Severe pain

[JoDaisy]

Hi

I am knew to this site. Lately I have had chronic pain in stomach going up to chest and partly in my back. My GP have said it's my IBS. I am on mebevrine medication but that gives me migraines. Can any suggest any medication. The doctor has offered me antriptaline for the pain but I'm not sure I want to take that because it is an antidepressant

[Nothingimpossible]

Hi. Welcome to the forum. Has your GP sent you for blood tests, stool tests,endoscopy? If not then I suggest you go back and ask for some tests to be done.

[JoDaisy in reply to Nothingimpossible]

I have been for an endoscopy and colonoscopy they were fine. I havent taken the Mevevrine for 2 days now the pain is still there but just dull. But the headaches have gone

[Hidden]

I take 6 - 8 Paracetamol a day

[JClaireS]

Hi,

I have been suffering with severe pain and related issues since contracting a tropical parasite. I would totally recommend the Amitriptyline. It has been really effective in terms of pain management. The dose you’ll get is much lower than the dose as an anti depressant. My advice is to try it because these issues could impact on your quality of life for a significant number of years.

[xjrs]

Here is some information about IBS that I have shared with others in this group - you will find some information about pain further down below, but the rest may also be relevant for your symptoms:

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. 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. Please note that at 10mg dose this does not act as an antidepressant, it acts as a nerve pain agent. Some doctors don't get this information across properly. In fact I originally rejected it for the same reason as you. 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 may also find assistance with enteric coated peppermint.

You can find some info on self management here:

theibsnetwork.org/the-self-...

[JoDaisy]

That you so much for your information. I have ordered books about low food map diet to try. The Alflorex you mentioned do you get that off your Gp or do you buy it. Another reason I don't want to take amitripitlyne is that the GP said it may cause drowsiness and because I work in a school I have to drive every day.

[Josepht110]

Sounds like acid refund. Do you have a nasty taste in your mouth ? If you do you need to take antiacid , maybe 30 g in the morning