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Pain AFTER a BM?


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#1 rjc

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Posted 26 February 2009 - 12:10 AM

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Anyone get abdominal pain or spasms after a BM?Thnx


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#2 CatUK

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Posted 26 February 2009 - 05:15 AM

I get really bad pains when I have to go then after I've been I get pain again and feel very very sick. Don't know why as usually it's a normal bowel movement

#3 Kathleen M.

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Posted 26 February 2009 - 08:21 AM

It can happen in IBS depending on what parts are sensitive. It is not the most common pattern, or so specific for IBS you would use it as a diagnostic symptom.Rectal hypersensitivity can go away after a BM because it is triggered when the rectum is full and eases off after the rectum empties. This is not the only pain issue in IBSers. It is found in over half of all IBSers.There really isn't any other thing that pain after a BM means you need to be tested for. It isn't like the IBD's or any other disease is pain after a BM and no other time and it can't be IBS. Some people get pain after a BM although pain relieved by a BM from the rectal hypersensitivity is almost diagnostic for IBS (that is if you have that symptom it is unlikely to be anything other than IBS as it really is the thing that causes rectal hypersensitivity).Some people (both with and without IBS) that have Proctalgia Fugax or Levator Ani Syndrome that is basically a cramp in muscles and sometimes a BM triggers those pains. This is still a functional pain, but in different muscles.For some people other parts of the colon get crampy after you move things along and out. A fissure or hemorrhoid can also have pain after a BM.
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#4 rjc

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Posted 28 February 2009 - 11:28 AM

It can happen in IBS depending on what parts are sensitive. It is not the most common pattern, or so specific for IBS you would use it as a diagnostic symptom.Rectal hypersensitivity can go away after a BM because it is triggered when the rectum is full and eases off after the rectum empties. This is not the only pain issue in IBSers. It is found in over half of all IBSers.There really isn't any other thing that pain after a BM means you need to be tested for. It isn't like the IBD's or any other disease is pain after a BM and no other time and it can't be IBS. Some people get pain after a BM although pain relieved by a BM from the rectal hypersensitivity is almost diagnostic for IBS (that is if you have that symptom it is unlikely to be anything other than IBS as it really is the thing that causes rectal hypersensitivity).Some people (both with and without IBS) that have Proctalgia Fugax or Levator Ani Syndrome that is basically a cramp in muscles and sometimes a BM triggers those pains. This is still a functional pain, but in different muscles.For some people other parts of the colon get crampy after you move things along and out. A fissure or hemorrhoid can also have pain after a BM.

Thanks for the info...please elaborate on what I highlighted.My pain following a BM is abdominal and I have very little to no pain before, unless I am constipated.

#5 Kathleen M.

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Posted 28 February 2009 - 12:33 PM

Some people think that if pain relieved by a BM is a symptom of IBS, then pain after a BM must therefore be a specific symptom of some other disease.It is not.There is no disease that I have found that only causes pain after a BM and means you cannot possibly have IBS.I do not know how else to tell you it doesn't mean you don't have IBS or it doesn't mean you must have something else.A few things do tend to hurt more after a BM, like a fissure, or a couple of non-dangerous in anyway muscle cramps back there.Any part of the colon can hurt in IBS and only rectal pain gets better after a BM. Pain after a BM is seen in some IBSers and is not a sure sign you can't have IBS.
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#6 rjc

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Posted 01 March 2009 - 10:48 AM

Thanks Kathleen...I'm not sure what;s going on but my GI thinks it's IBS and I/m not 100% on board with him on this one

#7 baz22p

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Posted 01 March 2009 - 12:14 PM

I often find after BM I feel worse - my bloatedness starts, I get chest pain, I feel lethargic. I can understand this because it is responding to the motility of my GI; but what I can't understand is when I start feelng like this when I have had a false alarm (ie been to the toilet but nothing has happened - no BM).Baz :(

#8 Kathleen M.

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Posted 01 March 2009 - 12:37 PM

Are you having symptoms of non-functional diseases or just can't find every last thing that occurs in in a list of IBS symptoms. You seem to be looking for something, anything to say it can't be IBS.Functional bowel disorders have a range of symptoms and the ones most common or most diagnostic is what you find on the lists. Not any symptom that might happen at any time in any patient.IBS is not the only functional GI disorder, but sometimes IBS is used when they really should pick a different functional disease for the name. However since they treat the symptom the same way no matter which functional disorder it is I'm not sure it makes much difference. Now if you have bloody diarrhea, weight loss all out of proportion to any calorie restriction (so you don't eat most days to avoid symptoms you are going to lose a lot of weight. You eat a large cheese pizza in addition to three large meals a day as a bedtime snack and that is inexplicable weight loss), or abnormal blood work like an elevated sedimentation rate you are seeing symptoms that tend to indicate non-functional issues.
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#9 baz22p

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Posted 01 March 2009 - 12:55 PM

Are you having symptoms of non-functional diseases or just can't find every last thing that occurs in in a list of IBS symptoms. You seem to be looking for something, anything to say it can't be IBS.

Sorry to be thick Kathleen, but I'm not too sure what message you are trying to convey. Maybe I'm secretly looking for a way out of IBS so that I can return to a normal life. Are you saying that, after all the tests I've been through, and all the medication I've tried, that my doctors may be wrong? Or could there be some underlying problemwith how I handle the issue of IBS - my GP is nominating me for CBT as the next step......perhaps this is a wise move (?)The only things I know are what I've been told, and how I feel. Baz :(

#10 Kathleen M.

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Posted 01 March 2009 - 03:42 PM

I was responding to rjc's statment that he didn't believe his doctor that what he has could be IBS. Some people will never believe any doctor they have IBS.The comments can be taken more generally as well.Some people have symptoms that are clearly red flags for other things and they really do need to make sure all the tests are done. If you have bloody diarrhea, cannot maintain weight no matter how much you eat or have blood tests showing high levels of inflammation you might not want to accept it is functional, but then again most doctors won't either.On the other hand we do see things with rjc and a series of posts where people seem to be trying to find one tiny little thing that is not on the major symptoms that define a functional disorder. The ones that are common to all the people with IBS symptoms. No one says the three biggies for IBS are the only thing IBSers can ever have, but most of the minor things are not listed as 5% have this and 5% have that, but stick to the ones that 100% have and define the syndrome. Not listed in the diagnostic symptoms doesn't mean can't possibly happen and must be something completely different.I understand some of that impulse because it feels that since some other things have a long list of assorted drugs specifically for them they must be easy to treat and live with. Some people are luck and do go into remission with drugs but most have way more problems than anyone on the outside seems to think they have. Often those drug cause serious problems so just because there is a list of drugs doesn't make it a much better disease to be diagnosed with.The other group we see is "not quite enough to have IBS". Many of the functional GI problems are some but not all the symptoms you need to diagnose IBS and having less symptoms than IBS is usually a very good sign. More serious things are always certain symptoms like bleeding.No matter what combination of stool consistencies, volume or pain timing every last one is seen in IBS.Some people have anxiety and other issues and the fact that IBS isn't that easy to test for, but is usually when you don't find other things means they never have to accept the diagnosis and can keep on the quest to prove they really can't have a functional disorder. Sometimes to the point they really make themselves a lot worse than those that accept the disorder and start working on dealing with it.
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#11 rjc

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Posted 01 March 2009 - 03:52 PM

Katheen, I also have UC... and when I'm flarring I get the very large production of stool followed by horrible abdominal pain/spasms which the GI thinks is IBS...I don't buy it and feel it is my UC as when I'm in certified remission via pathology plus visual assement I'm 100% fine and have no symptoms of any kind. The large stool production must not be a common symptom of UC and that's why he's putting the blame to IBS...but I hear of very few IBSers complaining of producing 4Xs the normal stool output in a daily BM followed by all the pain which can last 12 hours (I have no pain before I go) this in turn can cause serious weight loss which he is also aware of. I really didn't want to get into all this but I could see I needed to further explain the situation. What do you think?Thanks

#12 Kathleen M.

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Posted 01 March 2009 - 03:58 PM

My stool volume is all over the place with IBS. You see larger stools either with constipation when a lot all compacts together but hasn't dried up enough to be rabbit pellet stool or when you are a bit on the loose size and there is a bit more water.Some days I poop out a heck of a lot more than other days even when my IBS is in remission and having collected stool from normal people on a controlled diet the volume can vary a lot when someone has no GI problems.People get a dual diagnosis UC and IBS when they have GI symptoms other than bloody diarrhea, inflammation in the blood work and weight loss that usually are in the "every BM is different" or "I have pain" range of things.If you need to believe you have only UC symptoms and can't have functional issues on top of that, I don't know what to say.You have another diagnosis and you can believe everything must be that. However it is common that the inflammation from the flare ups of UC eventually causes the same kind of damage to the nerves controlling the gut that the inflammation from a GI infection causes in people who just have IBS.Inflammation causes the same damage no matter what is the trigger for it.I don't know why it is unacceptable that you have any symptoms that might be more functional than anything else. It isn't unheard of for UC people to have functional issues on top of the UC.Pain after you empty out is seen in IBS and doesn't sound typical of UC. Variation in day to day stool volume is typical of IBS and I can't think of reason why UC would cause that specifically in a way different from everyone else's variation in stool volume either when normal or the bigger variation you see in IBSers. Weight loss if you eat as much as maintains weight when you don't feel sick is probably explained by you have UC. Although a lot of people don't eat as much when they are sick and in pain.One of the reasons they think fiber sometimes helps with pain in IBSers is it tends to keep the colon pretty evenly full rather than have long stretches of mostly empty times.
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#13 baz22p

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Posted 01 March 2009 - 04:09 PM

Sorry Kathleen, my mistake - I mis-read the intention of your post. Rest assured that I've had all the usual tests (barium enima, endoscopy, blood tests, anal sphincter check/strength testing, etc). I have accepted the disorder but this is where most of my anxiety creeps in......the most frustrating part for me is identifying the triggers, as one day my food intake is fine, but another day it may cause a reaction. I have kept a daily diary of my foods for the last 3 years but nothing has shown itself. I have tried the life-style 'aids' (exercise, focusing on other activities/hobbies/interests, etc) but so far I have found nothing to help me. I will admit that life hasn't been to easy for me recently, coping with the death of my dad (you can imagine what that has done for my IBS!).The one thing I must learn to do is not to mis-interpret people's messages (sorry again), you can obviously spot the 'problems' a lot quicker than some of us - I appreciate you have vast experience in dealing with IBS, and I value your input/contributions.Baz :(

#14 Kathleen M.

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Posted 01 March 2009 - 04:12 PM

Sometimes it is just day to day variation in physical stressors (like sleeping a bit better or a bit worse, or the weather being more or less comfortable) that can effect why IBS is worse one day over another. Mental and emotional stress doesn't help, either.Some people find certain foods tend to be problematic regularly when the IBS is flared up for other reasons. So greasy chili on a bad IBS day may always be bad where something like grilled chicken and rice is almost always safe. But the food isn't really driving things but does uncover if it is otherwise a good or bad IBS day.
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#15 rjc

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Posted 02 March 2009 - 01:14 AM

My stool volume is all over the place with IBS. You see larger stools either with constipation when a lot all compacts together but hasn't dried up enough to be rabbit pellet stool or when you are a bit on the loose size and there is a bit more water.Some days I poop out a heck of a lot more than other days even when my IBS is in remission and having collected stool from normal people on a controlled diet the volume can vary a lot when someone has no GI problems.People get a dual diagnosis UC and IBS when they have GI symptoms other than bloody diarrhea, inflammation in the blood work and weight loss that usually are in the "every BM is different" or "I have pain" range of things.If you need to believe you have only UC symptoms and can't have functional issues on top of that, I don't know what to say.You have another diagnosis and you can believe everything must be that. However it is common that the inflammation from the flare ups of UC eventually causes the same kind of damage to the nerves controlling the gut that the inflammation from a GI infection causes in people who just have IBS.Inflammation causes the same damage no matter what is the trigger for it.I don't know why it is unacceptable that you have any symptoms that might be more functional than anything else. It isn't unheard of for UC people to have functional issues on top of the UC.Pain after you empty out is seen in IBS and doesn't sound typical of UC. Variation in day to day stool volume is typical of IBS and I can't think of reason why UC would cause that specifically in a way different from everyone else's variation in stool volume either when normal or the bigger variation you see in IBSers. Weight loss if you eat as much as maintains weight when you don't feel sick is probably explained by you have UC. Although a lot of people don't eat as much when they are sick and in pain.One of the reasons they think fiber sometimes helps with pain in IBSers is it tends to keep the colon pretty evenly full rather than have long stretches of mostly empty times.

I have no problem accepting that some have IBS and IBD but as I mentioned earlier when I am in remission I have no symptoms at all, either IBD or IBS and if IBS and IBD are seperate diseases/disorders then why do all of my disgestive issues clear up only when my UC is in remmission? I googled large stool amounts etc and came up with very limited info and just a handfull of people citing this issue let alone with IBS or anything else for that matter. Curious do you go into all day pain/spasms on the days you evacuate large amount s of stool and do you have the 4 lb episodes like me?Thanks again

#16 Kathleen M.

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Posted 02 March 2009 - 06:34 AM

When my IBS was bad I was in pain all the time. I never had a good day and never had a break.Even now I sometimes have days I can't believe how much poop comes out of me and my IBS is now in remission. I never actually weighed the stool every day to know my average weight is and what my "where the heck did all this come from" days weigh. I'm really not that interested in collecting the data for you. I do know some stool consistencies can have a lot more volume than other days.I do know for some people even if the stool consistency is pretty normal you can get a "flushing" so you might dump all 48-72 hours worth of stool in the colon in one day rather than just one days worth in one day. When the colon is overly empty that can cause pain in IBSers but that usually wasn't my pain pattern. I had severe pain every time ?I walked more than 10 steps, every time I ate for about an hour after eating and every time I used my abdominal core muscles to do anything. However mine is not the only pain pattern.I don't know of anything other than a functional issue to explain your symptoms and it sounds like it isn't UC, either. However it doesn't sound like it would be something even more serious then UC that your doctor refuses to look for or treat. It sounds like a functional issue even if it really annoys you to have a bad day every so often it doesn't sound dangerous or out of line with some of my experiences.All the issues that clear up when the UC are in remission are probably from the UC, this "flush day with empty colon pain" thing might be the only functional issue you have. Your lucky. I'd have killed for that back when my IBS was really bad.I really don't know if there is anything I can say that will either reassure you or explain anything, so maybe I should stop trying.
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#17 rjc

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Posted 02 March 2009 - 10:27 AM

Don't give up as I find your feedback both interesting and helpful. I never weighed the stool itself just weighed myself before and after my a.m. BM. The interesting thing is if I dump alll 48-72 hours worth of stool in one sitting, I still have a normal BM the next day, in other words I'm not missing/skipping days causing the large evacuation...was this the same for you too?Thanks again.

#18 Kathleen M.

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Posted 02 March 2009 - 10:52 AM

I usually go every day whether I have 1 BM the day before or several. It is very rare I skip a day. Now I do eat three meals a day and snacks so I am always adding more into the system. After a GI illness when I still can't eat for a couple of days that will sometimes mean it is a day or two before the next round gets to the end.You may not be completely dumping the whole colon, just a lot more than usual. Also remember that bacteria make up a lot of stool volume as well as shed colon lining cells. (it is like your skin it continuously renews it self). So even if you don't eat there is a certain amount of volume made every day.
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#19 rjc

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Posted 02 March 2009 - 04:44 PM

Thanks again Kathleen. Do you ever have one very large evacuation in just one sitting? That seems to be the case with me and then the pain/cramps/spasms follow for hours at time.

#20 rjc

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Posted 02 March 2009 - 04:44 PM

Thanks again Kathleen. Do you ever have one very large evacuation in just one sitting? That seems to be the case with me and then the pain/cramps/spasms follow for hours at time.





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