Gallbladder problems causing IBS D?

[Gaz869]

I was wondering if anyone has had experience of gallbladder problems causing IBS D?

I’m suffering persistent symptoms, pain under my ribs on the right side, on waking / in the night nausea, heartburn and wind. I generally have water diarrhoea 1st thing in the morning 2-3 times then loose stool 2-4 times each day. Constant digestive pain all over, some times food can reduce it, other times it can make it worse, even the same food one day fine, the next day not. Hot drinks and food cause more discomfort than they use to going down to my stomach. I’ve tried fodmap and several different diet plants in conjunction with a nutritionist, but no change, so I’m wondering if some sort of bile issue is occurring too much / not enough, I’m not sure how to tell. I’m due to see a specialist (again) in a couple of weeks so any experience or advice would be appreciated.

Background:

I was diagnosed in 2002 with IBS D endoscopy and colonoscopy with blood tests determined this diagnosis. Over the years I’ve found that in particular homogenised milk and xanthan gum (E415) made things really bad for a couple of days at a time, avoiding these minimised flare ups, with the occasional help of loperamide. Other antispasmodic drugs didn’t really seem to do much for me.

About 12 years ago I started getting pains in my right side under my ribs that were followed by bouts of nausea, heartburn, trapped wind and diarrhoea. The GP suspected gallstones but nothing showed up on an ultrasound. I started following a low fat diet, and with fodmap found too much fibre and foods high in inulin a problem, but again avoiding these seemed to help things, up until 2 years ago.

Regardless of what I ate I started getting pains, nausea, diarrhoea etc again, but this time it happened at any time of the day or night. The GP ran blood tests, took a stool sample but nothing abnormal showed up and the ultrasound was clear so said to continue with loperamide and try Mebeverine again. The Mebeverine didn’t help me and although loperamide reduced the number of visits to the toilet (after 4-5 tablets each day), I was still getting the other symptoms so went private. The specialist did a capsule endoscopy, but could not see anything wrong, but prescribed Amitriptyline and recommended symprove. In the first few weeks things settled, apart from pains under the ribs and heartburn. Unfortunately the improvement was short lived and towards the end of the 12 weeks I felt symprove was making things worse.

The last few months I’ve tried Silicol gel, Enterosgel and Dr Gut Ibs relief (mineral clay) all of which help with diarrhoea and reduce heartburn to a point, but I found I still suffered with trapped wind and general cramps and pain. After a few weeks it seems my body adjusts and I’m back to rushing to the toilet crapping brown water 2-3 times a day and a mushy stool 2-4 more times. If I’m travelling for work I find 4 loperamide 1st thing allows me to make the 2 hour journey in discomfort, making use of the office toilet up to 2 times before 2 more loperamide for the journey back, this is usually followed by a 5 am - 6am wake up call.

[Luisa22]

Take a look at this article about Bile Acid diarrhoea, or Bile acid Malabsorption, which is on the Guts UK site:

gutscharity.org.uk/advice-a...

Do the symptoms sound like yours at all?

I would definitely bring this up with your doctor.

[Gaz869 in reply to Luisa22]

Thank you for this info. The symptoms do match, other than heartburn. Interesting on the stool colour, difficult to flush, both the GP and the specialist weren’t interested this change, and GP didn’t recognise SIBO, so I went down the natural route to rule it out, followed plans developed by a nutritionist; had oregano oil, hydrolyzed guar gum, vinegar before each meal, ate a restricted diet etc, but after several months didn’t notice any real change, other than a I seemed to become more reactive to wider range off foods.

[Luisa22 in reply to Gaz869]

I'm not disrespecting Oregano oil. It's a good medicine for the right thing. But as far as I know it can wreck the gut microbiome. It is such a powerful anti-microbial,

I always prefer more "natural" solutions to any problem if I can, but without being too sure what's going on inside, herbs and diet changes can sometimes help or sometimes make no change or make things trickier. Plus there can be some malnutrition involved with some of the recommendations Naturopaths give.

And if it were BAM, then the regime you followed almost likely wouldn't touch it as your problem would be a more mechanical one with bile acids not doing what they are supposed to do in a circuit.

Yes, some UK doctors won't recognise SIBO. But I do believe bile acid malabsorption may be taken more seriously, so it's worth mentioning it. If your GP shrugs and says "what's that?" or some other fobbing-off....it's time to change your GP.

There is a test for it : the SeHCAT test. It seems that is available on the NHS, though I don't know, and I've never had one.

There's some info about it here:

uhsussex.nhs.uk/resources/s....

[Bracondale in reply to Luisa22]

That's a great link Luisa22, thank you.

[Gaz869 in reply to Bracondale]

Thank you this info.

[xjrs]

As Luisa22 says you may need to consider BAM. There is a separate test for it - see link below:

ibsresearcher.com/bam/

You may also want to check the diagram on the page below to see what you have already covered off in terms of tackling your issues:

ibsresearcher.com/diagnosis...

Unfortunately, there are private nutritional therapists who are over diagnosing SIBO - in fact every one of the very many I spoke to on the phone (and was treated by) said that I had it just from my symptoms - then they use the breath tests to prove the point. However, the tests for it aren't accurate and there are many false positives. Their treatments really messed me up as explained below:

ibsresearcher.com/my-journey/

They go about destroying your microbiome. I also found afterwards that there were foods I could no longer tolerate that I always used to before their treatments. This is possibly due to certain bacteria being undermined by the antimicrobials and these bacteria were needed to synthesise those foods. Additionally subsequently after their treatments my inflammation markers went sky high, such that my gastro was extremely worried and ordered an urgent colonoscopy. Luckily I still had IBS, but I have found out since that this undermining of the microbiome can cause inflammation since a healthy microbiome helps to keep inflammation under control. Plus their high protein and low fibre diets to 'treat' SIBO are pro-inflammatory. This is all explained on the website, including what I did to improve my situation after carrying out in depth research, since I wanted to help others avoid the mistakes that I made and certainly avoid the costs involved in gaining access to such information, since the gap in IBS research is being filled with people trying to make money from it.

[Gaz869 in reply to xjrs]

Thank you for the information, and sharing your story that I’ve started to read through, and can share similar experiences and frustrations.

[Luisa22 in reply to xjrs]

Well said! It's a minefield, and some treatments can be very damaging.

I can't completely throw away all "alternative" remedies though but we do have to be careful. I made a very slow and gradual improvement on Homoeopathy, although there is absolutely no proven scientific reason why I should have done. I am normally a common sense person but for some reason I thought I would try it and there were some interesting results, all of which did me no harm in the meantime.

The cost wasn't extortionate either at £65 a month.

But I have to admit, I got the creeps from some "alternative" solutions! And I'm glad I didn't go down some rabbit-holes out of sheer desperation.

[Gaz869 in reply to Luisa22]

For me (UK) GP’s have led me to seeking alternatives. Over the years with all blood tests being normal I just get fobbed off. I’ve spent thousands of £’s on tests, diets, new products, and tech. If the GP’s were more engaged and took an interest I would have wasted a lot less time

[Luisa22 in reply to Gaz869]

Yes, it's disconcerting that we can't even always trust our GPs to fight our corners. I can understand why you tried all sorts of things to find some help and healing.. I usually have a lot of faith in herbal medicines, as they have always worked for me and in some hairy situations, in the past. But using them is quite a skill, and can be tricky with antimicrobials. And there seem to be people out there who seem to have credentials, but who don't show they have a wise skill with herbs or who are just after the money, and set themselves up as alternative healers, Naturopaths, etc. We could spend hundreds or more chasing "cures", Shocking

[Bracondale]

To add to what has already been suggested here, have you been tested for H Pylori and other parasites? I had both and exactly the same symptoms as you, though no heartburn surprisingly. I'd seemingly picked these up in Portugal (I live in UK). My immune system was already below par, and picking up covid too did not help!

[Gaz869 in reply to Bracondale]

Thank you for this. These were tested for in a stool sample, and came back negative.

[Gaz869 in reply to Bracondale]

As you mentioned covid I did experience something strange when I had it. It caused all sorts of stomach problems for me, along with the other symptoms for 5 - 6 days, but there was a period of 9 to 10 days that followed, where everything went back to normal. No pain, no diarrhoea I felt like I was 18 again, I thought it was a one off, but when I got Covid again a year or so later the same thing happened for 9 - 10 days I felt great.

[Escherichia]

mebreverine helped with gut cramps due to IBS. After 12 mnths found not so effective and stopped. If I get a flare up I take it again until things settle.

[Gaz869 in reply to Escherichia]

Thank you for sharing. I do think the body seems to adjust to these meds.

[Meatloaf9]

Have you had a HIDA scan for your gallbladder, I think it is considered the gold standard for a gallbladder problem. Best to you.

[crispysundew]

Yes get the HIDA scan done and lookup billary diskinesea. Then get the gallbladder out surgically if it's causing that many problems with your digestive system.

[Gaz869 in reply to crispysundew]

Thanks for this info. I think it is gallbladder related as family history suggest this (although GP’s say this has no bearing on me). My Nan use to tell me the story of her Mum being the oldest person to have her gallbladder removed in her 80’s, (I’ve not fact checked this though), but I know my Nan had gallstones, my dad and both his sisters (aunties) had their gallbladders removed, but for the three of them nothing showed up on ultrasound, so it was intense pain that led to hospital visits to determine the impacted gallbladder issue.

[jardinamour]

I'm a bit similar but nothing untoward found. I take amitriptyline, but now cut the 10mg tablets into 4 and only take one 4th at night. I only have a whole one if I get a bad attack and need better sleep.

I find losing weight, and hardly having any sugar in anything has helped. Also i now have a lot of probiotics - kimchi, sauerkraut, kefir & bio live yoghurt. We also make 100% spelt bread and eat very little meat. And I have reduced my onion consumption. I am hardly ever without some sort of pain but it has reduced in intensity quite markedly - both the IBS and gallbladder.

[Gaz869 in reply to jardinamour]

Thanks for this. Being at a good weight definitely helped during my 30s, and I kept more control of things through diet, only had problems once twice a week on average, but now diet no longer seems to work the way it use to.

[BAM28]

just to echo what others have said - I had symptoms similar to you. Someone on this forum suggested bile acid malabsorption. I went to my GP and asked - I was already on a waiting list to see a gastric consultant. The GP said they’d never heard of it but would try and speed up the appointment with gastro so I could speak to them. Luckily a few weeks later I got the appointment. A young gastro consultant read all my notes and said I’m fairly sure you have BAM. Referred me for a seHCAT scan and started me on the medication immediately (I’d been trying to pay for a private seHCAT scan and couldn’t find anywhere I could do it)..

Long story short I know by the medication that I have BAM, as the medication and low fat diet have had a great impact and more or less stopped the worse of my symptoms! Just waiting for the results of my seHCAT scan which I assume will confirm diagnosis.

I had been like you in that I tried everything I could think of or had been recommended to me and nothing helped up until now!

[Gaz869]

Thanks for this, I hope the specialist I see reaches the same conclusion and at least starts to trial the meds.

[Brooksidevillas]

I wonder if you will be offered a gall bladder removal. I have ibs C and was told that it would help. It didn’t and I am now, I believe worse. Think hard before you let surgeons remove anything

[Gaz869]

thanks for the advice, I think I’d need to have gallstones before I consider removal!

[CryptoKid]

Hello.

Prior to being diagnosed with IBS I was getting alot of pain about an hour or two after eating in my right flank, just under the rib.WAn out of hours GP identified that my flank was holding onto alot of gas, they suggested getting charcoal tablets which worked wonders for removing the gas. But be careful if taking around other medication.

The biggest game changer for me was identifying that tomato triggeredflare ups and causing the right flank issues.

[Gaz869]

thanks for the advice.

[Gaz869]

After seeing the specialist he started me on treatment for BAM, but on getting the medication through one of the ingredients is on my no list as it causes issues. I found that Xanthan gum is a real problem for me (if interested search for xanthan gum stomach problems) and interestingly most of the possible side effects listed of the colestyramine light, I found are caused by xanthan gum. I’ve asked the pharmacist if there are any alternative brands without it, but debating whether to risk taking the medication in the hope that the xanthan gum will be counter acted by the colestyramine or just write off the cost and ask for another prescription!