Is it possible to have IBS without any diarrhea or constipation?

[Slothcheese]

Is it possible to have IBS with pain present but without any noticeable changes to your bowel movements such as constipation or diarrhea?

[Linley]

Any source of pain should be brought to your GPs attention.

[Slothcheese in reply to Linley]

Don't worry, it has been brought to the attention of my GP.

[DebbieSil]

Yes, I suffer the pain and burning sensation and lower back ache but generally don't get diiarreha or constipation. There are many symptoms to IBS. Had this for six weeks now.

What symptoms are you suffering with and for how long?

[Slothcheese in reply to DebbieSil]

Has a doctor formally diagnosed you with IBS despite you lack of bowel changes?

My symptoms started 7 weeks ago. I had to get emergency surgery 5 weeks ago to have a massive ovarian tumour removed. I thought my symptoms were due to the tumour but they have actually worsened since my surgery to the point I ended up in hospital at the weekend. I have severe stomach spasms, no medication seems to ease them. The spasms are triggered by movement especially. I am also nauseous and have no appetite, I've lost quite a bit of weight as can barely eat anything. I also had a bout of vomiting at the weekend. No diarrhea, a bit constipated but only since I started taking dihydrocodeine to try and help the pain. My stomach is also very bloated.

[Iesgobdafydd]

Yes that's what my IBS was like, and the cause in my case was TMJD rather than anything to do with stress or food intolerance.

[Hidden in reply to Iesgobdafydd]

I have this kind of IBS and also TMJD! Can you share a bit more of your experience or why they said that the one would cause the other?

[Iesgobdafydd in reply to Hidden]

Ok so caveat, I haven't managed to get on the same page with any doctor I've seen about my self-diagnosis, but I've spent a *lot* of time listening to what's going on in my body and while my interpretation of what I've felt is open to question it remains the best diagnosis I've had. I'm afraid this is going to be a long answer, I don't know how to give a short one and explain properly.

TMJD typically causes the connective tissue in the jaw area to distort and get misaligned. A dental injury happens, and in order for it to heal, the body causes the area to seize up if I understand what I've read correctly, preventing the normal flow of connective tissue in the area. From what I've felt in my body, it seems like it gets tangled up, like if you take a string and twist it too many times it forms a loop in the middle which makes a little knot. My theory is that having slightly hypermobile joints (which I have been diagnosed with by a specialist) has meant that instead of just the connective tissue in the jaw area getting twisted and distorted out of alignment, because the whole system is a bit more flexible the distortion can spread to a wider area not just the jaw area. Imagine us as marionettes and the connective tissue is the strings that make the puppets work - everything connects.

IBS is often caused by stress, and one of the symptoms of stress is tension in the gut. So it's not surprising that tight connective tissue in the gut, or lumps of connective tissue (those little twists/knots I mentioned get bigger if the twisting carries on and become lumps) cause the same symptoms as stress - IBS. What's kind of neat (but unpleasant) is that it seems like the physical discomfort of tight connective tissue or lumps of it in the gut area also tricks the brain into thinking I'm anxious and it goes looking for what it's forgotten that it needs to worry about. I am vulnerable to anxiety and organize my life to avoid stressors as much as possible.

My major presenting symptoms originally were fatigue, and lack of appetite / digestive discomfort / gas with some accompanying pains in my torso. I decided to pursue the digestive side with my gp - my hope was that the fatigue was caused by the digestion issues rather than the other way round, and I wasn't optimistic that seeing the chronic fatigue specialists would result in anything helpful. The end of that road was seeing a gastro specialist, who told me my gp was correct and I had IBS even though my symptoms weren't the classic pattern for IBS-C or IBS-D, I asked what she thought the cause was and she said stress.

By this time I'd read quite a bit about other people's experiences and was aware that stress often produces a quick and obvious response in people with IBS, worsening their symptoms. I'd already reduced the amount of stress in my life since getting IBS, and it wasn't helping, and there was no obvious correlation between times I was more anxious and times I was more ill. So what she said made no sense to me, but I kept thinking about it, and I remembered a conversation I'd had years before with my partner about storing stress, when we were exploring massage. He said he stored stress in his gut - it was often tense there though massage could help - and I had decided I stored stress in my jaw - there were very tight areas around where my jaw meets my neck which actually hurt a bit when massaged, and would only loosen very slightly when massaged. I thought, maybe I'm storing stress in my body somehow, and the IBS is caused by the longterm build-up rather than by a short-term response to immediate stressors.

To investigate this I decided to try lying down in a relaxed position with my eyes closed, scanning my body for possible tension, and focusing my inner awareness on any tension I could find, trying to make it release and relax. This is something I had learned to do from yoga classes, it's something they do at the end and it's actually easier to do after giving one's muscles a workout like that.

I had some limited success that way, but found that I was also experimenting with working particular muscles, tightening and loosening them, which seemed to sometimes help more with alleviating tense points than simply asking them to relax did. I eventually decided that the actual relaxation was comparatively ineffectual and the muscular work was what was actually making a difference.

I came across a description of TMJD online, and it immediately felt right to me that that was what I had based on my symptoms, and on my history of dental injuries at a spot where I'd had intermittent aching for many years and which was a point I kept coming back to in my muscular work.

A bit of cursory reading on the subject told me I could ask either a doctor or a dentist about this, and a doctor was likely to direct me to a physiotherapist. I tried the dentist, and was given a jaw exercise to try. I also sent for a book on TMJD, and tried the daily jaw exercises it recommended once or twice. I could feel there were major problems in my jaw and throat, for a bit I tried a method of focusing my inner awareness on the sensations from my tongue, and following the nerve path down through the root of my tongue - there was a lot of discomfort there to follow - to find where work was needed - I think that was when I was still trying the relaxation method.

Several years of muscular work later, my IBS is gone, and a number of minor symptoms have also gone - for example patches of dry skin on my elbows, and oedema in my ankles when the weather gets hot. I still have chronic fatigue, and get very stiff and uncomfortable - to the point of pain eventually - after exercise or standing. I've become very aware of my connective tissue and where it's causing pressure because it's too right and out of alignment. I know that I can always make myself feel much better by lying down and doing my muscular work on my connective tissue - usually I feel better quite quickly, but it can take up to an hour if I've done a lot, and on rare bad days it can take 24 hours. This is also emotionally calming.

When I still had IBS, I could feel the discomfort in my gut area affected and sometimes relieved by the shifting of the connective tissue as I did the muscular work. I could also feel the anxiety literally switch off sometimes when the movement of the connective tissue relieved pressure in my gut.

I mentioned the connective tissue forming twists that form lumps. At one point a few years ago I was working on connective tissue in my jaw and neck, and could feel the lumps there from the outside with my fingers - first appearing, when I guess I'd pulled them out of some more inaccessible area, and then getting smaller as I worked on them. I also have externally visible lumps from connective tissue in my feet and ankles - this is what was causing the oedema - and a small one behind my right ear that's been there for donkey's years but I didn't know that's what it was.

[Iesgobdafydd in reply to Hidden]

(continued)

My mental model of what's going on is that I'm pulling on the ends of long strands of connective tissue that are twisted, causing it to untwist. That's what it feels like is happening. There are sensations like something spinning, and sometimes when a lump is involved it bumps into something nearby again and again in a rhythmical way, like it's hitting it every time it comes round to it. There is also a gradual slow loosening, like you would expect when unwinding something. I've avoided reading about the actual biology of what might be going on - that's part of my stress avoidance, I found the book about TMJD was raising my anxiety levels for reasons I never really understood, so stopped reading it. So my mental model could be wrong, but it fits what I can feel very well.

That's probably way more than you wanted to hear and it might not even answer what you wanted to know. I'm going to leave it there but feel free to ask me to try again.

[MatthewU]

Yes, I've had the same as you for a long time, some periods of pain last for a few days, others have lasted for several months and all consume life and energy. The one thing that has helped me more than anything else is to 20mg citalopram each day, you can also try probiotics especially Alflorex and avoid wheat which may help.

[Tommyg279]

I have been diagnosed IBS without stool changes. I get upper abdominal pains and back ache but they found nothing on endoscopy or ultrasound. I have found cutting out dairy and gluten have eased my symptoms and cutting down on anxiety will always help. I recommend requesting tests from your GP to help ease your mind because until these are done there may be an element of doubt so then it’s hard to shift the anxiety. Good luck with it all- it’s not a pleasant ailment but it can be controlled.

[Slothcheese in reply to Tommyg279]

Thanks for sharing, Tommy. I have had an ultrasound and I'm awaiting a colonoscopy but could be a long wait unfortunately. It's quite complicated as I had to have emergency surgery 5 weeks ago to have an ovarian tumour removed. I thought the stomach spasms would resolve after this but they have become increasingly worse and are now debilitating. Just really fed up of the pain and nothing seems to ease it. Maybe I'll try cutting out gluten and dairy to see if that helps. I'm barely able to eat anything currently and have lost a lot of weight.