Any medicine recommendations?

[Dogloverintucson]

Hi all. I'm going to my primary doctor tomorrow because my IBS has gotten worse the past few weeks. Lots of stomach pain, diarrhea, bloating, nausea. I am wondering about antispasmodics...are they all they're cracked up to be? I'm no milk, low gluten, not much raw veggies or fruit already so not sure dietary changes will make a difference.

[Hidden]

I found getting off man made or highly refined foods and eating little red meat has helped me. I concentrate on fresh and natural foods. Now able to tolerate vegetables well, never been much of a fruit eater though. Getting better all the time, until I have an anxiety attack.

Then I start the process over again.

Three steps forward and two back all the time, but generally trending forwards. Tried most things over the years, gluten free, fodmap, no milk etc, until 4 years ago when I started down the CKD diet track. I have also minimised salt and sugar and stayed away from substitutes as well. Generally feeling better.

Anxiety is what trips me up all the time. Worrying about my health triggers a lot of it. Seems my cup is always half empty and never half full. Cure that and I have my IBS in check.

[Dogloverintucson in reply to Hidden]

Could be the same with me as far as anxiety. Thank you for your insights.

[Hidden in reply to Dogloverintucson]

You will be amazed and surprised how much anxiety and stress can affect the mind and body. Mimicking heart attacks to plain upset stomach and a lot of things in between to just feeling like crap for no good reason. Sadly I have no answers that I can use but plenty of ones that I hear regularly!

[bobbyrita in reply to Hidden]

I posted this before but since I have been on vraylar an antipsychotic for the past two weeks I haven't had any stomach aches, nausea and gas, It came on by a traumatic event over a half a year ago and that drug which helps all my bipolar 2 symptoms so far has solved all my IBS issues. I really had a ton of depression and anxiety. I think mine was all mental. I haven't tried all foods yet.

bobby

[Albertina_G]

Rifaximin is an antibiotic approved by the FDA for treatment of IBS with diarrhea. It works by reducing or altering bacteria in the gut. It has been found to improve IBS symptoms of bloating and diarrhea after a 10–14 day course of treatment.

[jointpain]

I was found to be gluten sensitive also very low on B12 serum on a blood test. I now avoid gluten and self inject B12 every fourth day. I now have no gut problems and can eat everything except gluten.

[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 excess gas, 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-...

[Dogloverintucson]

My, that's a lot of needed info. I think I am nerve sensitive. I do have internalized trauma and am doing talk therapy. I will ask about these things at doctor appointment today, thanks 😍👍

[xjrs in reply to Dogloverintucson]

Good luck.