I am sorry if this post contains too much information, but I am looking for advice what to do about my particular issue. I have IBS, mixed, but also have a small rectocele.
I try to have a diet which contains sufficient fibre not to get constipated, but I find it hard sometimes to have stools that are firm and bulky enough to pass easily. Often they are soft and I can't fully get rid of it all. It's very messy to wipe, and I can tell there's more that I can't get out even with straining, which, having haemorrhoids also I really don't want to do. It feels very uncomfortable. I've tried things like fybogel and that kind of thing, and all they do is make the stools even softer and hard to get rid of.
I have occasionally out of desperation had a glycerin suppository, but I don't really want to become reliant on these, otherwise my bowel will likely cease to work at all. I have also tried 'splinting' which doesn't help in the slightest.
Any and all advice would be very welcome, no matter how gross or detailed it is. I will try anything.
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iloveglee
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I would look at trigger foods if you haven't already. I was suffering from right flank pain, gas and stools very much like what you have described.
Turned out I'd developed intolerance to tomato.
Cut that out of diet and by end of the week id gone from IBS-D to IBS-C. But find the constipation much easier to manage as I don't suffer with pain or wind.
Some of the issues maybe down to your gut being inflamed, this is what the tomato was doing to me. Just before I identified the trigger I was managing issues with H&B charcoal tablets over night for wind and then fasting from wake up until evening meal. Drink as normal.
The rest my gut got from say 2000 / 2100 at night until 1700 following evening meant it started to tackle the inflammation itself. I can't remember but I think studies found the gut does this around the 12 or 17 hour mark.
Not sure if any of that will help, but that's my story!
Maybe too much fibre in your diet? Could try reducing it . If still an issue maybe ask your GP for something to bulk up your stool, avoid fybogel and other herbal laxatives which make things worse.
I did try reducing fibre. Then got constipated. Then ended up with profuse diarrhoea after getting rid of the sonstipated stool!! My gut seems to be slow slow quick quick slow. Hate the idea of having to put up with this but maybe will have to do.
Not sure what things would bulk up stool, theyd normally give fybogel or recommend psyllium husk.
I sympathise as my bowel movements are much such an issue. Pays to only change diet gradually. I have long-term poor bowel muscles, constipation (hence the suppositories) and tenesmus. I can never tell whether I really do have a need to empty bowels or just getting a wong message due, in my case, to internal haemorrhois/prolapses which have been treated several times with banding or injections. Is necessary to see a colorectal surgeon who can have a look.
I try to live with the "wanting to go feeling" and definately not straining too much. Not easy.
Your issues same pretty much the same as mine. Dysfunctional pelvic floor muscles basically. I have had tests for this and seen a colo rectal surgeon a few times. Had a stapled haemhorroidectomy 22 years ago which was successful or a while, but not now. I was at one time prescribed some kit to clear the bowel out, which involved having to fill a bag of water, hang it up and allow gravity to drain water into the bowel. It was more trouble that the actual problem. Maybe they have better and easier to use kit now, and possibly I ought to ask to go back.
That kit you mention was presumably the equivalent of an enema. Do it yourself enemas are now available . But that would only be a one-off solution not solving ongoing issues. I still think Fybogel should be avoided. i have a good book on the bowel which helped me as regards diet. I've had that stapling done, lasted a while.
I had been advised that soluble fibre is the way to go. Hence I eat oat cereals, wheat is a trigger food so avoid that. I have added fybogel, and psyllium husk which definitely bulks the stool but makes it so soft that even when the main bowel movement has done, some is left behind which is almost impossible to get out. And that's really the crux of my problems.
fybogel as part of my fibre intake diet. Worked fine for a while but probably overdid it by taking two. Found stools , although not hard, hard to get started and pass. Switched to one laxido a day which softens then up and easier to pass. Will see how it goes but if too soft, runny will stop
Have you tried sitting on the toilet with a step for your feet, so your knees are higher than your hips, this is meant to be the correct way for everything to fully open to allow it to pass. Have a look online and it will show diagrams of ideally how we should be sitting on the toilet. Hope this helps x
I was told all this when I was under the hospital and always use a small step to put my feet on. Lately, it hasn't been helping at all. I feel that something else is going on here, I had a bowel fit test not very long ago and that was fine.
Hi, I have all the same problems as you are describing and have tried most of the known remedies too. My problem is basically years of IBS and now a rectocile which leaves me unable to completely empty my bowels. I do find psyllium husk helpful added to my breakfast cereal, but too much can have a negative affect so it’s only about half a teaspoon. In desperation I have bought a small bulb enema which you use with warm water as a douche after bowel movements. This makes sure everything in the lower bowel is cleared out and it works very well. It sounds horrible and I was a bit hesitant to use it as unsure of its safety but my sister was given an almost identical piece of kit to use at home by the colorectal clinic so guess it’s ok! After lots of research I went ahead and found that it certainly does the job and is very easy to use as long as you use some lube and stay sitting on the toilet. Amazon have plenty to choose from and they are cheap and should be made of surgical grade silicone. Hope this is useful! 🤞🏻
Thank you for this, yes it is useful. I was under the colorectal clinic for a while, many years ago. They gave me this bit of kit to use, which involved hanging a bag full of water from a height and inserting all this water into the lower bowel. It was a total pain to use, for one thing nowhere to hang it, and having to sit on the toilet for a very long time afterwards. I am assuming that what you are describing is not like that. I'll have to have a look on Amazon.
So roughly how long do you have to remain sitting on the toilet afterwards, before you feel you can safely move away!! Do you use it in the morning, at night, or pretty much after you have had a normal (what is that exactly!) bowel movement.
I have tried psyllium husk, both the powder and in capsule form. They help me to have a bowel movement for sure, but unfortunately they cause the stool to be so soft, that it's impossible to remove it all. For me, finding the right amount of fibre, and what kind is extremely challenging. As I'm pretty sure it is for most IBS sufferers. I deal with it most of the time OK, but it's when you're going out somewhere, or going on holiday it's very hard to manage. In those circumstances I have been recommended to take immodium, but then that causes constipation, which opens up a whole other world of issues in the longer term.
Hi iloveglee, I know exactly how you feel! I dread going out if I haven’t had a successful (and complete) bowel movement but I have never been regular so can’t ever rely on this! I have a small kit I take with me which includes wet wipes, spare pants and hand sanitiser plus a few doggy waste bags all packed in a waterproof makeup style bag ( you can get these for baby care stuff) and just knowing I have it makes me feel less stressed. In fact I rarely have to use it! I have also just discovered Wype, a gel product for cleaning up just using toilet paper and this is brilliant as it is soothing too. So I have a handbag size pump of this to add to my kit. The enema/douche bulb I have I only use at home if I feel I haven’t emptied properly or have a messy or sticky bowel movement. It only holds a small amount of water and one go is usually enough. It works almost immediately to clean out the rectum and I only need to stay on the loo for a few minutes. There is no leakage afterwards either. Of course this may not work for really bad constipation but my problem is mostly retained pellets because of the rectocele I have, and I often have to splint them first too. Sorry about all this messy information but the bulb only costs as little as about £7 as is definitely worth trying in my opinion. Hope this helps for you! Good luck!
I'm very grateful for all of the messy information. Because it describes my experiences exactly. I am going to try the bulb and get some Wype (I am sure i remember seeing this on Dragons Den and they were all grossed out by the presentation. I wish they could have ibs/rectocele just for a week and know what it's like).
I do tend already to carry some wetwipes and spare underwear, plus a couple of decent sanitary pads (which due to age have no use of otherwise). Like you, I rarely have need of them but sometimes, I think its the fear of having the issues and not being able to deal with it when you're out, that causes them to happen. I know that many of the ibs symptoms are made worse by anxiety, but a recocele is a physical thing and is, well, there. My consultant was very reluctant to do surgery, as he believed it doesn't often help, and can make things worse. Which is something from a surgeon whose whole reason for being is to cut!!
I absolutely agree, it’s such a horrible thing we are having to deal with, especially at a later age when even the effort to go out and about is sometimes a challenge, for me in particular!
I’ve just thought of one more thing that may also help you which I find comforting — I have a sitz bath which I find wonderful ( because on top of everything else I suffer with piles!🙄). This also seems to help when I’m constipated or still not empty. I just sit in the warm water for a short while and even read my book or do the crossword or something, and guess that because I’m then relaxed, combined with the warmth, I can sometimes complete my bowel movement! If you haven’t got one, the sitz baths are cheap and easy to use and although not something I particularly want to show off in my bathroom, I just throw a towel over it when not in use to hide it away. It’s also great to help me feel totally clean! Maybe another thing to try?
Sometimes that happens to me, Usually only for one day or it might recur on another day. I am quite sensitive to fibre and also to certain vegetables which have a laxative effect for me.
So if it happens I don't mind too much as it's slightly uncomfortable but nothing worse. That evening I will eat something slightly more fibre-rich with my dinner. For me that usually means carrots, brown rice, or oddly ...-potatoes (peeled!) or even some small amount of something "wholegrain" or high fibre, In a way I quite like the opportunity to eat those foods, as I usually have to be careful with fibre.
If I feel it's a touch of actual constipation. I will go further and eat a real treat....boiled beetroot! Especially if I have that with chips!
A half of a small apple or half a banana will do the trick for me too, or even just a few blueberries.
Next morning I definitely "go" more completely After that I go back to my usual diet, which does contain good foods and vegetables. But I have a mental list of the ones I should eat in those circumstances, and they always work. Weird because I remember the time when I could eat those, and it didn't feel like I'd taken a laxative!
But my gut is very sensitive to those foods. That might well not work for everyone. Or people might have their own foods which cause more bowel evacuation.
I, also am very sensitive to fibre, and getting just the right amount, and the right kind is very challenging. Some days I think I have it just right, and try to eat exactly the same thing, which is kind of boring. And doesn't always work.
I would dearly love to know why this happens, but it seems as though it is a complete mystery. It's like having a disease, that's specific to you, and no-one else has it in exactly the same way
With fibre I can eat some but not too much. I go through times when I can eat more and be fine, then suddenly eating those foods will really upset my tummy and I have to lower fibre again. I do find the unpredictability of IBS can be difficult
I have no idea what causes my IBSD, I have spent years restricting food and trying different supplements. The stools were always soft, loose, a constant feeling of wanting to go all the time. Urgency and lack of control. Imodium (loperamide) seemed to work well, bulking up the stool. I was worried about becoming reliant on it, so I kept messing about with the dose, usually 1 a day, increasing to 2 or 3 when necessary, then skipping day when I felt confident. It didn't work, my stomach wouldn't settle. Everything changed when I decided I had had enough of my stomach ruling my life, I will take immodium every day, and eat as many different foods as possible in small quantities. After a week, my stomach settled into a routine, it rebelled at first! I now have only one firm bowel movement every morning, and i take only 1 loperamide a day, also vit d and magnesium. I have had no problems for over 3 months, a miracle! I think my digestive system had become so sensitive it just threw everything out, it needed a routine and a healthy diet, and loperamide provided that. It also tightens the anal sphincter which is a big plus! Good luck.
This is very interesting information. I have used immodium from time to time, but even with one now and again, get constipated, then once my bowel begins moving again, it is followed by profuse, very loose stools, almost diarrhoea. Almost as though it moves quickly all of a sudden once I have had a bowel movement with the constipation. It's very very weird, and I too have no idea why I have it. i have had it for many years, but following a very bad episode of campylobacter food poisoning a couple of years ago has got much worse.
I have also gone through the food restriction thing, and it gets to the point where everything that's presented to you, you are refusing because it causes a bowel upset. I have tried increasing fibre, decreasing fibre, using different kinds of fibre, and had a course of symprove on a trial basis, none of which has helped.
I also know anxiety makes it much worse, I was prescribed a very low dose of anti anxiety medication, which helped for a while. Currently I am going through a period of high anxiety (husband undergoing radiotherapy), so once this is over, and so far as the oncologists are concerned is curative, maybe my anxieties will settle.
But your suggestion is one I think worth trying. It's wonderful that it works for you, and the art of this is definitely finding something that does work for you.
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trying something different 
Please l am beyond myself
Does any body else have constipation followed by diarrhea in the same motion ?
Can't keep up! What even is normal anymore? 
Worried and don’t know what to do
