[CJ78]

Sorry, I did post this on a UK only forum (seems quiet on there), but have just come across this one.
I am sure I am worrying myself unnecessarily, but can't help it at the moment.

Anyway, i've actually been quite anxious and have thought it might be a good idea to discuss my recent thoughts/feelings/anxieties amongst those who have got/had similar problems, issues etc.
To be fair, I have bored my wife of this for many months now, which only goes to show I really need to speak to those who are in the same boat.
I'll list as much as I can about myself, symptoms etc, but really looking to see whether others have similar symptoms/worries, or if it really is just me.

I'm a 33 year old male, being diagnosed with IBS around October 2011.
It is quite a long story, so you may need to bare with me whilst I bullet my points down (what I think are significant points).

I gave up smoking in Jan11, with the aid of Champix.
This was succesful (still not smoking), and came off Champix around June (although I did question with the nurse if I should have come off gradually, but she said no (even though I did about 3 years earlier!)).

Around March11, I noticed an increase in flatulence, and a marked increase in the 'wiff'
Lets say it wasn't well received, and after some time (I think June) I went to the doctors.
I was told at this point, it was likely to just be a change in my digestion - part and parcel of both the medication and giving up smoking.
Anyway, I continued on my way, and never thought about it too much.

Just to note, in May11, I also changed my job (was quite a change to the last 10 years - nothing stressful, but a big change in the way I worked (both positive and negative)).
This was a move of my choice, so no stress of redundency.

During September I noticed quite a dramatic change.
My 'wiff' disappeared, and was replaced with loose stools (bristol chart 7).
I have been back to the doctors numerous times, and have been essentially diagnosed with IBS.

I was first prescribed peppermint capsules, which had not effect.

I then tried loperamide for a couple of weeks, one after each loose stool, with no effect - by this time I am having bowel movements 4-6 times a day on average.

I have now been on Mebeverine for 1 week and 1 day, and whilst I still have loose stools, I have about once a day more of a bristol chart 6 stool.
However, I am now a little worried that this also is not working.
Since taking this, I also seem to have developed 'dump syndrome' - not all the time, and mostly in the evenings.

Now comes the anxiety.
When I originally went in with my loose stools, the doctor (I guess jokingly) said "well we will test for caeliac first, and if that comes back negative, there are plenty more things we can try before we have to worry about the big C".
Well, that panicked me straight away, and thanks to 'google-scaring' myself, I do feel quite anxious at times.
The reason - whilst I do not have blood mixed in with my stools, I do sometimes have, at the end of passing my stools, a little red blood (seperate to the stool itself).

I have now had full blood and stool tests.
Nothing has shown up (iron levels, inflammatory markers, bacterial infections etc), and a different doctor has said the blood is most likely to be coming from my rectum due to passing (and physically pushing (with no stool)) of stools at the frequency I have.
No haemarroids that he could see.
I also do not feel or look dehydrated.

Anyway, on my last visit to the doctors, I mentioned my anxiety and what the first doctor had said, and she has now booked me in to a gastro-specialist to at least remove my worries.

I now have a follow up appointment with my doctor next week, and a telephone assessment for the gastro-specialist next week also.

Apart form the diarrhea, the only other symptons I have are:

1. Bloated feeling (mainly in the evenings) and in the upper part of my digestive symptons (just below my rib cage).
2. Occasional feeling to empty my bowels after passing stools and dump syndrome.
3. Occasional blood after passing stools - separate to the stool itself, but right at the end of my stools

I also get the 'gurgling' tummy, but would have thought I would with the diarrhea.

I however have no pains at all, vomiting, weight loss or any other symptoms come to think of it.

It may however be worth mentioning that since giving up smoking I have put on over 1 stone in weight, and my diet is poor (I do eat the correct foods, but a lot of what I shouldn't eat).
I was also a smoker for 17 years (typically 10-20 per day).
I also found out I was going away on business for a week not long before my diarrhea started - but I am used to being away from my family (although not for a whole week).
I also had suspected IBS when I was a teenager, which did involve stomach cramps, vomitting and diarrhea (but only ever lasted for a few days) - this was typically around exam times though.
The time I also started diarrhea was around 1-2 months after I gave up having sweeteners in my tea (so Saccharin/Asparatame/Ace-K type tablets (possible combination of 1-3 of these depending on the brand purchased), two tablets in each tea/coffee, around 5-8 mugs a day over the space of around 15-18 years!).

Sorry there is so much information, but at times I feel quite alone, but also anxious it is something else.
I will also find this useful for my telephone assessment to put everything down, but it really is about putting everything down and seeing what others thought.
I do get quite low at times (which is always a worry with previous (once) depression) about the loose stools and the frequency, but I do have mostly good times in terms of how I feel myself.
But I have so many questions that keep going around my head.

I mean, is diarrhea something that can be long lasting, even with medication?
Has anyone else had passing of blood?
Does it take time for the medication to work?
Am I just being paranoid that it is something else?

Anything anybody can advise would be appreciated and comforting (I guess I am both not asking the right questions to the doctors (out of worry) and also the doctor is not really reassuring me without prompt).

Thank you.

CJ78

[jmc09]

You give up the loperamide way too early. You can safely use lots and lots of loperamide,just drink plenty of fluids to avoid dehydration.
I was using 12 a day and occasionally 16 before switching to another medication.
Try to take the loperamide with each meal,maybe 2 with breakfast and 1 with dinner and one with your tea if mornings are worst as they are with a lot of us.
Even 2 with breakfast and 1 or 2 with your evening meal,its up to you to find the dose to suit you.
Im also in the uk so feel free to ask any questions you like.

[CJ78]

Thanks JMC.

This is the problem i'm having - the doctors (with no disrespect to them) seem to be a little 'hmpphhhh' about it all.
I wondered whether a more prolonged use of Loperamide would of helped, but the doctor just said stop them if they hadn't worked.
They also didn't fathom the idea of taking them with the mebeverine.
In fact, the conversation was that if mebeverine didn't work, there was nothing else thy could do medically speaking about from refer me to a specialist (which they have now done).

I just get this impression that they are not too bothered (that is 2 out of the 3 doctors, one of them whilst I was asking questions and trying to get my head around things (considering this doctor after reading my blood/stool results didn't even mention anything about the blood) actually said that they didn't have time to discuss all of my questions (and stuck me on the loperamide) - perhaps its just me

[jmc09]

Up the loperamide dose and see how it goes for a couple of weeks and see how it goes,the worst that can happen is a bit of constipation.

If the loperamide dont really help you could take low doses of antidepressants like amitriptyline or nortryptiline or even try codeine phosphate,which i currently use.

FYI no antispasmodics ever worked for me either.
Also if you arent happy with your doctor change them. Ive had 4 different GPs over the last couple of years.

[CJ78]

Thanks again jmc09.

I'm guessing i'm worried the GP's will just slot me in the IBS pigeon hole, give me the usual to try (so not thinking outside of the box such as the anti-depressents, codeine etc) and leave me to get on with my life.

Its not at the point the diarrhea is stopping me doing anything, but I can be driving up to 500 miles a day some days, sat with customers etc, and only get embarresed around somebody else's house or in public.

I just feel that there are so many avenues to explore, but wonder whether they will be fully explored or not.

I need the specialist to be underway, my fears removed, and to start looking to at least try and resolve/control this (at least as much as possible).

[jmc09]

I should also point out linda's calcium sticky at the top of the page.
A lot of people have had success with calcium and it appears to be safe to use with other medications,such as imodium.
There is no cure so the aim is to control the condition and it can be done.

[PrettySparkly]

Hi CJ,

About your anxiety over the blood, as this can be really worrying and it was very unfair of the doctor to even mention cancer before any other tests had been done! Some might say downright unprofessional.

If you have red blood, right at the end (ie, you notice it on the tissue), then this is most likely a small tear either in your passage, or on the skin just outside. I get them sometimes, tiny little tears which heal up in a couple of days. Can be caused by anything from a difficult BM, or other damage to the area (over wiping....)

If the blood is red, it means it is fresh. Just think about when you cut yourself, you get very red blood. If the blood is darker red or even brownish in colour then this is old blood, which means that it has been in your system for a period of time and has essentially 'gone off' (for want of better words!) and should be checked.

I really hope that this hasn't worried you more. I know its really grim but try checking the actual BMs if you notice blood on the tissue and if you see blood actually in the BM then ask. But there are other complaints for which blood in a BM is a symptom - colitis for example which my brother had and is now over.

From some other stories on here, unfortunately it does seem that diarrhoea can be long lasting. Others have mentioned that calcium supplements can help to 'firm up' the stools but my doctor told me that even this can have problems.

Any medication takes time to work but your doctor should be able to give you a good estimate of when you should start to see results.

About the paranoia - probably, but I think that's the same for a lot of us. I've recently been diagnosed myself with mild IBS-D and have been trying very hard to follow guidelines on eating (what / when / how much) and it does seem to be working. I've only had one episode this week so far which is great - I was having them every day! I also try to get exercise and I do Yoga which is good for relaxing. I also have good talks with myself about being a paranoid wuss when I don't have a loo within 5 feet!!

Chin up, we're all here for each other and you need never be alone. And keep on at the doctors if you are worried.

[CJ78]

Thanks PS.

After many months of the odd blood here and there, i'm 98% certain that it is only ever after the end of a stool passing (i.e. when I look at my stools, there is no blood in the stools themselves, just a small blob of blood (on its own) sitting right at the top - and when I wipe, yep...it is there for one or two wipes, but then stops.
All red blood as well (all looks fresh).
Sorry - thats quite a gross description

But you're right about the doctors.
If they had never mentioned it, I would never have thought about it.
But then I wondered the other day if they meant colonoscopy (sp?) instead of cancer?
Who knows, but it did its damage I guess.

I guess what I am needing is to look to find the cause, and then look at a control.
I do feel the docs so far have just been about finding a medical solution, and the specialist appointment next week will hopefully look at the cause and effect, and perhaps start to look at the control side.

I do wonders how much of this is physcological - if I am out and about, I never seem to need the toilet. But when i'm at home, or round a house, I just keep thinking about going to the loo

I seem to have had most tests blood/stool wise (annoyingly, to a degree it all was fine), the only ones left probably physical now.

Has anyone tried or had success with both loperamide/mebevrine combinations?

Sorry, some questions on lactose intolerance as well.
Has anybody had this intolerance come out of nowhere?
Does anyone know if this can be tested by blood tests?

Thank you

[TIGRITSA]

Separate red blood in the stool may happen bwcause of microcracks. I use antibiotic cream for several days and it helps. Also if you do not have good results after proper diet, etc. ask you our doc of ysing Salofalk in small doses. This medicine is used for colits and Krone, but sometime it helps in Ibs. Also ask you doc about microkolits. this type of kolits are difficult to diagnose. I also past all blood tests ,gastro and colonoscopy, nothing was found, but 10 years ago my gall bladder was removed, then for several years I have got constipation that later became D. First treatment, antibiotics, debridat, kreon helped a little. But after some period D appeared again, specially un the morning several times, sometime all day. When I felt really bad and had mucus or loosy watery stools again drank antibiotics-metranidazole. Then started Salofalk, adsorbent Smectite, debridate, probiotics. After salofalk became better. Loperamide is not good for a long time, my doc does not recomend.

[jmc09]

TIGRITSA, on 13 January 2012 - 12:34 PM, said:

Separate red blood in the stool may happen bwcause of microcracks. I use antibiotic cream for several days and it helps. Also if you do not have good results after proper diet, etc. ask you our doc of ysing Salofalk in small doses. This medicine is used for colits and Krone, but sometime it helps in Ibs. Also ask you doc about microkolits. this type of kolits are difficult to diagnose. I also past all blood tests ,gastro and colonoscopy, nothing was found, but 10 years ago my gall bladder was removed, then for several years I have got constipation that later became D. First treatment, antibiotics, debridat, kreon helped a little. But after some period D appeared again, specially un the morning several times, sometime all day. When I felt really bad and had mucus or loosy watery stools again drank antibiotics-metranidazole. Then started Salofalk, adsorbent Smectite, debridate, probiotics. After salofalk became better. Loperamide is not good for a long time, my doc does not recomend.

Loperamide is fine for as long as you want to take it.
Quite simply put your doctor has no grounds for not recommending loperamide long term.If it works then keep taking it for as long as you like.

Ive found taking loperamide for a long time can cause me,not everybody,to become tolerant of it and it to work less.

[CJ78]

Thanks folks.

I would understand the body becoming familiar with loperamide - I think I might ask my doc again when I see them.

Another questions about intolerance/aggrevation - for both questions I guess I refer to lactose/dairy and caffeine; Can small doses activate the symptoms, and for what period of time (I guess varying)? I'm just again thinking whether if it is one of these whether, for example, a cup of tea with milk be enough to cause D and keep my stools loose for over 24 hours (by which time I would have at least had another cup to tea)?
In other words, I need to cut these out of the diet.

I also just read this -> http://www.patient.c...drome-(IBS).htm

I was actually given the link/advised to read the patient information, but reading the doctor information actually makes sense.
It also re-enforeces that the first doctor (which BTW was actually my usual doctor (perhaps thinks i'm a hypocondriac )) should not have mentioned the C word, and the latter doctors should have re-enforced their opinions about such matters as it seems to be a common thought process of people with IBS.
Interesting they all missed this part of the diagnosis

Its still all very confusing - I'm coming round to the fact it's IBS (the worry of C hopefully starting to subside (but then think I might be too relaxed and still need it confirming that its not)), but really trying to work out if it was caused by physical changes, psychological changes or dietary changes.
I can then perhaps work on that, and then look to also control my D.

Ah....tomorrow's another day (and have to count myself lucky, as I clearly am not too bad (serious sympathy for others on here!))

[jmc09]

These are the team who I deal with and the information is very good.

http://ibs-care.org/

[CJ78]

Thanks again jmc - actually used too live not far from there.

The more I read in to this, a lot of what to do, to feel, to try comes down to how good the doctors can be/want to help.

I'll certainly see how next week goes - time to push for what I deserve.

[CJ78]

Just wondering whether there were any thoughts on the below?

CJ78, on 13 January 2012 - 01:58 PM, said:

Another questions about intolerance/aggrevation - for both questions I guess I refer to lactose/dairy and caffeine; Can small doses activate the symptoms, and for what period of time (I guess varying)? I'm just again thinking whether if it is one of these whether, for example, a cup of tea with milk be enough to cause D and keep my stools loose for over 24 hours (by which time I would have at least had another cup to tea)?
In other words, I need to cut these out of the diet.

Also, in respect of psychological triggers.
Can these episodes trigger IBS-D, and then nothing else is required for the longevity of the IBS-D (i.e. IBS-D stays until x point in time, and medication is used to try and control it?)?

I guess i'm trying to find learn about my triggers.

Thank you for any advice.

CJ78

[jmc09]

I cant say anything about intolerances as i dont appear to have any that i know of. Ive been tested for many things and no results have been positive.
I would however like to give a wheat or gluten free diet a short go sometime as things like weetabix or shredded wheat breakfast cereals do cause bigger problems than other cereals and bran cereals too.
If i have medication i can eat most things.

As many have said on here though,sometimes food gets a bad rep as IBS is a functional disease and its purely the function of the bowel which is to blame.If IBSers dont eat for a while their bowels are pretty normal yet once any food is introduced the symptoms kick off big time.

So basically,sometimes there arent any triggers except for insoluble fibre which can cause problems with normal people too.

[CJ78]

Thanks again.

I have been tested for caeliac, but this came back negative. So cereals containing wheat shouldn't cause me a problem, although the fibre aspect is a good point.
Food tolerances though could very well be my next step...just in case.
I haven't yet stopped eating anything myself as there doesn't seem to be anything that specifically triggers it off (but do have certain foods in my diet that are constant daily).

Strange as yesterday as whilst I had the usual BM types I was only on the toilet 4 times. I also have only been twice today, but with loose BM's.
I remember last night thinking I needed to go, and whilst I didn't hold in/back (if you get my drift), after a few minutes it went - a little like a craving for a cigarette when giving up.
So then I start to wonder, whilst the loose BM's are physical, is the frequency psychological (e.g. I only seem to go more regularly when I am in a place of comfort (such as my own house, my parents house etc).
When I am somewhere else, I don't always (so not a rule of thumb) feel like I need to go...quite often for half a day.

[TIGRITSA]

Ive found taking loperamide for a long time can cause me,not everybody,to become tolerant of it and it to work less


That it what i say. As long as u can stay without it is better. Otherwise after some period of time u will start to increase the dose & one day it will not work. We had this kind of things. I mean the russian forum. I have many friends there, they are really hardworking IBS fighters and try many things. Then we discuss it.

[CJ78]

Well week 3 of Mebeverine, and from Sunday evening to today (bar either Tuesday with 7), my BM's have moved to 6 on the bristol chart so an improvement.
Movements are also less frequent at the moment too - 3 times only today and 4 times yesterday.
I don't want to jinx it, but maybe the mebeverine is starting to work

I phoned up for my telephone assessment with the Gastroentorologist, and never even had an interview - the consultant looked through my notes and had automatically referred me for an appointment on........March 09th.
So whilst it is good to have this is the diary, perhaps also a relief from a paranoia point of view from anything more serious

Also taking a precautionary test for H Pylori. The doctor doesn't think its likely, but my wife, her sister and her mum have all had it.

Fingers crossed everything carries on as it is - it is so much more pleasant pushing than having to hold back (sorry about the details, but IBS-D on bristol 7's and 6-8 times a day is not nice).

[CJ78]

Perhaps i spoke too soon. Back to proper IBS-D (Scale 7) since Sunday evening

Can't put my finger on it. The only thing is whether lactose is a trigger. I had quite some cheese on Sunday in a risotto, leftovers Monday lunch and also cottage cheese yesterday. I also had cereals both Monday and Tuesday morning

More time and help needed me thinks. Frequency is also up to about 5-6 times a day.

[jmc09]

Take imodium as much as necessary. Antispasmodics are very hit and miss while imodium is pretty useful.