I have been suffering diarrhoea for the last three months, sometimes up to 10 times per day, that has settled down and got it down to around 2 times a day provided I watch what I eat. My stools are very thin from what they were before this started. I had a colonoscopy last Sunday and apart from a single diverticula which the surgeon said was diverticulosis and of no cause for concern, however the symptoms which I had before the colonoscopy are still there. So what now? He discharged me and said no further treatment necessary. I wonder now if the symptoms are nothing to do with the bowel and maybe something to do with the liver or pancreas. Advice please. Thanks.
Colonoscopy Clear: I have been suffering... - IBS Network
I feel for you. I developed a problem over a year ago. I'm 77 - pacemaker, blood cancer and other bits and bobs. Recently had: colonoscopy, gastroscopy, 2 CT scans - small intestine and pancreas. Similar to you. As far as I know nothing has been found though still waiting for Consultant's letter to GP. Problem started with episodes 4-5 times a day but now settled to once or twice with loose stools, often explosive and very urgent. Tried to find out if GP had got the hospital letter yet as I am really fed up and exhausted. Phone response late in the evening from an overworked GP after my having filled in an eConsult form (only way to communicate with the Surgery). New Surgery - GP whose English is not first language. Had a probem following our convesation. He insisted he was only interested in the colonoscopy result which he had. Said "IBS" and prescribed Mebeverine. The packet says that they should not be stopped without medical advice and I have been given a month's supply. Still shaken by the news and uncertain about starting them before Christmas as it will be difficult to plan for '20 mins before a meal'. Given no advice about diet or anything. Websites rather confusing. All of this started after a heart operation in April where I became within seconds of dying - my bp flat- lined and I had an emergency sternotomy to open the sac around my heart which was full of blood clots which was severly restriciting my heart rate. A tough year. Glad to find this site. Hope you get some answer soon.
With regards the mebeverine, if I was you I would wait until after Christmas before starting it. It never did a lot for me when I was given it about 30 years ago. Regards the packet saying they should not be stopped without medical advice, I would ignore that. I just stopped them and nobody questioned the fact that I didn't ask for any more!
Hi Eadaoin, thanks for the reply, I know how you feel and wish you well, you seem to be having a really tough time. I do not know anything about Mebeverine unfortunately so cannot help you with that. Hope you get a proper diagnosis soon.
I would say it's "just" IBS. That's what happens, they do a colonscopy and if all is okay you get a diasgnosis of IBS. The fact that you say you have got your toilet trips down to 2 from 10 times a day also would also indicate this is the case. You don't say if you have diarrhoea or constipation prodominent IBS. I would point out that there is something called BAM (Bile Acid Malabsorption) which can give you diarrhoea about 10 times a day. See link below to see if this applies to you.
Hi Maureen thanks for the reply. I checked the link you left. I will make an appointment with my GP after Christmas to discuss it further. I do not have constipation just loose narrow stools as I said in OP. For 3 months however I had explosive diarrhoea up to 10 times a day, even Imodium would not stop it. That slowly tailed off to two times a day of semi solid. It is strange, I have looked up every illness there is to look up about it but all usually come with other symptoms which I don't have. I had stool tests which showed no blood but did show an elevated calprotectin level hence the colonoscopy. Anyway at least they didn't find anything horrendous with the colonoscopy. Have a good Christmas.
Go dairy free .. stop cheese. Replace with lacto free cheeses/milks and you will be amazed!
if I were you I’d be delighted they had a full look at everything without finding anything. I’d highly recommend the FODMAPS diet which has helped most people. Just have a look and see the foods that don’t work with a sensitive gut. Also probiotics are good for getting stools back into routine. Plus look at digestive enzymes to help your body digest the food it has. Everything is rushing through you with your colon in spasm and shock. The food doesn’t have time to allow for essential nutrients to be absorbed. Use lots of ginger, eat little fats and processed foods, and the worst thing you can do is worry which is mostly where this all stems from. Good luck with managing it all. I know exactly how you feel!
Do you have any other symptoms like an increase of gas or aching stomach etc?
I'm surprised that they didn't offer you any further help or even refer you to a dietitian.
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:
This is why it’s worth trying probiotics such as Alflorex (which has been scientifically studied for IBS) 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:
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:
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.
If colonoscopy clear and symptoms still present then it’s back to further investigations. See gp again. If the gp discharged you then it is time to change your practitioner. Con amore Bx
Hi I don’t know if this will help but I had a lot of problems following surgery where I lost 2/3 of my small intestine and 1/3 of my large intestine. I had had a stoma but this was reversed. The surgeon just said my bowels would never be the same and that was all the advice I was given. After struggling with bowels, and IBS symptoms and diet for over 2 years I have now found that cutting down on lactose (as mentioned by others) and fibre has been very helpful. I am now restricting fibre to low fibre and keeping to a low quantity - this has really made a major difference. I hope you make some progress soon.
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