Please help

[CaptainHowdy]

Hi everyone, apologies if this is a long one and very TMI but I would really appreciate some advice as I feel right at the end of my tether with this. I have suffered with IBS from the age of 17 (I'm 32 now) and it was predominantly IBS-D which seemed to be stress-induced.

Over the last couple of years it seems to have changed to IBS-M (mixed) and doesn't seem to have a trigger. It used to be that I'd only have a really bad attack once every few months, but it is getting more and more regular and I can't pinpoint why. I'm here to ask for help with food & diet to stop this from happening if possible. Here are my symptoms:

*Almost always happens in the middle of the night, and always after I haven't been able to go to the toilet for a day or two

*I wake up with excruciating pain in my lower abdomen, but when I go to the toilet nothing happens

*The pain steadily builds to the point I am absolutely saturated in sweat, literally dripping, and need to strip all my clothes off

*I feel extremely nauseous (haven't vomited yet but I feel it's on a hair trigger)

*The pain is too great to push for a bowel movement, I can't stay upright and collapse to the bathroom floor

*I lay there until the nausea & pain lessens a bit and drag myself to the toilet to try again. I honestly just want to die in that moment, the pain and nausea is too great

*This happens on a cycle for the next half hour until I'm finally able to have a BM

*The BM itself starts off hard with a rush of diarrhea behind it, almost like a cork blocking a bottle

*I then have intermittent cramps all night, backwards and forwards to the toilet with a little more diarrhea and gas.

*Feel very sore in the abdo area all day after.

I would be keen to know if anyone else has similar symptoms with their attacks, and how they cope with it. I'd also like advice on which foods I should eat to stop this bottlenecking from happening, as I think if I can stop the mixed BM's I won't have that horrendous pain experience as it tries to evacuate. I'm willing to overhaul my whole diet if it stops these harrowing attacks.

Thank you so much for your help and much love to anyone else suffering 💖

[FRreedman]

Hi, this is a difficult one, because we don't know your medical history. here goes, then, with a general (ish) response. First, you must stop drinking all alcohol and fizzy drinks, and stop eating peanuts, sweetcorn, Brussel sprouts, and baked beans. You should only eat small mouthfuls of food and make sure they are well and truly chewed before swallowing. You should aim to drink 2 litres of still water per day, and walk, briskly, for about 15 minutes each day. I have found that eating 2 kiwi fruits per day helps with BM. The next part of the plan (which is slightly controversial, so you may wish to check with your GP or GI team in advance) is to take a 300ml can of Coca-Cola (diet/Zero/or regular), but no other brand, and drink two cans, with meals, on the first day and then one can per day for the next 3 days. (I don't know why, but a few of us, on this site, have tried it and it works.) All I can say is put a dirty two pence piece in a dish and pour the cola over it, and then look at the coin, maybe it blasts its way through, I don't know.

Please let us know how you get on, and, in the meantime good luck and stay safe.

[Hidden]

Sorry your feeling so low which is very understandable. Getting blocked and then D is very painful, and lack of enough sleep adds to the perception of pain and ability to deal with it I know.

Have you spoken to health professionals regarding your change in bowel movements? Have you kept a dairy?

IBS network has a good one that can help identify triggers to your symptoms. Drinking plenty of water is usually helpful/ advised.

Different foods/ diets can be of help, we are all individual so what helps one may not another. I find pineapple or kiwi can be helpful, others may not. Many with IBS find FODMAP diet helpful as I have, speak to your GP about it, before trying anything.

[Tess359]

I have found that the low FODMAP diet has stopped my IBS C completely for the time being. I am also on a low Histamine diet because I suffer from chronic inflammation and myalgia. It's not easy and I have only been on it for a month so I don't know whether it will give long term relief or whether I will ever be able to eat a varied diet again. It may be worth seeing the doctor about your bowel movements as you may also have diverticular disease.

[xjrs]

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. 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.

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 only) & Alflorex have helped me with this intestinal pain. - Linaclotide also helps with constipation in some people.

Linaclotide and Alflorex in combination have reduced the pain I am in considerably so that 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, plus quinoa, wholewheat bread and whole grain pastas at other meals. 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...

Exercise can help with BMs. 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.

You need to ensure that you are drinking enough fluids (2 litres of fluid per day).

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

You can find some general info on self management here:

theibsnetwork.org/the-self-...

[Meeowla]

Hi, I’m certainly not qualified to diagnose you but I am qualified in knowing some of your pain!

I have IBS C and I stumbled across my hero some weeks ago, so my advice to you is check this lady out online her name is Heather Van Vorous and she is certainly in my eyes qualified.I hope you feel better soon.