Diarrhea related terrible IBS

[Immigrant]

I have IBS diarrhea related all my entire life .I'm 36 now & can tell it is a terrible disease with many triggers which is hard to control as only temporarily can get relief from medicines or some foods.It affects mental health,overall health,energy & mood.It is a nightmare.Can anyone please tell how to control diarrhea for long time as I could only get relief from Immodium or eating some yougurt.

[Maureen1958]

I believe it is safe to use imodium long term. Have you heard of Bile Acid Malabsorption (BAM). Some people with diarrhoea prominent IBS actually have BAM. It may be worth googling it to see if it sounds like what you are experiencing.

[xjrs]

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 and Kings College fodmap apps, they 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 and you are still experiencing diarrhea, 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.

[Immigrant in reply to xjrs]

Thank you very much for your precious tips.I will definitely have in depth studies & applications of the above.Immodium is the only medicine that controls diarrhea in my case.Yougurt specially in foods does good for me & some foods with high fibre do well as well.I have to avoid caffeine & processed food .I do eat fruits regularly but eating them is of not so useful when digestion system is broken.I wish medical science can find a treatment for IBS.I always have diarrhea whenever IBS attacks & mostly it is after a meal.I can't remember if ever I had constipation .Trying best to keep & eat healthy.

[Batteria]

I know my management is drastic but it’s the only way I can get out of the house.

I only eat late at night

I force an evacuation by glycerin suppository every morning.

I take an Imodium tablet every other day.

This is the only way I can avoid being taken short. If I know I’m not going out I eat normally.

I know people who are even worse than me.

All good wishes

[Viklou in reply to Batteria]

Surely a glycerine suppositories and imodium are big contradictions. I would only take a glycerine suppositories if I was severely constipated then never followed by imodium every other day.

[Batteria]

No. My doctor and my psychotherapist say that anything that works is valid. And it works for me. Don’t do this without speaking to a professional first. I play the drums in one band and the mandolin in another. I can’t afford to void while on stage. Love and best wishes. Batteria (which means drums in Italian).

[Batteria]

Batteria here again. Also can I recommend the following:

The clever guts diet by dr Michael Mosley

He knows all about the tricks our intestines play on us. He’ll help set you out. Good luck immigrant.

Nota bene. You know of course that every other day means one day yes and one day no. Or, on alternate days? You regulate this yourself according to the consistency of your stool.