Help needed to get on top of this IBS

[DebbieSil]

Hi, I was originally diagnosed with IBS nine years ago and I can only recall having bouts of IBS twice since then.

Now, I have been suffering with IBS almost every day for six weeks. I've had a blood test that has come back clear and have spoken to the doctor three times now.

Firstly I was prescribed meberveine which seemed to aggravate things, so I stopped after 10 days. Then I was prescribed peppermint capsules and Omeprazole. I've been taking these for three weeks now although I'm not sure if they are doing anything for me.

I am suffering with a burning sensation in my intestines and localised pain in my right side, then sometimes on my left side. Sometimes I get tingling (pins and needles feeling in my joints. I don't have any good days, just some slightly better than others.

I can't get on top of this and now it is getting really tiring, having to deal with this daily. I have a cry now and then. It's hard to try to ignore it as it's always there, and the more I think about it the worse it gets!

I know that it was brought on by anxiety, because I am an anxious person and I suffered a lot of anxiety as we went into the lockdown.

Any advice would be greatly appreciated please. Also, if my IBS was brought on by anxiety, would my diet need to be looked at too, to help control this, or not because it stemmed from anxiety? And, any other thoughts on what I can do to calm this please?

[FRreedman]

Unfortunately, once an attack has been brought on, it is difficult to know what to do to stop it. My suggestion is to go back to basics, so, don't drink any alcohol or fizzy drinks, stop eating peanuts and sweetcorn, Brussel sprouts and baked beans. Make sure you drink a minimum of 2 litres of water a day and also walk 1mile a day, briskly. You say the pain is more on the right-hand side than on the left, which leads me to believe it may be due to BAM (bile acid malabsorption) or maybe our gall bladder. It may be an idea to ask your doctor to check these two items out while he is giving you any other tests. Good luck and stay safe.

[Linley]

Since lockdown some IBS sufferers have found their anxiety has calmed and symptoms eased, like me, but others like you have found the opposite. Anxiety is a factor. Suggest you look into CBT, it helped me. As for diet if you have not changed it since going into lockdown it should be OK, but since your tum has become sensitive it may be an idea to cut out the common triggers as suggested by FReedman and see if it helps. If your IBS doesn't ease by the time we are out of lockdown suggest you contact the IBS network helpline. Keep safe!

[Rederic77]

Good advice from everyone. Definitely look at your diet and lifestyle. Being in lockdown effects both.

If you have someone you trust, talking helps with anxiety as sometimes we dig so deep that someone else who is not in that hole can give us a different perspective.

Now this works for me personally. In fact I’m suffering right now and applying it.

What I do is I boil the kettle, pour just plain water into a large mug. Laying as horizontal as I can and without scalding myself I take a small sip and exhale any air in my lungs completely once I swallow. I take my next breath followed again by another sip. Whilst doing this I’m resting the hot mug on the part of my abdomen i feel the contractions and go in a circular motion.

Sometime it works, sometimes I need a second or third cup. But I find it calms the symptoms and me down.

I too suffer from anxiety and I’m not sure if it’s the heat and breathing, but it helps.

[DebbieSil in reply to Rederic77]

Thanks for your comments, I'll give it a go. How long have you been suffering with this fare up?

[Rederic77 in reply to DebbieSil]

Hi apologies for the delay.

The flare ups individually lasts between 3-8 hours. Which means for me it varies. Normally it lasts longer than 3 hours if I’ve had a flare up after eating a large meal or I carried on eating meals despite feeling uncomfortable.

I’ve been suffering for over 10 years but I’m finally starting to change my diet and get serious with it. I’m really sticking to no gluten which seems to help and keeping a food diary.

[xjrs]

You mention that you have had blood tests recently. Have they taken a stool sample test recently too? Normally you have both before being cleared to say that your current symptoms are IBS.

Here is some information about IBS that I have shared with others in this group:

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. Generalised anxiety including being in lockdown can contribute to this. 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. There is an interesting infographic on this here:

gutmicrobiotaforhealth.com/....

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, increasing over a 3 day period and wait up to 4 days for symptoms. I go much slower than this - only introducing a small amount (1/4 to 1/3 of a normal portion size) 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 and your bad bugs are under control with a good probiotic. 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.

Since 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 only) & Alflorex have helped me with this intestinal pain.

You can find some info on self management here:

theibsnetwork.org/the-self-...

[DebbieSil in reply to xjrs]

Thank you for getting back to me. I haven't had a stool sample test as my GP said that they don't do this any more. I'll give them a ring and check with someone else. Are you from the UK?

[xjrs in reply to DebbieSil]

Yes. I am from the UK. Here is the NHS guidance on diagnosing IBS:

nhs.uk/conditions/irritable...

Your GP may arrange:

-

a blood test to check for problems like coeliac disease

- tests on a sample of your poo to check for infections and inflammatory bowel disease (IBD)

I don't think the blood test alone is going to give them the complete picture.

[DebbieSil in reply to xjrs]

Thank you

[asbayford]

So sorry to hear you're going through this! I would ask the GP about the low fodmap diet, sometimes they'll refer you to a dietitian. Monash university are the creators of this diet and have an app in app store, its honestly incredible, it's made my IBS 80% better. A food diary app is another to thing download and put everything that you eat/drink into the app, when you get a symptom - count back 6-12 hours, usually 6 to find the culprit x