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Ibs-a ibs-c Bloating

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#1 Nurse Josh

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Posted 24 February 2015 - 02:59 PM

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Hello everyone,

My name is Josh and I'm a healthcare worker in California. I have suffered from GI ailments for about 4 years, but wasn't diagnosed with IBS until 2 years ago. I have had 2 colonoscopies, 1 endoscopy 1 CT scan and about 15-20 blood draws to date. I kept looking at this site as my symptoms worsened and I found no relief. My biggest issue is with incomplete bowel movements and long bathrooms times. It has absolutely destroyed me, my personal life, my social life, my job, and my schooling. I have missed tremendous amount of time from work and school because I'm laying on the floor or sitting on the toilet. I've become obsessed with my stomach because of how uncomfortable I am during the day if i don't completely go. I hope that I can find someone with similar symptoms who has advice for me so I won't let my life slip by. I have extensive knowledge in healthcare and science, help patients feel better daily, but can't take care of myself.

- Josh

#2 marleyma

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Posted 24 February 2015 - 04:37 PM

Hi josh,
Welcome to the forum. You will find many of us with similar situations. I definitely can relate to an unsuccessful morning turning into a complete downfall of a day! So frustrating, isn't it? Im here if you need someone to chat with.
:-)

#3 annie7

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Posted 24 February 2015 - 05:49 PM

HI Josh

 

welcome to the board.  and so sorry for all your problems....yes it can be very difficult, struggling with all of this especially when you are working.  you have my sympathies. and empathy.

 

i have colonic inertia, pelvic floor dysfunction and other problems. i  found it very difficult to drag myself off to work everyday for so many years when i was all backed up and miserable.  i always have tried very hard to immerse myself in whatever i am doing to distract myself from the pain and discomfort and distraction does help, i found,  but the pain is always there in the background, like bad muzak.

 

about incomplete evacuation--not going completely--have you tried putting your feet up on a footstool  while sitting on the toilet.  elevating your feet on something like a footstool, shoebox, etc or a squatty potty  while sitting on a toilet will help straighten out the anorectal angle and allow  a more complete evacuation. it's easier to get everything out that way.  i've been doing it for years--started with a shoebox and now i have a squatty potty.  it does help.

 

that is wonderful you are helping others in your work as a health care professional.  i do hope you can find some relief.  take care.


these are just my own thoughts. for expert medical advice please contact a health care professional.


#4 Nurse Josh

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Posted 25 February 2015 - 01:07 PM

Thank you annie and marley for your support and replies. I will try the stool idea. I'm not sure if it's okay to getting into specifics on the introduction page or should i start a new conversation under "my story"? I guess I feel lost because I don't have IBS-D (only occasional diarrhea) and I dont have hard stool that holds me back 2-3 days of nothing, IBS-C. The doctor first of course prescribed stool softeners, fiber, and laxatives. I take fiber supplements daily but just feel bloated and gassy all of the time, ive tried psyllium husk, citrocel, and vitagummies fiber and they all seem to at least get me started going. The stool softeners are a waste because everything is totally soft, softeners can turn it to diarrhea. The laxatives are pretty much the worst thing in the world, make me feel like i have the stomach flu. So basically im left with fiber increases that arent actually bulking anything much. I can't recall the last time I passed anything hard. The symptoms are intense, but ultimately the one symptom I HAVE to figure out is my bathroom time in the morning. My record is 2.5 hours in the bathroom, I was almost in tears that day. I start slow, keep feeling like i have to go, dont want to leave or Ill be in pain or uncomfortable or fatigued, so i stay there just hoping, go a bit more and so on. Usually right as I'm about to pack my backs and leave the toilet due to not much happening (an hour in) Im hit by the fury of hell and feel serious urge to go, straining still and pushing, and going a tremendous amount. Doesn't help that I don't even get to having a full meal for the day until 2 pm. Don't get me started about public restrooms and school......I just can't keep doing this! I'm losing my life in the bathroom!

#5 marleyma

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Posted 25 February 2015 - 01:18 PM

I dont know if this is a GOOD idea, but its an idea. Have you thought of trying an enema before you leave the house? Or maybe at night? My dr told me to do this every day. I definitely dont like the idea of it (and I found it an odd suggestion coming from a dr) but i guess its one way to get everything out.

#6 Nurse Josh

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Posted 25 February 2015 - 01:27 PM

Marley I have a few concerns about that. Ive heard that regular enemas can cause the bowels to become dependent on them. I'm only 27 so I'm hoping I can exhaust other methods. Secondly, I think my problem is a full motily and irritibility issue, because it seems like things coming out are not fully formed so I don't think they are sitting at the bottom of the colon like in say full constipation. Im not sure if an enema would reach up high enough to cause relief.

#7 marleyma

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Posted 25 February 2015 - 02:12 PM

Totally understand. That dr was an idiot. We broke up after that appointment :-)

#8 annie7

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Posted 25 February 2015 - 02:14 PM

Josh--it may not be that you have ibs-c. i know you've said you had some tests--colonoscopy, endoscopy, blood tests--but there are some other, more specialized tests that can help pinpoint the cause of your constipation. do you have a good gastroenterologist?

 

the sitz marker test (colonic transit study) will dx slow transit constipation (colonic inertia) I have that. if your colonic transit is slow, this test will tell you that.

 

if you're spending lots of time in the bathroom and are having problems with getting stool out and with  incomplete evacuation, it could be you have pelvic floor dysfunction or another outlet problem.  pfd is not just a woman's problem--men can develop it, too. a defecography (defecatory proctogram) will dx outlet problems such as pelvic floor dysfunction, a rectal prolapse etc. an anal manometry is usually needed to further dx pelvic floor problems. I have both those fun tests too.  and pfd.  biofeedback can help with pfd. ti teaches you how to relax the pelvic floor muscles so you can get stool out more easily and completely.

 

having to strain can be another indication of pelvic floor dysfunction.  straining not good to do--i imagine you know that--and is counterproductive--it just locks those pelvic floor muscles up all the more.

 

 

those little fleets enemas doesn't go up all that high unless you use several of them but one of those big red bag enemas--the kind that hold a quart of water--definitely would.

 

about where to post.. you can keep your thread going here if you want . or you might want to post over on the constipation board. that would give you a bigger audience. i think more people read over there--especially us constipated folks lol--than over here or on the  " your story"  board.   you'd probably get more replies that way.  i could maybe try to move this thread of yours over there to the C board if you wanted.  or you could just repost it over there. or ask new questions over there.


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these are just my own thoughts. for expert medical advice please contact a health care professional.


#9 Nurse Josh

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Posted 25 February 2015 - 03:33 PM

Annie you have no idea how weird it was to recieve your post. I finally had the courage to change my GI of 2 years yesterday and met with my new specialist an hour ago. After interviewing me and reviewing my information he immediately focused on pelvic floor dysfunction, something my other GI didnt even seem to acknowledge. He planned on a glycerin suppository to try out in the morning to stimulate nerves, and set me up with biofeedback therapy, a sitz marker test, and TCA antidepressant afterwords if they dont work. I hope this is a start of something finally! I currently take a low dose of tramadol that has worked wonders for me when im in stomach pain but slows motility so im going to wean off of it but it scares me because i know i will be in more pain for a while. You are awesome Annie.
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#10 annie7

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Posted 25 February 2015 - 04:06 PM

oh what wonderful news!!!!

I am SO happy for you, Josh, that you had the courage to change your GI doc (that can be hard to do) and finally found a knowledgeable, proactive doc who actually listened to you and who has a terrific treatment plan for you, complete with tests, biofeedback--the works!  Hooray!!!  

 

biofeedback really can help with pfd. I've had pfd for years so I had years of tight muscle memory to unlearn.  I had two courses of it --8 weeks and 6 weeks--and then bought a home biofeedback machine (love it) for daily practice.  it really helped teach me how to relax those muscles.  my biofeedback PT was terrific.  so supportive, caring and knowledgeable.  I asked her tons of questions and learned a lot.

 

i  sometimes use glycerin suppositories. they often help. they are especially effective when there is stool stuck down there in the rectum. 

 

good for you for weaning off the tramadol.  i can't take tramadol or any of the stronger meds like vicodin--they are all so constipating. they totally kill what little motility i have left. yes, it's hard to wean of but you're strong--you're brave--you can do it!  take it slow.  it'll be worth it --getting off of it will help your motility.

 

so happy for you smile.png


these are just my own thoughts. for expert medical advice please contact a health care professional.


#11 annie7

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Posted 25 February 2015 - 05:51 PM

a couple more thoughts--

 

yes do try using the footstool while on the toilet.  it was one of the things my biofeedback PT recommended although i was already do that.

 

here's a great video on "how to have a bowel movement without straining" . it's done by a pelvic floor physical therapist, Michelle Kenway.  her instructions are a lot like the ones my biofeedback PT gave me.  such as, instead of straining with your rectum (not good--counterproductive) do the "belly pooching" thing or as Michelle puts it, the "brace and bulge" technique. it really helps. push with your belly--make your waist wide and push that way--not from your rectum.

 

         


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#12 Nurse Josh

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Posted 25 February 2015 - 09:33 PM

Did they talk to you about pushing on your stomach? I am always pushing on my stomach now to push gas out or when im on the toilet, and im worried it's hurting me more. My First GI doctor dismissed it completely.

#13 annie7

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Posted 26 February 2015 - 05:39 AM

i didn't ask her specifically about pushing on my stomach. i do that, though, to get gas out and also to try to move stool out when i'm a bit backed up. i do it lying on the bed, though. for some reason i've never had luck with that when doing it while sitting on the toilet.

 

i have told both my gastro docs that i do this and neither of them had a problem with it. they said it was ok.

 

i do remember a post here from a long time ago from a guy who was having to push on his stomach rather vigorously  every day in order to have a BM.  he was concerned about this and asked his biofeedback PT if this would hurt him and she said no--that it was ok to do.

 

one thing you want to make sure you don't do while doing this is to tense up your anus or your pelvic floor muscles. keep them relaxed while doing this. i found that i was tensing them while doing bowel massage or just stomach-pushing.  it helps to keep your muscles relaxed down there so gas and/or stool can move down.

 

my PT did tell me to do bowel massage. she discussed it with me on the very first visit, showed me how to do it and gave me an instruction sheet on it.. she advised doing it for 5 to 10 minutes a day, in the morning after eating breakfast to help stimulate a BM.  it there are some good u-tube videos on bowel or colon)  massage.

 

what you do is, you massage the colon starting on the lower right hand side and slowly moving, massaging with your fingers--using not just the finger tips but the whole upper part of the finger --in a clockwise, circular fashion, up the ascending colon, over, across and down the left side. many times i can get the gas to move out this way and sometimes--if i'm really lucky--even stool. 

 

i do hope you can start biofeedback soon...


these are just my own thoughts. for expert medical advice please contact a health care professional.


#14 annie7

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Posted 26 February 2015 - 05:51 AM

if you're interested, here are the pfd exercises my PT told me to do daily--sort of like "reverse kegels"--they teach you how to feel your pelvic floor muscles how to  relax--not strengthen --them.

one simple exercise to do for this is to gently squeeze your pelvic floor muscles--the muscles around your anus-and then relax them. squeeze just enough so that you can "get the release" as my pelvic floor PT puts it--- get the relaxed feeling. this helps you identify your pelvic floor muscles and also helps you to relax them.

here are two other exercises she told me to do:

1) slow contractions: contract your pelvic floor muscles for 5 seconds (gently) then relax them for 5 seconds. 10-15 times in row, twice a day. always relax for at least as long as you squeeze.

2) quick contractions: contract your pelvic floor muscles gently for 1 second and then relax for 1 second. again, never hold your breath while doing this.

 


these are just my own thoughts. for expert medical advice please contact a health care professional.


#15 Nurse Josh

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Posted 26 February 2015 - 11:28 AM

Thanks annie Ill try these out and watch the videos. Im waiting on a physical therapy call.

#16 annie7

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Posted 26 February 2015 - 12:12 PM

oh good smile.png sounds like you'll be getting started soon.


these are just my own thoughts. for expert medical advice please contact a health care professional.


#17 Nurse Josh

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Posted 26 February 2015 - 05:16 PM

So today was my first experience with a glycerin suppository (advised by my new Dr.) and i just grabbed Pedia-Lax off the shelf, only one there. Anyone have experience with these? Any thing I should know or avoid? It definitely seemed to kick start things when i knew i had to go but couldnt.

#18 annie7

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Posted 26 February 2015 - 05:25 PM

i googled pedia-lax and that's for children...is this what your gastro wanted you to take?

 

i use gylcerin suppositories.  the ones i buy aren't for kids--the are the adult ones.  a bullet shaped suppository made of glycerin (soap).   Fleets is one brand name but i buy the generic (cvs pharmacy)--it's cheaper.  

 

yes, a glycerin suppository can get things going.  and there's no laxative in them, so they are safe to take.


these are just my own thoughts. for expert medical advice please contact a health care professional.


#19 Nurse Josh

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Posted 27 February 2015 - 12:44 PM

Well, it was the only glycerin suppository available. It did work haha. At least for temporary relief. Maybe i need to check out another pharmacy for more adult options? This was a liquid you push in vs. a solid bullet capsule. I think I would prefer either over an actual enema, but my fear is that it doesnt go high enough, so the irritation of incomplete evacuation still remains in the intestines with some cramping and gas.

#20 annie7

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Posted 27 February 2015 - 02:06 PM

glad it worked--that's good!  that pharmacy must have adult ones somewhere...i've always found them in the laxative section of the pharmacy  (my second home lol) right there along with the enemas, various laxatives etc.  all the fun stuff.

 

yes there are the liquid glycerin ones and the solid bullet ones.  maybe  experiment and see which type works best.

 

in my experience they don't really work on stool higher up.

 

i also use dulcolax suppositories. they contain a stimulant laxative--10 mg bisacodyl.  these generally give me a little more action..


these are just my own thoughts. for expert medical advice please contact a health care professional.






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