IBS: leaving the house

[loveanimals1]

Hi, this is my first post and I'm always scared to go out (especially with people) mainly due to my ibs. I find it very embarrassing and anxiety provoking. I was wondering if anyone had any tips on coping with this

[bookeater]

Are you taking anything that help you? Have you had a gastrologist appointment as well to make sure it is IBS?

if the situation is causing stress maybe you need to talk to your doctor to see how they can help.

[ANB80]

Hi. I too worry about this all the time. Everyone is different though. I plan out every journey to make sure there are toilets around, and I make sure I know where they are. I also take loperamide 3 times a day to try to slow things down, which helps a lot. I also take Psyllium Husk too, which was advised by my Gastroenterologist. I also suffer with anxiety with all this so I have been prescribed Amytriptiline, which I take before bed. Oh, I also take Alverine too, twice a day.

I changed my diet last year to only eat low GI foods, as I suffer with Hypoglycaemia too. This also includes mainly eating gluten free foods, and I have found this has significantly improved my IBS.

All of that helps but I still have odd days and flare-ups where I don't feel I can leave the house. But I am able to leave the house more than I have to remain.

Sometimes I take a loperamide tablet before leaving the house. I also take with me some Peptobismol tablets just in case it goes bad. These are great! But only take them in an emergency. I call these my emergency tablets.

You have to try things to see how your body reacts.

[Carlettejaque]

It's very difficult to have a social life with bad IBS. People just don't understand the need to be near a toilet and the restrictions in diet if eating out. Eating out for me is impossible.

I do hope you are following the low Fodmaps diet. That's soluble fibre foods only. I was told not to eat fruit but to eat what veggies I could. The only veg I can eat is well cooked carrots. Actually, that made a huge difference. But, I can't eat oats. High fibre is not good.

If you haven't already done it, do an exclusion diet. Start with all dairy. Check all ingredient lists for lactose, milk and when powder. Then try yeast. Then wheat. You need to do it for 3 wks.

I suffered terribly for 7 yrs until I discovered I had dairy intolerence. Cut it out and My life changed back to normal with the exception that I couldn't eat nuts, lentils and seeds. They don't break down in the gut.

I really feel for you. It's very difficult to live with and doctors in general can't help. Good luck.

[xjrs]

Have you been formally diagnosed with IBS by eliminating anything else by stool and blood tests via a GP?

It can be possible to get on top of symptoms so that you feel more in control when you go out.

IBS can be due to a number or combination of factors - these can be stress (including stress from early life experiences) which impacts the communication between the brain and the digestive system. There are lots of free webinars online at the moment regarding mindfulness meditation which might help. Plus you can ask to be referred for CBT or something similar to reduce your anxiety - I would have thought online appointments are available. Exercise can play a major role in IBS in terms of reducing stress, helping your gut microbiome and regulating bowel movements.

There is also not absorbing certain types of carbohydrates called FODMAPs very well, the residue ending up in the colon and bacteria feeding off them causing symptoms. Ordinarily feeding gut bacteria is a really good thing - when you feed good gut bacteria these produce by-products that have great health effects in the gut and throughout the body. However, in some people with IBS bad bugs might have the upper hand over good - these bad bugs may cause symptoms such as pain or disordered bowel movements. This is why it’s worth trying probiotics such as Alflorex (which has been scientifically studied for IBS) or Symprove to crowd out the bad bugs and make their numbers die down. If that doesn't work you can try the FODMAP elimination and reintroduction diet. This is normally under the guidance of a nutritionist via GP referral - this may not be possible at the moment so you can read about it online. If you download the Monash University FODMAP app it will tell you which foods contain FODMAPs and in what quantities. You can eliminate all FODMAPs for 2 weeks and then introduce each type of FODMAP one at a time starting in small quantities and wait 2-3 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 for longer and then try to increment again. I've read your microbiome can adapt to handling a new food if introduced very slowly. Ideally you want to eat as many FODMAPs as you can since they are good for your health. Many people with IBS don't have diverse gut bacteria - it has been found that people who lack a diverse microbiome are more prone to diseases in general. In the long run, if you can get your symptoms under control, the ideal situation is to have a very varied diet - lots of different coloured fruits and vegetables, a variety of protein and carbohydrate sources including cereal fibres. This may seem a long way off, but with the right treatment all of this is possible. Last year all I could consume to control my IBS was white rice, protein and limited low fodmap veg. Using the approach above (particularly introducing Alflorex) I am now able to consume far more foods - more than I've ever dreamed of including wholewheat bread which is unheard of for me.

If you are also suffering from pain. You may be suffering from visceral hypersensitivity (functional abdominal pain) - there is info about it here:

iffgd.org/lower-gi-disorder...

It is where the brain interprets the normal activity of the bowel as pain - this is due to a wearing down of neurons in pain control centres of the brain which can be caused by PTSD, neglect or abuse in childhood, extreme stressful events etc. The first line treatment is nerve pain agents such as low dose amitriptyline. There is a theory that being on something like amitriptyline for 6-12 months can help the pain control centre neurons to regenerate. Note that amitriptyline can cause constipation, but this can be helpful in people who are diarrhea dominant. Unfortunately I couldn't tolerate these. Linaclotide for IBS-C & Alflorex have helped me with this intestinal pain.

You may also find assistance with anti-spasmodic medication such as mebeverine (Colofac) or enteric coated peppermint.

You can find some info on self management here:

theibsnetwork.org/the-self-...

[TaraqMahmood]

Best thing I can suggest is speaking to your friends that you are going out with to tell them about you having IBS and your worries.

They will be supportive and if you’re in a place you got to go, they will know what’s going on with you and go to places where there are toilets

Speak to your GP too asking if they can refer you to someone for cognitive behaviour therapy...that will help deal with the stress you get thinking about it

[Viklou]

When I go out which I have to most days I have an emergency kit in my car. Spare clothes, underwear, loo roll, wet wipes and a bucket just in case. I have had accidents usually because I can't get through my front door quick enough. If I'm flaring I stay home as sometimes it's painful and I can't function. Not safe to drive. If on site I wear depends as they're ok for short term sharts.