Advice/treatment?

[blue9482]

Thought I would add to my previous post as I left some things out.

My doctor has recently told me she thinks I have IBS. I am a 22 female and I have done blood tests, stool tests - everything normal, so my GP has ruled out things like H.pylori, IBD, iron deficiency and coeliac. All other blood results were fine in terms of the functioning of my organs. I have been referred for further tests regarding my ovaries to rule that out as an issue, but my GP doesn't think its that.

I have tried buscomint, mebeverine, and windeeze and none helped. I am now attempting a low FODMAP diet and I am finding it very limiting and hard to stick to but I have cut out a lot of things for a few days and so far no relief. My symptoms dont seem to be affected much by what I eat but instead I seem to react to anything I eat and get a bubbling, bloated and uncomfortable gut.

My main symptoms are sharp pains, especially lower LHS, cramping pain, bloating and gas. After I eat now I get incredibly loud and uncomfortable digestive noises. I know digestive noise is normal to an extent, but this is very loud and accompanied by discomfort. My intestines feel like they are bubbling all the time, as they would if you were to have an upset stomach. I don't really often suffer from diarrhoea or constipation but my digestion feels very uncomfortable and unhappy.

I also experience belching after eating and I hiccup a lot. I was wondering if anyone had any advice on what could help these symptoms as the discomfort and volume of the bowel sounds don't seem normal to me and worry me. I was thinking of trying an anti-acid but then elsewhere it says to take apple cider vinegar which is the opposite so I am a bit lost with what to try- any advice would be really appreciated.

[XDjames]

yes, IBS means no evidence of anything physiologically amiss, you just get the symptoms.

2nd and 3rd paragraphs ring many bells for me. The gas; good grief, the gas! Something messed up with my biome, the GP says. Easy to say, hard to fix. Maybe too many of the bad and too few of the good bacteria (I know what I have or at least had thanks to an expensive Zoe analysis). I have a researcher colleague trying to identify what probiotics would best fix this imbalance but even though is very capable he's so far been defeated!

You may be able to correlate pain location with parts of your gut -look up location of bits and the flexures (bends) of the colon. I do wonder if stuff gets stuck here (I don't have hepatic flexure or appendix since 40 years ago). Alas symptoms of 'stricture' are a feature of IBS even through there actually is nothing blocking flow.

Belching and hiccup I don't get. I'd be cautious about the cider vinegar -not saying it's wrong but it is acidic. I find pepperoni in various forms (tea, Colpermin) is a bit useful.

Also I don't find low FODMAP too limiting, but I know for sure that pulses (beans in particular) are really bad news for me, likewise onion, corn on the cob and cheesecake (with normal dairy stuff). I like UHT milk so the low-lacto stuff is fine for me. Alas all kinds of bread are not so good for me. Last pizza I had was not a good move.

You're actually supposed to try reintroducing FODMAP items but I never really got to that stage, although I'm cautiously eating croissant again!

IBS means having to manage and work around the symptoms and letting the right people around you know enough to make allowances. Really tough when you're young.

[Hidden]

Your age is very reassuring, although sorry to hear that you are troubled by unpleasant symptoms. It’s also good to hear that Coeliac has been excluded, malabsorption, and a gut infection-Giardia Lamblia, for instance, can produce symptoms similar to yours. In addition, that your GP has excluded inflammatory bowel disease.

I’m sure your GP has taken a full dietary history to ensure that you haven’t been taking anything in the way of medication, foods, or OTC health remedies that might be causing your current symptoms.

You don’t indicate whether you have tried a probiotic, if not, you should. Their usage is now recommended by all gastroenterologists in this country.

As I suggested in my previous posting, you could start with Ferrocalm, and then change to Alflorex if no improvement after 6-8 weeks. If your system is stressed, very likely, ordinary probiotics don’t work because they cannot utilise iron which is released into your gut during this stress periods.

Ferrocalm, though, can utilise the iron, and, thus, competes with the harmful bacteria,

I’m, actually, taking both together, recommend by the company which make Ferrocalm. I have had persistent symptoms for eight years, so it’s looking promising!

You do need to be wary about companies offering to test your gut microbiome. The tests are not universally uniform, and there is no official approval. In addition, they are relatively expensive.

If you try the three I recommended, you’ll know, I believe, whether probiotics will work for you.

You can also try unpasteurised Sauerkraut which is cheaper and a rich source of probiotics. You do need to start with a small dose because it can cause side-effects if your gut health is not good. Do avoid Sauerkraut purchased in supermarkets, unless it states that it’s unpasteurised, because the process of pasteurisation kills off the useful bacteria.

So that’s Ferrocalm, Alflorex and symprove. What is essential, is that, if your symptoms worsen, it means that the probiotic is working so you should continue.

My suggestion of rarer causes should be born in mind if symptoms don’t subside as I suggested in my last posting.

My opinions are my own, but based on personal experience with severe IBS-C, and medical knowledge. In addition, and on the assumption that you, indeed, are suffering from IBS.

Good luck!

[xjrs]

As mentioned in my previous post of yesterday, I wouldn't go straight for FODMAP elimination and reintroduction. The main reason why low FODMAP can work, at least initially, is that it stops feeding the bad bugs that may be dominating in your gut. These bad bugs can give symptoms. However, you aren't going to be feeding the good bugs either and these are needed to keep the bad bugs under control, so in the long run, things eventually get worse and not better. This is what happened to me when I was low FODMAP for far too long.

In the first instance it is best to try a very well studied probiotic such as Alflorex (which has been tested with people with IBS in clinical studies). The probiotic should help crowd out and kick into touch any bad bugs that are dominating. Once these are more under control, your symptoms should ease a bit. A proper trial of the probiotic is 3 months, to see how well you get on. Some people experience a backlash in the beginning as the gut gets used to the new bacteria in your gut, so this may be expected for a couple of weeks to the first month.

If you have had some relief after 3 months, but are still experiencing some problems after the full trial then try the FODMAP elimination and reintroduction diet. At this point your body should be more accepting and tolerant to different foods. The Bifdobacterium in Alflorex helps to digest complex carbs, so you may find that you can tolerate fibre more (I can eat a huge amount of fibre now, compared to hardly any previously). This means that when you reintroduce foods you should be able to tolerate much more than if you'd gone straight for the diet without probiotics. Additionally, you need to work towards as varied a diet as possible and this mechanism helps with this. The more varied the diet, the more diverse the gut bacteria and these diverse gut bacteria help to keep bad bugs under control.

[Wallace-s]

I was the same age as you when diagnosed with IBS, so I understand the worry and depth of the world you’ve been thrown into!

But IBS is such a broad term for an overall , not really understood condition of conditions.

It can be a physical issues, neurological issues, biological issue……the list goes on.

Unfortunately my personal experience has been ‘trial & error’ - and I would encourage you to focus one aspect, give it time to ‘work’, and then if no success, try another focused solution/option.

For me, food made no difference whatsoever, medications except SSR’s like amitriptyline, made no difference.

Eventually through this site; I found information on ‘visceral hypertension’ have a search online and see if these relate, as you symptoms sound very similar to mine , and I now ‘self diagnosed’ as having IBS due to visual hypertension = which in my mind would answer why the SSR’s meds worked.

Have you had any surgery if you abdominal area - if so, look into intestinal adhesions, as another possibility.

Lastly, to try and aid the worry and help alleviate your symptoms- don’t over mindfulness and meditation (cognitive behavioural therapy even!) It may sound hocus pocus, but there is research that suggests brain wave signals do change when focussed breath work and mind connection is practiced for even as little as 5mins a day.

If anything you find does perhaps point to a neurological type IBS - although I’m no doctor!!!! I would at least try SSR’s like amitriptyline as they ‘could’ big ‘could’ be the help you need🙏🏻

I wish you all the best in search for answers and cures

[Bracondale]

Your symptoms strike me as possibly due to low stomach acid. If stomach acid isn't high enough many processes further along the gastrointestinal tract don't work properly. You'll need to research causes and solutions, but stress is a big one. This article may be helpful.

ion.ac.uk/news/low-stomach-....

[E3178]

I have lots of similar issues that are definitely made worse through anxiety.I expect your symptoms may be making you very anxious. I know it does for me.

Latest studies back this up as there is a strong gut to brain connection.

Look into trying hypnotherapy or cbt if you can afford to try it or practice meditation and relaxation on line or a cd.

Maybe your doctor could offer you some medication for anxiety to try.

Everything is worth a go.

[Letsfixit1]

I tried low fodmap for about a year (I ignored the warnings about only doing it with a dietician) expensive and almost impossible for find! It made me miserable and no improvement whatsoever. Then I got diagnosed with osteoporisis and I think its likely eliminating the milk/dairy products may have caused that. I am late 60s but had had no bone breaks/fractures etc so was very surprised. I've found eating much smaller amounts of anything I fancy has worked much better, maybe it was the portion sizes rather than the food type? I'm not overweight, but on a restricted diet I found I ate more of what I thought was "safe". I agree with others that dealing with anxiety might be more helpful than all these medications. Hope you feel better soon

[Escherichia]

my symptoms were very bad lower abdominal pain within an hour of eating. That was associated with signals of an almost immediate bowel movement which used to be voluminous and loose. Following that the pain would subside but grumbling intestinal noises persisted often followed by further bowel movements.

Prescribed Mebreverine to be taken 3 times a day everyday. After about a week things settled down I assume due to the Mebreverine. I still had occasional fare ups but not as severe as before Mebreverine.

After about 18 months things deteriorated again. I read that longterm use could cause loose and painful movements. Assuming Mebreverine was loosing its effect I stopped taking it and this did the trick.

I am on standby to recommence should things worsen.

[Pevsner]

I was recently referred to Priya Tew an nutritionist of note who works out of Southampton. Her team consult over Teams so I'm guessing they operate nationally. It's well worth a few hundred quid as taking a self help to Fodmap diets is hit and miss and not without drawbacks ( reduced intake of key food groups). In a nutshell they will assess you and give a range of simple interventions first for a month and then move to approaches such a restricted diets should that be required. In a nutshell provide yourself with some expert help.

[askjacqui]

dear blue9482, after my diagnosis of IBS, I immediately cut out wheat from my diet and switched to lactose-free milk. I also avoid fruits with pips in them, such as apples and pears. As far as medication is concerned, I take one capsule of Symbiosys Alflorex per day and that seems to help. Good luck with your search for relief!