Sertraline

[CrampyMan]

I think my doctor is going to change me from Mirtazipine to Sertraline. I have constipation predominant IBS, Please can anybody who is on Sertraline with IBS-C tell me how they find it? Thank you.

[Surget56]

Hi there, CrampyMan...I went the opposite way - from Sertraline to Remeron. The Sertraline gave me diarrhea (my IBS is the C variety), including a number of 'accidents in my trousers' (to quote a certain comedian). It gave me bad nausea and gut pain, and all in all I couldn't wait to get off. The Remeron was an immediate improvement and has been working well, to the extent that for the past two months about 90% of my symptoms have gone. Sure, there's constipation, Remeron is known for it, but I have a glass of psyllium husk and water every evening that keeps things moving. This is in addition to a mostly FODMAP diet.

We all react differently; you may find that Sertraline agrees with you - SSRIs work for many. But Remeron needs to be tapered slowly first.

Could you post details of your symptoms including food triggers. Are you following the FODMAP diet?

All the best to you.

[CrampyMan in reply to Surget56]

I've tried eliminating various foods and vegetables but nothing seems to make a difference so eating a variable healthy diet. Currently I'm using senna (2 at night) and either Fybogel or Laxido alternating. Stool is very unformed and just can't push it out. Worst symptom is trapped gas and bloating. Hoping to be referred to a gastroenterologist soon.

[Surget56 in reply to CrampyMan]

Sounds just like my symptoms - poo like rabbit droppings compressed into crazy shapes. Hovever, I no longer suffer from wind pain and bloating since starting Remeron.

Your IBS default is constipation and it strikes me that trying to induce diarrhea using an SSRI won't end well. With IBS-C, the main problem is motility, or lack of it. That's what I would work on. I've never used senna or a laxative. I have a large glass of lukewarm water with a heaped teaspoon of psyllium husk stirred into it for about a minute, thus ensuring the psyllium is waterlogged. I take it in the afternoon, about half way between lunch and dinner. Since starting that regime, I have daily bowel movements, and it's relatively easy - no great effort required.

I would continue to try to improve motility rather that switch to another drug. The diarrhea I got while taking Sertraline was unpredictable and sudden. I became totally housebound.

Good luck with the gastroenterologist.

[Profound15]

I’ve been told I have IBS C and met my specialist yesterday and I’ve been told it’s more like pelvic floor dysfunction. This makes it very difficult to coordinate the muscles down there and leads to significant straining. I’m using biofeedback to help as well as laxido daily but just wondered seeing your post whether this drug helps in my situation. I’ve tried prucalopride but that whilst making things soft gave me palpitations and didn’t seem to help with peristalsis which I thought it would.