Imodium

[Rainybean]

I've recently been having lots of stomach noises, passing lots of gas, urgency to get to the bathroom and soft/loose stools and sometimes it also happens during the night and wakes me from sleep. I was concerned so I contacted my doctor who ordered bloods, normal stool sample for testing and a FIT test (to begin with had no idea what this was but Google told me) all of which came back clear (fit test negative, stool sample normal, no blood present in stool, kidneys fine, liver fine, not diabetic etc) so was told based on my age (31) no further testing was needed as all those coming back clear are enough to rule out anything serious in someone my age. I have to speak with my doctor in a couple of weeks for a follow up, I'm finding though lately I need to take 1 imodium tablet evert 2-3 days to help me out. It doesn't cause me to be constipated, I still open my bowels every day it just helps make it more of a 'normal' bowel movement. Is this safe to do so? I've seen lots online say it is a very safe drug to take long term. Does anyone else do the same thing? I'm going to mention it to my gp when I have follow up in a few weeks time and see what he says

[Rainybean]

I should have added in post my gp said if I'm same when we speak for the catch up he would prescribe me mebevine, is anyone else on this? Is it helpful?

[Linley in reply to Rainybean]

Yes, I am on Mebeverine time release capsules and they have helped me. And yes, my Gastro said Imodium is OK to use long term. Also I agree with xjrs CBT can be most helpful if you are anxious😊

[Maureen1958]

Yes, one tablet every 2 to 3 days is fine. You might want to look into BAM (Bile Acid Malabsorption) because generally IBS is not a night time thing. See link below, just in case, it fits your symptoms.

gutscharity.org.uk/advice-a...

[Rainybean in reply to Maureen1958]

Thank you for your reply, does this cause lots of intestinal movements? Especially after eating, it's like something is going to break out of my stomach 😂

[Maureen1958 in reply to Rainybean]

Do you mean IBS or BAM? Well I guess they would both be more or less the same. I don't have BAM myself, was tested for it, but didn't meet the criteria. I certainly get a lot of movement inside me, which makes me feel sick and like I want to go to the toilet.

[Rainybean in reply to Maureen1958]

I've contacted my doctors today and asked for a call back, the doctor who called me back was a locum and when I was telling her my symptoms and mentioned bam she said she hadn't even heard of it!

[Maureen1958 in reply to Rainybean]

Why does that not surprise me. So what is she going to do?

[Rainybean in reply to Maureen1958]

She's suggested I buy peppermint capsules and mebeverine over the counter. Don't know whether to call again tomorrow and ask to speak to my normal doctor who knows what he is actually talking about

[Maureen1958 in reply to Rainybean]

If you think it could be BAM, I would. I know people do say that some doctors don't know about it! My doctor knew though.

[xjrs]

I used to have to rely on Imodium until I got on top of my IBS. There are many things that you can do to help yourself, so that you don't have this diarrhea any more.

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 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 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.