Hi there, 26yo female suffering with debilitating daily morning diarrhoea followed by incomplete evacuation, where it feels like my muscles just stop moving and there's an obstruction. I was diagnosed with IBS in 2020 when symptoms started, tried fodmap diet, mebeverine, linseeds, anitbiotics for suspected SIBO, antidepressants but no positive improvement. Recent Fecal Calprotectin was significantly raised at 361ug, but colonoscopy and biopsies returned normal. I also had lower GI physiology tests that shockingly returned normal as it definitely feels like my pelvic floor is out of whack, and I am straining every day. At my wits end with this condition, my quality of life is really poor, eating is now just functional to keep myself alive, severe depression has developed along with suicidal ideation. Nothing feels real and I am not sure where to turn to. Things are also not helped by a lack of explanation or way forward re: treatment with NHS gastro and I can't seek private healthcare as it is classed as preexisting. I haven't met any IBS sufferer with my symptomology which leaves me hysterical in my isolation!
Incomplete Evacuation and Diarrhoea: Hi there... - IBS Network
Incomplete Evacuation and Diarrhoea
Hi. I am so sorry to hear about your situation.
First of all, recognise that you have taken the first step to a positive outcome by joining this IBS network and secondly, and more importantly, please be reassured that you are not alone and we are here to help you in anyway we can!
In the seven years that I have had IBS, I have never been on any kind of medication or used things like Buscapan to alleviate my symptoms. Although I confess that I have come very close to doing so, but something has always stopped me. I know that I have a sensitive stomach and taking any kind of medication will only interfere with the gut!
I try to eat as normally as possible but I know that if I certain things and/or late at night then my IBS will flare up and I have to deal with consequences.
Reading between the lines I suspect that you might be quite stressed and anxious with everything! Be kind to yourself and take some time for yourself. It is ok to be selfish!
Whenever I have a physical sensation in my body, I get anxious very quickly, become nauseous and worry about my health. I also stress out a lot with having a teenage daughter who I find difficult to connect with at times. I also have problems with social anxiety. All of these contribute in making my IBS worse.
Having said all this, what I do know that the IBS symptoms will improve (not overnight unfortunately or even a few days). Feeling better is achieved by exercising regularly, getting out in nature, eating healthy by eating plenty of fruit, veg, nuts and kefir (yoghurt).
I am also believer in doing things that I really enjoy every single day, whether it is a hobby, or treating myself to a 'Costa'. I also get empowered by being able to help people like yourself with advice in this group.
Since about the first week of the new year, my IBS has settled down and I am in a happy place and I am confident you can get there too…
No one who doesn't have IBS will ever truly understand our situation! Hopefully you have an understanding partner and friends but I know that isn't always the case.
Remember, you are not alone and we are here for you.
Take care. x
Thank you so much for such a thoughtful and affirming response. This has drastically changed my life to say the least, and gets in the way of so many personal goals I have for myself especially my PhD, to the point that I am considering quitting my programme. Much like you I want to avoid medicating myself beyond natural supplements (peppermint capsules, Senna etc). I could probably do with upping my fruit intake, but I feel scared to have more frequent bowel movements and more sensations of incomplete evacuation. I will brave this anxiety though and see how I get on. Most definitely stress and anxiety are huge triggers for me, and I need to really interrupt the vicious cycle, although much easier said than done! I love the idea of treating yourself everyday! I would like to get to the point where my life doesn't feel like such hard work, although I am optimistic about that I just wish it were a lot quicker!
Have you tried or are you aware of physical support groups by any chance? I feel it would be helpful for me to also have conversations like this in person.
Do you also have any suggestions for how you manage your daily routine? I feel I am constantly running behind trying to manage symptoms and fit in my routine.
Please don't give up on your PhD and don't let your IBS rule your life!
Yes there are times when IBS can be really difficult to live but I know that there are times, like now, that I am in a really good place and wouldn't even know that I have IBS.
My bowel movements aren't perfect and every day is different. I don't worry if I have diarrhoea one day and am constipated the next. I just continue to eat has healthy as I can and it keeps my anxiety and stress at bay!
Be patient with everything that you do and give yourself time to recover from IBS flare up.
I think there are support groups out there and I think there is one in Liverpool near to where I live but haven't gone down that route as yet. I agree it would be helpful to have a one to one conversation with a fellow sufferer.
Perhaps we should set up a Teams meet up within this group so that other people like us could get the help and support we need. Not sure how you would go about this, perhaps you are more tech savvy than I am.
Alternatively I would be more than happy to converse on the phone if that is of help to you!
Take care.
hi just reading your story I too have had bloods showing calprocetin levels high also had a colonoscopy and a gi one same they came back normal has been prescribed medicine from my gp which don’t help much I do suffer from nausea has well when I not feel great with my ibs im also too do suffer from bad excessive gas which disturbs my sleep I hate how it affect my day to day life especially when I have children who depend on me I find this quite a struggle I been looking at online and come across Nerva which is a subscription for gut and health I have signed up has there’s a lot of information on how to mange the gut to brain maybe see this would help I started yesterday so only on day one but hoping it does help me has my symptoms seem to be more and more and different symptom which doctors say to do with ibs like fuzzy headaches pins and needles lack of energy .
Hi Foody79,
What do you eat in a typical day?
Hi at the moment I’m find it hard to eat big meals I usually try have probiotic yoghurts scrambled eggs or plain omelette has I find it ok when I eat it I struggle with a lot of food soon has I eat it with 10 mins I feel nausea and stomach gurgles since I had this flare up it lasted nearly 6 weeks now but still feel uncomfortable I had numerous test done colonoscopy ,gastrocopy and gi endoscopy and full blood count done including me b12 my calprocetin level was 619 ng/ which indicates that 98%chance of been ibs/ibd and that shows on the test I had done
Thank you for sharing and strong relate! biggest impact is on my PhD which I thoroughly enjoy but I never feel like i have enough hours in the day to take care of my symptoms and study. But of course my relationships (romantic, platonic, family) have all suffered too, just feel so guilty that I am not as happy as I used to be.
Oh yes another nerva recommendation! I think I'll give it another go. I have tried meditation and hypnosis and I hate to think it doesn't work for me. I did find nerva soothing when I did try so I'll see if it is about commitment. Keep me posted about how you get on!
You don’t mention if your gastro tested for Bile Acid Malabsorption (BAM). Daily diarrhoea is a red flag for that condition and is frequently missed. I can’t see why a private consultation would not be possible, all you need is a referral. My diagnosis was made privately after many years of frustration with GPs who incorrectly kept referring to IBS. You are so young and I feel for you having to deal with your condition which is not yet managed. You need further expert help. I suggest you look up BAM and see if you recognise the symptoms.
Hi Whitesugar, I hope you don't mind me reaching out to you. I have chronic diarrhea and have symptoms that could be BAM. The dairrhea comes on like attacks, no time to react with left shoulder , neck and back pain,headache, a slight rise in temperature, nausea, fried foods seem to cause a fast reaction. My test for calprotectin was slightly elevated. The new Gastro doctor I am seeing wants to do scopes. After reading so many posts, I don't want to just rule out things with no answers. I was already underweight and lost 16 pounds in the last year. It is my neurologist who referred me to the gastro doctor thinking this may be linked. Does this sound like BAM at all. Thank you so much for your help.
Healing hugs.
Hi Whitesugar, I forgot to mention, I also have lupus and hyperparathyroidism with othe issues and anemia off and on.
Healing hugs.
You sound a lot more complex than me and of course nobody on here can diagnose medical conditions. My experience of BAM syndrome is sudden gurgling in the descending colon (left side of your abdomen) followed by uncontrollable diarrhoea. There was no obvious trigger. Over 40 yrs I had looked at my diet many, many times searching for a link. As you can imagine I had some terrible accidents as there was no warning. I would certainly feel very unwell, no pain as such, just very sore and nauseous, but no temp. If you understand the mechanism of BAM, it makes sense that fried food would trigger an attack as bile is released when we eat fatty foods. If you are able to ask a gastro if you may have the condition it could be worth it. I don’t know how many doctors consider it. I asked mine and he very reasonably agreed it was possible. There is a test, but he decided that I should trial the medication. This has worked for me like a miracle. Not a cure but a route back to normality.
Thank you so much for your response. I have the accidents as well and although tried to figure out food connections, not sure of anything. I am going to agree to the endoscopy that looks at the small intestine, but I think depending on what that shows if anything to see if he will consider BAM. I go from being quite sick andthen diarrhea to all of the sudden it just happens with barely any warning. AT this point I am frustrated and depressed. i know you understand that it rules your life. Again, thank you so much. Glad to hear that you arehaving some good results. I hope they continue.
Healing hugs.
I had almost identical symptoms for nearly 40 years. Then I took charge of my own B12 deficiency treatment and, apart from the occasional dietary indiscretion, am almost cured of it. So is your B12 high enough? If so it's something else, but might I add my thoughts on mebeverine - it gave me most severe cramping in my abdomen - and linseed - which made my diarrhoea worse, foul smelling too. Can I take it you've used loperamide to slow everything down? I was also tested - negative - for gut parasites. I don't know if they still do that, but it's a thought.
I forgot to ask if your stomach and pancreatic enzymes had been tested?
Any suggestion that you might have tenesmus? This is a very common feeling of not having completely evacuated the rectum even though there’s nothing there. It would be odd to have diarrhoea at one point, immediately followed by constipation. I certainly have tenesmus, have developed alternating IBS, but try to avoid straining as it usually moves on its own accord given sufficient time. You might find it helpful to discuss this possibility with a health professional, then you can concentrate on the IBS-D.
Sorry to hear about what have been/going through. Do you think that your diarrhoea might actually be overflow diarrhoea whereby liquid food seeps around impacted stool?
If this is the case, might be worth working on fibre in your diet. Though this can be problematic for IBS sufferers. However, Alflorex probiotic helped me over this hurdle since it helps to digest complex carbs and helps to kick bad bugs into touch which so often contributes to IBS. With Alflorex, I can eat a much wider diet including wholemeal bread which was unheard of for me.
If you think that constipation is the root of the problem, I can post detailed advice on this to you if needed.
I can also recommend the Nerva app.
If you've had to severely restrict your diet to control symptoms, this might have been what caused your high calprotectin reading. I am pretty sure that my reading of 327 (after which I was still diagnosed with IBS) was down to the highly restrictive diet nutritional therapists put me on (which I'll never do again). I read some research that a low fibre, high protein diet can cause inflammation in the body. The year before I went on this highly restrictive diet my calprotectin was normal. Restrictive diets also make IBS worse in the long run since you're not feeding your microbiome, which is required to keep the good bacteria healthy enough to keep bad bugs under control. The bad bugs can cause IBS symptoms. The Mediterranean diet is the best diet for the microbiome but you need to get yourself into a position where you can tolerate more foods. Both Alflorex and Linaclotide (for IBS-C only) have helped me with this. Linaclotide helps to calm intestinal nerves and speed up motility (though doesn't for me), though you'd need to be sure constipation is the root of the problem.
Hopefully, if you can gain more control over your symptoms, you can focus more on your Phd, since it is such a positive thing to do for your mental health. I had overflow diarrhoea myself and it meant that I couldn't leave the house. Now I lead more or less a normal life apart from some residue food intolerances to deal with which prevents me from eating out.
Hi there, this was really useful. I’ve been told that impactation might also be at the root, but I’m so confused why I’m having daily bowel movements but still impacted? I usually only have one bowel movement a day which starts as loose stool followed by incomplete evacuation. It feels like a mix of IBS-D and C. Initially when my symptoms started i had more urgency and frequent bowel movements but still incomplete evacuation. It feels like I need to get the balance right where things I’m trying don’t tip me to either more loose stool or more strained bowel movements. Would be great to talk to you more about some things you’ve tried if you have the capacity. 🙏🏾✨
It is possible the 'loose stool' you are experiencing is the overflow diarrhoea. The incomplete evacuation may be the impacted stool. Many people who feel they have mixed D and C may have overflow diarrhoea.
All you can do is very gradually and very slowly try to increase fibre. My tips on this are below - note only try one new thing at a time in small amounts - preferably get onto Alflorex on a 3 month trial first to help you tolerate more foods if you feel this is necessary. This doesn't work for everyone but worth a punt. It may help you without you needing to make further changes (always keep a food diary for anything new, including Alflorex and monitor for 2-4 days depending on your turnaround time - mine is 48 hours):
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.
Note that fibre can be needed even with diarrhoea since it can help bulk out stools.
Hi Unroolygut, First, I like you name. I think you have gotten some good advice. I feel for you so much because you are so young and need answers and deserve to feel better. I deal with different diarrhea issues, but I know how horrible it is to have your life constantly disrupted and no answers to why. The more I read about gut issues, the more I feel that the doctors don't have answers. The important thing, is don't give up. I don't know how you feel about counseling, but I am worried about your depression on top of everything else. I know that finding someone who is the right fit is hard, but if you do, it can help to feel unconditional support. Even friends and family can't understand what you are going through. They can't understand that you have not control over this.
Sending you many healing hugs and hope.
Hello UnroolyGut,
Keep it simple.
You don't need fibre, fruit, veg, nuts, grains, linseed, flaxseed, or any seed. Fibre isn't necessary for bowl movements, but fat is.
Eat nothing but meat, fat and salt. Drink water.
Try it for 30 days.
Read Unroolu Gut this morning. First, I agree with Mountain Hare. U are not alone. Remain calm. Relax. Drink lots of water. Eat fiber supplements like flaxseeds & Psyllium husk. Pour some on everything u eat, like cereals, lunches, dinners. Get regular exercise. I maintain my walking schedule on a daily basis. I am 87 & have had chronic constipation--until I learned to manage it with a low fodmap diet & supplements & even laxatives. I stay away from all dairy & all sugar. Unlike Mountain Hare, I do not eat yogurt.
I had IBS with all your symptoms for 20 something years . Tried every IBS remedy there was. It wasn't till one doctor said they are going to test me for everything I found out I had hypothyroidism. They put me on levothyroxine and since not had any symptoms. Was low acid and slow bowel movement and all remedies were making it worse. Need to ask your doctor to test for everything. I know that's easier said than done but got to push with GP's. Not replied to an IBS question for a while since finding out hypothyroid but felt your pain . Hope you find your cure.
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