Peristalsis/loperamide

[Letsfixit1]

Hi all, I've been trying to manage my gut without loperamide for several weeks. Without it, the consistency of my stools seemed to get softer daily, with increasing bms, and a constant feeling of possible leakage and discomfort. Eventually, it always leads to a bout of diarroah with urgency with stomach craps, nausea, fatigue, etc. And although I am aware of the build up to this, reducing/or increasing, the fibre, eating lots of oatmeal, bananas etc. makes no difference whatsoever. It feels to me that my digestive system is working too quickly, and I suspect in the past I have had inadequate nourishment from my food. So I've googled peristalsis to see if it can be overactive, it mentions too slow movement, but not the opposite. I have now taken 1 loperamide daily for 10 days because I'm on holiday, and I feel great - one normal bm every morning, no bloating, gas, indigestion, and the hotel diet includes many triggers I just can't normally tolerate, like onions, garlic, mushrooms, grapes etc. This same hotel diet is causing constipation for my partner! I just don't understand it - I feel its not the diet itself that causes my problems - but that it passes through my gut too quickly? And I'm sure the more fibre I eat, the worse my stomach becomes. Years of restricted diets have made no difference whatsoever, its just got worse.

[Luisa22]

We are all different with IBS and what foods suit us. But personally, I found all the advice about high fibre foods (yes, in my own case even bananas!) to be the absolute WORST advice for my IBS D. It was only when I went low fibre, and gradually, listening to my body's daily reactions, managed to introduce more vegetables and "healthier" foods to my diet, did I have ANY chance of managing predominantly loose stools. This was not "overflow diarrhoea" as a result of constipation, but just chronically loose stools.

To me it was obvious that high fibre foods (which always made me "go" more even when I was well), would have a strong impact on IBS loose stools, and I could never understand the advice of "experts" to the contrary!

The rest has been a gradual journey of finding which foods "fit with me" and which don't. I have been able to extend my diet to include many good healthy foods, but there are some things I have to be careful with, have to avoid, or have to save for days when I get a slight touch of the "C". Now I can eat 17 or 18 vegetables, healthy proteins, fats, and most carbs except I have to eat potatoes carefully. Those act like a laxative too!

I have found hacks too....such as peeling certain veggies suddenly made me able to eat them ! So it was a win for me to be able to include those again in my diet.

Honestly, I have to put oats, wholemeal anything, many raw foods, and many fruits on "standby" for a while. Yet at the same time I am eating very well.

So what I'm saying is you can maybe start off with low fibre, low residue to settle your tummy,, then gradually try some small amounts of vegetables or fruits, see what suits you, expand that as you go along, and see what happens?

Hitting a very upset gut with all this "healthy high fibre food" we are all told we should eat masses of daily, is probably going to end in tears, is what I'm saying. Find your own way. If something makes you "go" too much, lay it aside and eat lower fibre until things settle, then experiment gradually.

If you're worried about nutrient intake while you do this, take a good quality vitamin&mineral complex.

[Lilagrace87]

I have the exact same problem, I have had a year of a lot of stress, despite me being adament the stress is under control and that I do not think it would have this effect on me, after running lots of tests my GP has put it down to IBS caused by stress. If that is the case, which I am still not convinced, it could be the same for you, the constant worry in the back of your mind about the bowel issues could be causing the stress on the body, therefore your body is in a constant fight or flight mode and emptying quicker than it should be. You could try what I am trying and finding ways to manage stress levels so your body feels more at calm and at ease. Easier said than done xx

[711debbie in reply to Lilagrace87]

Both of you should look at "Nerva", which is designed to manage IBS stress. mindsethealth.com/

[Letsfixit1 in reply to Lilagrace87]

Hi, I don't think it's caused by stress as sometimes it flares up when I'm most relaxed! But I can recommend the Nervapp which taught me breathing exercises and helped with insomnia. Didn't help my IBS unfortunately but it's supposed to be very helpful to many.

[BabsyWabsy]

I agree with Luisa. Too much fibre can have a negative impact. I love a nut roast, and lentil dishes, such as dahl, but I have to eat them sparingly. A friend is having tests for a gut problem. He insists on eating nuts and wholegrains because he thinks he should. It's not helping. I can't eat bananas either, because of 'pollen mouth'. Same applies to fresh pineapple. Luisa is right when she says you have to find what works for you. It may not be the 'perceived wisdom' of a high fibre diet. Truly a case of going with your gut! Some people find a low residue diet is helpful, so steamed fish or chicken with white rice for example, to give your gut time to settle. Good luck.

[Snowcat18]

it’s a nightmare isn’t it? I have IBS mixed and diverticula disease. I was referred to a nutritionist when I was at the end of my tether with gas and bloating - if it wasn’t sudden unexpected diarrhoea it was miserable bouts of constipation - neither was much fun! Saw nutritionist who said more fibre! Stuff can’t pass through your gut in any normal form without it - she said you can’t have enough fibre - guess what? You can. Then another health professional said cut out dairy and gluten - minor improvement with bloating and gas. Then I went to stay with my mum and had a complete rest - within a few days my bowels were back to normal - despite what I ate … I admit I ate a bit less as mum isn’t a big eater and we ate regularly whereas at home I tend to have a small breakfast, not much (if anything) for lunch and then a big dinner but it does make me wonder if stress is the biggest factor after all. Our gut is more affected by our mind than we might think - I believe that the tissue in our bowel is the same as brain tissue so it’s not surprising that the two are intrinsically linked. Think of the expression ‘gut reaction’ or ‘sick to the stomach’ or how many of us feel before an exam or a medical appointment- sometimes I only have to think ‘toilet’ and I get the urge to go! As for diet I guess following a non ultra processed food diet is likely to be of most benefit but as for me, too much fibre is a real trigger or maybe I just eat too much of it! Sometimes I wish I could just be fed by a drip and forget about it altogether!

[Sparrow58]

I agree with Luisa, not everybody can cope with a lot of fibre. I was referred to a health coach and she said about my fibre intake. I explained that It upsets my IBS. She advised me to just to eat a couple of spoonful of porridge with a tiny amount of Chia and flax seeds ( they can have a laxative effect) but she said to soak it all over night as this makes it easier to digest. I do this now and it does work. I can this every other day. She said that any changes to your diet must be done slowly and with small amounts. You are also more relaxed on holiday and stress can cause IBS to flare up. I hope you have a lovely holiday.

[Mollydav]

Oh how I can relate to this. Having received a clear colonoscopy and told I was eating too much fibre and should look at FODMAP diet, I am now totally at a loss on what to eat.

I have paid for a food intolerance test - negative results (slightly raised on yeast) so no further forward. I am now waiting for the results of a full stool sample test. This is being done privately as it covers over 63 different tests which I am hoping will give me answers to my completely random BM. Apparently the NHS tests look for cancer and do not test further. I am coeliac and follow a strict GF diet and now feel my already restricted diet is doing nothing for my overall health. I have also thought that being tube fed would be the answer to a prayer at times but this coming from somebody who loves food and eating out is alien to me.

I have also tried different pro and pre biotics with no real success. Imodium is the only thing which allows me to go out with confidence!! Oh joy and we are now at Christmas so different food and more uncertainty.

[swarfgricer]

For me Alflorex capsules was the game changer. I was diagnosed with Diverticular disease and prescribed Loperamide for bouts of diarrhoea. I suspected that rapid transit was at the root of my problem -- food not being processed by the small intestine. My diet has been nothing special but I have always had a good measure of porrage every morning.

The reviews that I have read about Alflorex are quite a mixed bunch, with "must give it a good 4 weeks trial to take effect" being prevalent. For me, a positive result took place within one week and has remained so for about 18 months. I still take the occasional Loperamide but the whole process is now very predictable. I take one Alflorex capsule every day but it may be possible to reduce to a maintenance dose if the cost is a problem.

I'm 87 now and generally fit and healthy. Good luck with your quest.

[Whitesugar]

So many people on this site have this problem with urgency and diarrhoea. Bile Acid Diarrhoea (Malabsorption) causes these symptoms and is underdiagnosed. It is always worth asking your GP to be investigated for it by seeing a gastroenterologist. It can be treated with bile acid binders.

[Mollydav in reply to Whitesugar]

Thank you - think I will see my GP so I can rule this in or out.

[Eastbourne11]

Hi I suffer from Mal Absorbtion of Bile MAB. But used to have constant diarrhea. I tried every diet. Doctors were no help just said it was IBS. I now take Colestyramine (available on NHS) It must be taken four hours or more after any other medication you take as it strips the Vit and Minerals from the body. It is worth it though. Try it - what does it matter if you have to take it forever, at least you can go out and take journeys etc without fear of accidents. I piles are soft at times just take one Loperamide a day until it gets to normal. Good luck

[Linley]

Yes, agree with my fellow sufferers high fibre diets do not suit all, even though its pushed by the professionals. I have had IBS -d for many years and have learned to manage it. Just a couple of suggestions that may help.1. Ask GP about BAM

2. Instead of Lopermide try an antispasmodic such as Mebeverine time release capsules or Buscapan(if you are over 40 speak to your GP 1st), they should calm the muscle contractions.

3. For the urgency one gets I do sphincter excerises, gives me some extra mins to get to a toilet.

Wish you good luck

[Flowerpottime]

Hi i can relate to your comments. I had a bowel resection and food goes through too quickly. Had been using codeine to slow things down but was recently advised to take a morning dose of loperamide as well. I have tried this and it seems to help but i need to take 2 2mg doses per day. I have tried to reduce to 1 per day but this doesn’t work. Loperamide on irs own doesn’t work either. Diet doesn’t make any difference although I have tried different things like fibre v no fibre etc!