Loperamide for IMO?

[skylark15]

Hi, community.

About two years ago I had a Hydrogen/Methane breath test, which showed that I had IMO, rather than SIBO.

I wasn't particularly interested in the name because my chaotic bowel continued to be chaotic in its usual way. However, in the last couple of months, things have really ratcheted up and I'm spending much of my time either in the bathroom, or anxious if I'm not sure when or where I will find one, if we're out.

I've asked a dietician and also a private Nutritionist/ Functional Medicine practitioner and they both advised me to "...cut out the sweet stuff." So difficult, but I'm persevering.

In an attempt to manage the situation ( temporarily, I suspect, as this is likely to be a losing battle), I was looking for a way to slow down the uncontrollable passing of very soft motions, and to help firm them up. It looks as if Loperamide ( Immodium here in UK) may be the best drug to try, and is even used for people with an ileostomy.

Has anyone with IMO found Loperamide helpful in similar circumstances?

[BabsyWabsy]

Hi Skylark, I had to look this up. You could try taking a loperamide for a day or two (cheaper than Imodium, but same licenced medicine) and see if it has a beneficial effect when introduced cautiously. Some people with IMO have constipation rather than loose stool. Check with your medical team if you are unsure.

[skylark15 in reply to BabsyWabsy]

Hi, BabsyWabsy,

Thanks for your reply. I have actually (and cautiously!), tried exactly that; taking Loperamide for a couple of days and LO!, it helped. I won't go into detail, but just say that I wasn't in the bathroom for half an hour 😊.

x

[BabsyWabsy in reply to skylark15]

Brilliant! No details required. I find it helpful on occasions. Something that helps me if I have an event coming up is to take one a couple of days before and another the next day. I am then Ok for a few days.

[skylark15 in reply to BabsyWabsy]

Thanks, BabsyWabsy.

x

[xjrs]

Bear in mind that breath tests can be inaccurate and create many false positives. It seems unusual to have loose stool and urgency with methane dominant bacterial overgrowth, since this tends to cause constipation, unless you are suffering from overflow diarrhoea where liquid stool is seeping around impacted stool. In this case you could try working on the constipation.

The reason I say you cannot 100% know for sure, is that I was misdiagnosed from the breath tests and actually had IBS with visceral hypersensitivity. The treatments for SIBO made my health far worse in the end. The syndrome does exist but maybe not a prevalent as people think.

The reasoning behind this is here:

ibsresearcher.com/sibo/

I know you mention IMO, but the link talks about both.

My journey here:

ibsresearcher.com/my-journey/

Looking after constipation here:

ibsresearcher.com/constipat...

Diarrhoea and general symptoms:

ibsresearcher.com/diarrhoea...

IBS overall:

ibsresearcher.com

[BabsyWabsy in reply to xjrs]

Thanks for sharing this, I was also under the impression IMO tended to constipation.

[skylark15 in reply to xjrs]

Dear xjrs,

Thank you for your kind and helpful response, and the links. I'll definitely check those out.

Overflow diarrhea was my first thought, actually, but it doesn't fit with what's been happening.

I have written to my Gastroenterologist, described the pattern of what I've experienced over the last few months, and asked for her opinion. I've sent her a scanned copy of the breath test report.

Meanwhile, as Loperamide seems to have helped, there'll be no harm in continuing a small dose. Thanks again.

x

[Letsfixit1 in reply to skylark15]

Hi, I also had to look it up! I haven't had any tests for my IBS but after years of restrictive diets and various supplements, the only thing I have found to work is loperamide. I've found it best to take just 1 tablet every day, rather than using it only when necessary. This seems to have desensitised my stomach and settled it into a regular routine. I agree with the suggestion of cutting back on the sugar, it's scary how much you eat without realising it. And I think I became malnourished with the daily diarrhea so I'm trying to improve the quality of my food, more protein and vegetables, and less snacks. Good luck.

[skylark15 in reply to Letsfixit1]

Thanks for your reply, , Letsfixit1,

It's great to learn of other peoples' experience. Yes, the amount of 'unconscious' sugar (of all sorts) that I've been eating is quite shocking. Plus, sadly for me, limiting potatoes, white rice etc, will be very difficult because I really like potatoes, in all their various forms, and my husband grows a variety called 'Pink Fir Apple', which are delicious 🙁. The obvious thing,s like home made cakes, scones and such like,, are perhaps a bit easier to cut down on.

These limitations and possibly the low dose Loperamide, will probably be for the rest of my life, if cutting out the sweet stuff and a course of Rifaximin and Metronidazole,, actually clear out/starve the methanogenic bacteria and relieve the symptoms. Sadly, it also clears out the beneficial bacteria, which will take some building back up.

x

[Letsfixit1 in reply to skylark15]

I eat a lot of potatoes, and I bake my own bread to make it at nutritious as possible, without the horrible preservatives they add. And without potatoes and bread I would be starving! But I am cutting out the biscuits, cakes, crisps which is hard, and increasing my exercise.

[Kestrel66 in reply to Letsfixit1]

Yes this also works well for my IBS-D

[Mkimber1]

I live on Immodium for my IBS-D. The only downside is that after many years I've built a tolerance and have to take a lot at a time for it to work

[skylark15]

Hi, Mkimber1. Thanks for your response. What a bore, developing tolerance after taking a lot of Loperamide for a while.

I put "...drug in same class as Loperamide" into a search engine and thought I'd found an alternative. on the IBS Network. I wonder if you've spotted that? However, NICE has "withdrawn guidance" on that and the drug doesn't appear to be prescribed in UK.

Oh dear. Good luck for the future.

x

[Eastbourne11]

I have used immodium for some years, one, two or three a day - they do top diarrhea. There do not seem to be an side effects. Try one after each big meal, the effect can be seen next day. If motions still too soft try three thoughout the day. Doctors can prescribe it. It is all trial and error. good luck

[skylark15 in reply to Eastbourne11]

Hi, Eastbourne.Thank you for your response to my question; it's really helpful advice, which I'll put into practice.

Trial but too often error, is my own SIBO/IMO experience so far!

I may write another post soon, asking for people's experiences using either a combination of powerful antibiotics to blast the gut clear of all bacteria, good and bad, vs trying a gentle approach with diet and 'herbal' management.

X