Lower Abdominal Cramps

[tdsmithj]

For almost a week now I have been getting lower abdominal cramps.

I normally suffer from IBS-D every once and a while but after a stressful time of my mum passing away about over a year ago I got a change in bowl habits and for 4 days I have cramps pretty much on and off all day every day. It would consist of sharp pains below, lots of trapped gas. I went to the doctors and did some stool samples and checks and all come back fine.

Now after about 6 months it has come back, I been more stressed lately and it has come back in full force and have had it for about a week. The symptoms are...

Lower abdominal pain when gas is passed through the intestine that makes me need the toilet briefly.

Mucus in the stools

Lots of gurgling sounds

passing water

Seems to come on more when active

Excess gas (this has helped when taking something to neutralise it.)

Pain seems to radiate from the front to the back kinda line I have a band around me.

Once it has passed I feel completely fine like nothing has happened. then a wave will come and the pain would start up until it passes through. normally about 10 seconds which would be extremely painful cramping. Cutting down my eating seems to help too.

Is it normal to have bouts this long?

[xjrs]

Sorry to hear about your Mum passing.

Unfortunately on a couple of occasions I have had IBS-D bouts in the past that lasted for 6 months at a time due to work stress.

Have you been getting any help with your IBS? Here is some information about IBS that I have shared with others in this group in case any of these tips are of interest to you:

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-...

If all of the usual IBS remedies fail, it is worth getting tested for BAM (Bile Acid Malabsorption), which can cause constant diarrhea - there is a separate test and treatment for that. Good luck.

[tdsmithj in reply to xjrs]

thanks you. I shall read up on this. I not really had any help but its something I have had all my life and mainly affected me in the mornings. Only since my mom passed I have had 2 attacks, which I never had constantly before one lasting around 4 days with constant cramping pain about 6 months ago and this one lasting 6 days and counting. I did go to the doctors for tests and all came back negative. I currently had a hot bath yesterday and a hot water bottle on my lower abdomen today and feels so much better. I have cut down my eating which helps.

thanks for the advice.