New to IBS struggling to find a pattern

[Liquido]

Hi All,I have recently joined this community after I have spent the last 10 days in pain and after my doctor suggested that it could be IBS and as far as I can tell I tick all the boxes for IBS-C.

I have gone to the hospital where all checks were negative but haven't done a colonoscopy because they said it wouldn't be necessary, matter of fact they could not pinpoint my issue and just said to avoid milk and sent me home.

It is the first time it has happened to me and over the last week I have tried to keep a diary of what triggers the more severe pain bouts but I can't seem to find a pattern food-wise.

I have started eating a low FODMAP diet but that isn't helping much and from what I can see online there is a lot of confusion and discrepancy over what can be eaten.

Could anyone recommend a good evening routine or diet that works for them since it seems every evening if I eat anything after 7pm my stomach and intestines go haywire and I have to battle with pain all night. No amount of paracetamol or buscopan helps!

I am also getting more tired as days go by as I am not eating enough and that scares me, how long will it last I wonder?

Any halp would be much appreciated

[Pte82]

Are you staying hydrated? Look for natural diuretics you may be consuming. Also, look for anti-thiamine factors that may also be in your diet or medications. Low activated vitamin B1 (thiamine) may also be a factor for your symptoms. Magnesium is required for activation and a deficiency of magnesium can contribute to this condition. Adequate activated thiamine is needed by the brain and vagus nerve for proper function of the digestive system. Search on "SIBO thiamine" to gain a better understanding. Study the forms of magnesium and thiamine and look for those that are quicker to pass through the blood brain barrier. When emphasizing a B vitamin it is important to use a B-complex as a base, the B vitamins work better together. Always consult with your health care professional before using any supplement.

[Luisa22]

I have found it difficult to find a pattern with my IBS too, and it's been that way since the beginning. The Fodmap trial and reintroduction didn't show me very much, though that can help some people LOTS. Neither did keeping a detailed food diary for absolutely ages.

Whether my IBS decides to flip out on me or not doesn't even seem related to diet or stress, or sleep and tiredness either.

There are only about 3 things that seem to be present on each time my gut is worse. Those are often: the first few days of the month (though not always) bear in mind I am way past menstrual cycles! That makes no sense to me.

Then thunder on its way, and the third thing is awful dark gloomy days with endless rain.

But I'm not even sure of those being actual patterns and even if they were I wouldn't have the first clue what to do about them.

Sometimes there are obvious diet related things But on other days I can eat that same food and be fine.

For IBS C, yes, as Pte82 mentions, keep hydrated. That's so important. Fruits and veg might help you but the "gassy" kind like cabbage, broccoli, cauliflower etc may make things worse. I have heard that kiwi fruit is brilliant for constipation.

I have IBS D predominantly but occasionally it flips to C for a couple of days. Then I find brown rice with some kale or green beans or a slice of wholegrain toast helps me in a fairly gentle undramatic way. I always keep some wholegrain in the freezer for those times!

[xjrs]

Like you I have IBS-C with visceral hypersensitivity (pain). The things that work best for me are Linaclotide (for IBS-C and calms intestinal nerves) and Alflorex probiotic (since IBS pain can be due to a dominant bad bug in the gut over sensitising nerves). These may make you more tolerant to different foods.

Linaclotide is normally taken a little time before food, but I take mine at night since my IBS pain tends to be overnight. Everyone's food intolerances are different so no one person can tell another person what to eat every night with IBS, although there are guidelines regarding the FODMAP elimination and reintroduction diet.

The only thing with reducing FODMAPS with IBS-C is that is reduces fibre for the microbiome. However, fibre is needed far more with IBS-C so it could be counterproductive. In fact I did low FODMAP for too long and in the end I had pain no matter what I ate, because it can undermine the microbiome long term, making dominant bad bugs more likely, which then cause pain, so it is catch 22.

The best thing to do is try to get the symptoms under control so that you can have as wide a diet as possible, especially fibre (Mediterranean diet is best for the microbiome). This creates bacterial diversity in the gut which can help guard against IBS symptoms.

[Warriorofpain]

If its constipation, suggest with fybogel if it hurts , maybe lactulose

[richard_jw]

Hi you have my sympathy. I have suffered with IBS-C for 20 years give or take.

I have tried low FODMAP diet trying to find the trigger foods. I went to a "doctor" who came to the conclusion that pretty much all food groups would give me trouble. This was the result of a "prick" blood test.

The only thing which helped, and it helped a lot was prescribed by a gastroenterologist. After he did a colonoscopy which was OK, and he tried me on Fybogel and an exclusion diet (only eat the things which almost certainly won't give you problems, then slowly include others (did not work)

He recommended low dosage tri cyclical anti depressants. Specifically Amitriptyline 10mg at night.

It worked like turning off a tap. It worked for 3 months, increasing the dosage (to 20mg) after that helped somewhat.

I believe this does not work for everyone.

[Liquido]

Hi All, thanks very much for your messages they were really informative and helpful. An update from me: as I have had really bad flare ups pretty much every night for the past week and it has gotten worse every day, regardless of what I eat and how much I eat, I had to go to A&E last night and after more tests which resulted all negative, they sent me home and gave me cocodamol to take home to manage the pain during the night flare ups.

Also they have prescribed fybogel which I have just taken and I will follow up tomorrow to see if that helped.

Thay also told me to test stools for calprotein and coeliac screen and follow that up with my GP.

That being said, I have found this guideline journals.lww.com/ajg/fullte...

Online and I am trying to follow the recommendation mentioned in it there. Specifically the use of peppermint tea which seems to calm my pain after lunch.

Thanks all again for your help! All the best and I wish you all well

[IBSkidnestoneshirnia]

your pain killers/anti-inflammatory will only aggravate your problems.