Ibs... Something?

[Ruralquirks]

Hi all, so I'm not really sure how to best "class" my Ibs.. I am quite fortunate that bloating and tummy pain only happen a few days/week before my period starts. I notice most problems happen the week before my period. I sometimes get loose stools, or complete opposite, I do hard small nuggets, and cannot completely empty my bowels. I also struggle with feeling sick sometimes and lots of gas, but I normally drink peppermint tea or take Senocalm for that, and it does calm it down. It's just difficult when my bowel movements change, what is the best for me? I've been taking Alflorex for nearly two weeks now and that has been helping..

[Linley]

Do you get painful/heavy periods?

[Ruralquirks in reply to Linley]

I get heavy periods, I use to suffer with period pain that would make me cry and bring me to the floor, but I'm now on the yasmin Contraceptive pill and it has worked wonders for me.

[Linley in reply to Ruralquirks]

The reason I ask is that ladies with confirmed IBS can get bowel fluctuations when our period is due as our bodies release hormones (prostaglandins) which can stimulate all muscles and as we have all our bits in the same area its not easy to work out what's causing nausea, diahorrea, heavy bleeding and pain. Is it IBS or is it a Gynae related?🤔

[Ruralquirks in reply to Linley]

Oh okay I see. I have had some gynaecology tests done, such as an ultrasound on my ovaries and all those bits and bobs, and swab tests. All seem okay! X

[Linley in reply to Ruralquirks]

OK so you know your own body better than anyone else. If your symptoms change/or you get more pain from the area of the ovaries then a Gynae prob may be the cause. If you are sure it is your IBS then xjrs has some good suggestions for you. Wish you well 🤞

[Ruralquirks in reply to Linley]

I know that my blood tests will be testing for coeliac, any inflammation, my kidneys, liver and thyroid

[Ruralquirks in reply to Ruralquirks]

Oh and a full blood count

[xjrs]

Keep going with the Alflorex. It has changed my life. It can take a couple of months or so to reach full effects.

In case these other tips are of interest to you, here is some information about IBS that I have shared with others in this group (I mention Alforex in the below information too):

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.

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-...

[Ruralquirks in reply to xjrs]

Thank you so much for this! That's really thoughtful of you and I really appreciate it! Have a blood test next Friday morning and have to do a poo sample (yay!!) to make sure we're all good in that department 😅