Is my experience with IBS normal/Any tips?

[Quackerz99]

Hi, I’ve had IBS for for around 4 or 5 years now and was wondering whether my experiences with it have been normal or if something else could be wrong also. I think my IBS flares are brought on due to anxiety more than diet as ever since I was at school I would get diarrhoea and pains nearly every day, no matter what type of food I was eating or medication I was prescribed. This flared up even more in days where I was particularly anxious and would cause me to have a lot of absences, as at times it was unbearable. This still affects me now with my work and pretty much anytime I need to leave the house for the day. The way I have dealt with this recently is taking Imodium or loperamide on any day that I am working (4-5 times a week) and any time where I know I will be out of the house for most of the day, this is mainly because it gives me peace of mind that I will be ‘safe’ having taken them. This gives me problems though when I am not feeling signs of an IBS flare up as I feel I need to take them just in case, this then leads me to take them way more often than I feel I need to. My problem is if I don’t take them I will worry about a flare up which then makes me anxious about going to work and being in immense pain and embarrassment. Just wondering if this is normal and asking for any tips people might have!

Thanks

[kleelibby]

Hi quackerz99, I get in the same loop of worry, which causes anxiety, which causes diarrhea. I avoid going out if my bowels are rumbling. I’ve sat on the nastiest public toilets because I just couldn’t hold on any longer. And I’m embarrassed to say I’ve ruined more than one pair of panties😲

I wonder if you have medical guidance? I didn’t when first diagnosed, I used otc remedies. Finally went to a gut doctor who helped me get some control over the flares.

[xjrs]

Have you been getting any help with your IBS? I used to get IBS-D when anxious/stressed, but if found some measures (such as low FODMAP diet/probiotics - see below) that helped my IBS even when stressed.

Here is some information about IBS that I have shared with others in this group which you might find useful:

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-...

[S969]

I have been taking Alflorex and enteric peppermint capsules for a couple of months and this helps. It took about 3 weeks to make a difference