 8 prunes, 2 tablespoon chia seeds and 3 shredded wheat (or GF version: Nutribrex) for breakfast. These fruits are particularly high fibre and can help with BMs: hard pears, dried apricots, raspberries, oranges (contain a natural laxative) & 2 kiwi. In some people the Linaclotide also helps a lot with BMs which is its primary purpose.

There is some good advice about constipation here:

theibsnetwork.org/constipat...

theibsnetwork.org/constipat...

Please also remember exercise is required for the intestines to do their job properly. The government recommends 150 mins of moderate exercise (e.g. walking as if you are late for an appointment) or 75 of intense exercise (e.g. jogging) per week. I also have a bit of a walk around straight after breakfast to get things moving. Exercise also generates endorphins which helps with pain.

Plus you'll need at least 2 litres of fluid per day (but ideally not tea or coffee).

I used to not drink before bedtime, but I used to wake with palpitations due to dehydration and need to drink in the night. Since having a mug of water at bedtime (with my Linaclotide) I don't have these episodes.

If you really get stuck you can try 800mg+ of Magnesium Oxide. I used to take these for a regular bowel movement when having to be low fibre:

myvitamins.com/vitamins/mag...

- unfortunately out of stock at the moment.

I used to start around 800mg at bed time on an empty stomach, then increment by 100mg (1 pill) each night until I got a response the next morning or the morning after. Most of it goes straight to your bowels where it draws in water to bulk out stools.

You'll need to consume enough water throughout the day for this and before bedtime. This worked well when I was low fibre, but when I started to introduce fibre it became more unpredictable (either not working well enough or too well), so I had to give it up.

IBS and GERD often go hand in hand. I've had both over the years. If the Alflorex doesn't make you more tolerant to foods, have you taken a look at the FODMAP diet? FODMAPs are carbohydrates found in some fruits and vegetables - there may be specific ones that are causing you problems- they enter your colon undigested, bacteria feed off them and create gas as a by product. This gas can build up pressure in your system and weaken the valve that sits between your stomach and your throat allowing stomach contents and acid to flow back. This is normally under the guidance of a nutritionist via GP referral - did they discuss this with you? If you download the Monash University FODMAP app it will tell you which foods contain FODMAPs and in what quantities.You eliminate all FODMAPs for 2 weeks which should help to alleviate symptoms and then introduce them in small amounts one by one for 3 days and then wait up to 4 days for symptoms. I go much slower than this - only introducing a small amount of the same food for 3 days and then increase if tolerable or no symptoms and cut back to the previous amount if symptoms. I've read your microbiome can adapt to handling a new food if introduced very slowly.

You can also raise the head of your bed by 20cm using sturdy plastic bed risers found on the internet or a bed wedge pillow to keep the contents of your stomach there overnight (though in time the pillow put pressure on my hips).

Lots of processed sugar can ultimately make your blood sugar levels drop due to an excess of insulin release. Since processed sugar doesn't exist in the natural world, your body thinks that you are consuming a large meal which is why it releases so much insulin - this will make your blood sugar drop and tire you out.

Bright red blood is likely to be due to fissures from your constipation.

Your palpitations may have equally been due to omeprazole as well as the lactulose. The only way to know for sure is to try one at a time and see what your reaction is.

[Alikatte123 in reply to xjrs]

Thank you so much for taking the time to write such a helpful and informative reply. I was on the Second Nature NHS approved diet before Christmas this was a high fibre diet and made my constipation worse and made me feel quite ill. It stripped all the water out of me. So your comments about a low fibre diet made sense. Your comments about sugar also rang bells, as sugar certainly does send make me very tired.

I did look at the low FODMAP diet but wasn't sure if this would be right for me.

Yesterday, I ate a whole tin of prunes and a couple of figs and have felt so much better today. I also took a Gaviscon yesterday evening and that seemed to help me sleep. Interesting that you say the palpitations may me due to me taking omeprazole. I will try this out tomorrow to see if they cause palpitations when taken on it's own. I still have a dry throat probably due to GERD so I'll take a Gaviscon this evening which hopefully enable me to get a good night sleep and I'll use your pillow tip too. I do tend to sleep on my front which probably isn't helping. Thanks again for so much great advice. Glad you have found what works for you.

[xjrs in reply to Alikatte123]

Ouch, yes sleeping on your front will put pressure on your stomach forcing stomach contents up if you have a weak valve. In the long term it will affect muscles in the neck since the head would need to be at one or other side. I used to sleep this way - I think it may be connected to how babies used to be placed to sleep, so for some of us this comes naturally. When I had shoulder pain a physio told me to stop sleeping this way and to sleep on my side instead. It took a little while to get used to, but I naturally sleep that way now. For GERD they say the left side is best in terms of retaining stomach contents.

I haven't heard of the Second Nature diet. The reason why a high fibre diet might be giving you problems is that if you have a bit in the way of bad bugs in your gut getting the upper hand, the residue from the fibre will be feeding them and potentially giving you symptoms. Alflorex probiotic made me far more tolerant to fibre. The low FODMAP diet can be implicitly low fibre, but obviously this can have ramifications for constipation, though on the other hand it can help with the gases/GERD.

So glad that you have just found some relief. Good luck with experimenting.