Chronic pain

[pwllmawr2]

Hello All,

Not been here for a while trying to learn to live with Chronic lower abdominal pain ( as the GP) said. Now have pain 24/7 in lower abdomen, no blood in poo, no weight loss just constant pain I've had enough don't know where to turn

[MyStar86]

Have you spoke to your gp? Have you seen a gastro? Have you had any tests done? You should not be expected to live with chronic pain without any tests or treatment. We have to be our own advocate and fight for help just keep pushing till they do something the gp should refer you to a gastro and a gastro should do more tests to try to find the cause of the pain or at least advise on pain management. Do you have any bowel symptoms apart from the pain? I hope you get some help soon xx

[pwllmawr2 in reply to MyStar86]

Hello MyStar86

Thank you for your reply, I have had several tests over the years, Colonoscopies, Ultrasound scans, CT scan and have spoken with two different Gastroenterologists, most recently a Colon rectal surgeon, all tests come back clear, the origianl diagnoniss by my GP for IBS was several years ago, I dos'nt help being Coeliac however I manage this by only eating Gluten Free foods,

My kast visit to the GP to discuss the pain was last year where she said you have had all the tests and they always come back clear and I have no red flag sysmptoms (Blood in stools or any weight loss) , go away and try lactose free for a while and try the Fodmap diet which I did for about 3 months and it made no difference, I now take 20mgs of amytryptylene at night and pepermint capsules, I still have constant lower abdominal pain, if the pain would ease after a bowel movement I think I would relax more,

Had two boughts of loose stools today for some reason, I guess its visceral hypersensitivity (functional abdominal pain) That ajrs mentions.

Thank you taking the time to respond

[xjrs]

Have you had the necessary tests to diagnose IBS by eliminating other things?

nhs.uk/conditions/irritable...

Do you have any other bowel symptoms?

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.

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.

[Mutleyforever]

Hi, sorry to hear you are suffering chronic abdominal pain. I too was in that position for 3 years, tests showed all was normal and it was hard to get my head around but all the pain was normal functioning that you are not normally aware of,( trapped wind sensation ,pain in abdomen after bowel movement, squeezing,twisting sensation, all different but always present) in other words visceral hypersensitivity. Initially ( after more than a year) I was given Imipramine low dose, which worked but I felt my insides had absolutely come to a standstill and I had to come off them, to which I was given no alternative. 2 years later after further research and off down many rabbit holes, I asked my GP if I could try a SSRI ( Selective Serotonin Reuptake Inhibitor ) which is a different type of antidepressant that also works as a neuromodulater, she said this was ‘reasonable’and I have now titrated from 20mgs to 40mgs with a huge difference. I probably still need to go up to 60 mags but have had a week of no pain after all this time. I found the side effects a little off putting as there can be many but ultimately they have worn off and I feel great. Hopefully this may give you hope that there are other things to try, just try to keep your GP on board, and research it yourself, very best wishes Mutley

[Jackie1612]

sorry that you are going through this. If the pain is caused by IBS, amitriptyline might help.

I am on a low dose, 10mg, and it has made a huge difference to my life. The downside is that it causes bad constipation, but I am taking stool softeners, Dulcoease, for this and I now seem to have got the Balance alright at present.

[CrazyChickenLady]

What helped me was low fodmap diet, slippery elm tablets and a prescription for Bentyl. The diet is a game changer! I couldn't stand or walk for more than a few minutes just 3 months ago. Now I am mostly pain free. At least in the abdomen. I do have other issues to resolve, but this is better.

[Poshy]

Exactly the same as happened to me. I chose not to go down the route of tests etc because I do not believe in invasive procedures (it is a process of eliminating causes) and it was all too radical for me but everyone makes their own mind up. It did worry me though as to what it was about. Xrjs advised me too which helped. I am now on low dose amitriptyline and I do take Alforex and it has helped enormously. Now my gut seems to have calmed down somewhat and I can lead my ordinary life again. I do understand that with constant pain you feel worn down and at the same time worried. Whilst I am not happy to be on chemical remedies I have my life back. I have to watch what I eat at times as the wrong food will produce pain and indigestion for me but overall it is so much better. I hope you get help and maybe try my route?