IBS or not

[Dexter1289]

I’ve had ongoing stomach pains for over 2 years, had ct scans, sigmoidoscopy, endoscopy, nasal gastosgraphy plus mri scan . I have a sliding hiatus hernia which my doctor thought was the problem, but they couldn’t find it ! Hospital have said all tests are fine, and abdominal pain is due to something like ibs . Have told my doctor my stomach still playing up and very constipated. So she gave me mebeverine which has made it worse . Has anyone taken the mebeverine with fybogel ? And does it work ? .. thanks

[Minty00]

Hi Dexter sorry to hear about your stomach pains All my life ive had stomach issues even as a kid . Ive had diverticulitis in 2017/18 lucky i needed no medical intervention it was painful mt abdomen has still not deflated properly since and ive got horrible IBS C I take one sachet of ordinary Fybogel every day sometimes twice it defo helps me to go rvery morning but i also think that my three coffees help in the morning to move things along my problem is if i eat things like salads i get stomach pain fibrous veg also causes me to get stomach pain so i think maybe look st what u are eating and eliminate them from your diet

[Dexter1289 in reply to Minty00]

Thanks for your reply, I’ve been using fybogel sachets but they don’t always work. Will give it a go and take it twice a day. I was told that golden flaxseed helps so I might look into that too. I still keep worrying that it’not ibs and I’ve not actually been diagnosed with it ! I think they say it could be as all tests are clear and there’s no answer for it ! Thanks for your advice and will up the coffee too . Take care

[Minty00 in reply to Dexter1289]

yeh i normally would take one sachet after breakfast and one in the evening after dinner and drink plenty of water all thru the day and evening aswell

[Dexter1289 in reply to Minty00]

Will do 😀

[Minty00 in reply to Dexter1289]

One more thing i do if u like banana try eating a couple during the day (RIPE) this helped me

[xjrs]

Mebeverine probably isn't a good idea with constipation since it is likely to slow things down.

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, so probably not a good idea in your case. Unfortunately I couldn't tolerate these. Linaclotide (for IBS-C only) & Alflorex have helped me with this intestinal pain.

The reason why Alflorex helped me is that my IBS started with a bout of holiday food poisoning. This led to a gut bacterial imbalance, which is true for many IBS sufferers. This imbalance can also be caused by other things such as restricted or unhealthy diets and stress. When bad bugs dominate the system, they can oversensitise the nerves in the gut too. When put together with visceral hypersensitivity, with the brain incorrectly interpreting signals and then the gut sending even more signals than it should, it ends up being a double whammy effect. If this is true in your case, something like Alflorex might help to bring things back in balance. When I took Linaclotide, it reduced my pain by 50%-60%. After taking Alflorex my pain reduced to zero and only comes back when I am challenging with new foods and before my body gets used to them (or I have to continue to give them up). Alflorex which has been scientifically studied for IBS has made me more tolerant to a much wider range of foods. Having a more diverse diet increases bacterial diversity in the gut. Bacterial diversity helps to additionally keep bad bugs away, in turn helping IBS symptoms. There is also the Nerva gut directed hypnotherapy app to consider. This helps to calm intestinal nerves.

Here are my tips on constipation (may be some repetition from above):

What is your fibre intake like? To improve constipation in the short term you can try ground flaxseed on your breakfast, starting at 1 teaspoon and increasing at 1 teaspoon every 2-3 days - you'll need to consume extra water with it.

These foods are also high fibre:

8-9 Prunes

2 tablespoon chia seeds (soaked for 10-15 mins in milk or non dairy milk with cereal or water)

Shredded wheat (or if GF: Nutribrex)

60g Quinoa

Wholewheat bread

75g Whole grain pastas (if GF: Buckwheat)

2 Hard pears

5 Dried apricots

90g Raspberries

1 orange (contain a natural laxative)

2 kiwi.

I find that I need to have 1 orange or 2 kiwi a day and then another high fibre fruit later in the day to help with BMs. Introduce new foods and any fibre increases slowly, starting with one new thing at a time, waiting for 2-3 days for a response and keep a food diary. You may not need to consume as much fibre as I do.

For breakfast I make a porridge of 4 tablespoon of oat bran and 4 tablespoon all bran (wheat bran), 2.5 small cups of water and microwave for 10 mins. I then mix in 2 tablespoon of chia seeds and 1 tablespoon ground flaxseed and leave to stand for 15-20 mins since the chia seeds need to form a gel. On top of that I place 8 prunes and eat. The best thing to do is to start with normal oats in similar quantities and, if needed, replace one of the tablespoons of oats with oat bran for a couple of days, carrying on doing this every couple of days until you get to 4 tablespoon of oat bran and 4 tablespoon of oats. Then start replacing with wheat bran in the same manner. You can then add the other ingredients one at a time. You might find you do not need the complete 'recipe' to have a BM. All these individual components are down to tolerance e.g. you may not tolerate wheat (see later about Alflorex), so it is best to keep a food diary (I do this on a spreadsheet) recording symptoms for up to 2-3 days after each change.

I also take 30 drops of ginger extract before bedtime to aid motility. You may need to work up the dose to say 7 drop increments each night.

Exercise can help with BMs. The government recommends 150 mins of moderate exercise (e.g. walking as if you are late for an appointment) or 75 of intense exercise (e.g. jogging) per week. I also have a bit of a walk around straight after breakfast to get things moving.

You need to ensure that you are drinking enough fluids (2 litres of fluid per day).

There is some good advice about constipation here:

theibsnetwork.org/constipat...

theibsnetwork.org/constipat...

There are also medications that help IBS-C (constipation dominant IBS). I suffer from IBS-C and have been prescribed Linaclotide for it. I also take Alflorex probiotic which has made me more tolerant to taking in the extra fibre I need for a BM.

Failing dietary measures, you can try Optifibre, which needs to be worked up to a dose according to instructions. You may not need the full dose - watch out for gas and increment to a level that is acceptable for you.

Some people are more prone to constipation due to their intestinal anatomy. Through colonoscopies I have been told that I have a long loopy (redundant) colon. This means that food takes longer to pass through and in the mean time the intestines have more time to suck out water from the stool, drying them out and causing constipation. I have found that I need to consume much more fibre than other people to have regular BMs.

I have also found useful having most of my food at meal times, leaving 4-5 hours of not eating between meals, eating my fruit snack before a meal. This means that your digestive system has time to process each meal. It also allows something called the MMC (migrating motor complex) to run which sweeps food waste from your small intestine into your large intestine. This only happens when you have an empty stomach. When people snack regularly, it prevents the MMC from working properly. I also find the larger meals help to push things along better than drip feeding through snacking.

[CrazyChickenLady]

I don't know if it would help in your case, but the low fodmap diet is helping me more than any meds so far. And it doesn't cost anything to try. Hope you find what works!