Nausea

[Gillyflower18]

What do you do to handle the nausea that comes with diarrhea? I’ve been under a lot of stress at work along with the covid thing worrying me. Yesterday I had a bad attack. My body said enough already! I even threw up a lot. I’m being careful and quiet today. I’d appreciate any input. My stress o meter is maxed out!

[Maureen1958]

Hi, I tried Pepto Bismol last week for the first time. It did help with the diarrhoea (maybe a bit too much) and I also noticed it helped with the nausea too. It might have been a fluke but might be worth a try! I haven't found anything else that has helped with nausea.

[Gillyflower18 in reply to Maureen1958]

Thank you for your kind reply. I think everything is just heaping up on me and making it all worse. I’ll try your suggestion. I can’t believe they don’t list vomiting as part of ibs! The diarrhea is enough to make you throw up by itself!

[Viklou]

Cyclizine

[xjrs]

Vomiting is not a usual symptom of IBS. It is worth contacting your doctor or 111 in the UK for a diagnosis in case this is due to another reason or a bug (which means that you should be off work). Nausea is normally caused by trapped gas - Rennie Deflatine can help with this, but it's not a long term solution.

To reduce your IBS attacks in future, 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, regulating bowel movements and reducing stress.

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.

[Gillyflower18 in reply to xjrs]

Thank you for your kind reply. It’s a lot to take in! I think the vomiting happens because the diarrhea is so nauseating. I’ve had the test and am not working till I get the results. Ibs is only one of the chronic things I’ve had to deal with. Several doctors think it’s go to.

[Gillyflower18 in reply to Gillyflower18]

Sorry last sentence d Should read fibro

[xjrs in reply to Gillyflower18]

Good luck with it. Hope you find the answers and treatment that you need soon.