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I have had IBS C for two years. It took me a long time to figure out things and I have more figuring out to go. My problem is related to eating to much fiber. The Fodmap elimination was not helpful as I don’t seem to have specific triggers. Insoluble fiber is more of an issue. I find the low residue food plan the most helpful and probably eat 10 to 14 grams of fiber a day. I can’t eat too much fiber at a time so I spread it out through the day.

I have been on Linzess for 3 weeks and take in morning. I continue to feel gas and distention in middle of night. I usually have a BM daily but I feel it coming hours in advance in middle of night. I started taking a teaspoon of psyllium in middle of day to see if that will help. I am looking for relief of night symptoms which interfere with my sleep. I would appreciate any suggestions. Does anyone else relate to this specific problem?
 

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Hey Greer,

I'd like to help you if I can.

Everyone's system is different. Everyone's bowel movement and timing is different too, so its unlikely that someone else's timing of the medicine or fiber amount will be exactly your solution.

Most of us with IBS have multiple issues or experience multiple effects from the IBS, not just one thing.
I'm not sure if that's your case as well.

You describe here having both constipation as well as gas.
But do you have gas without the Linzess or/and fiber?

It may help to know that.

In any case, consistent gas is usually caused from bad bacteria eating undigested food in your gut (food you didn't absorb well).
Linzess may have also caused the gas (the medication says its one of the side effects).

Your fiber may have caused the gas as well.

I prefer not using medication for either constipation or diarrhea. They tend to move us too far on a see-saw between the two states and they are hard to control and moderate.
You have the right idea with trying to incorporate a daily fiber.

However, you may have the wrong fiber (one that doesn't agree with your system) or/and the wrong amount (as you stated, maybe too much at this point).

We'd need more information to know best, but given what is said here, this is what I'd recommend.

1. Stop using the Linzess. Let's try to make fiber your solution for regularity.
2. Find an agreeable fiber. Find a fiber that works for you that doesn't cause gas or upsets.

-There are many fiber sources, maybe the one you're using now doesn't work with you. Metamucil causes me gas too, if that's what you're using.
- Miralax is a good gentle laxative, that generally doesn't cause gas in most people. You can start with that for a week or two. Its not recommended for long-term use.
- In the meanwhile find fibers that work. You can try:
- cooked celery (like in a soup that has cooked for hours) or raw celery
- spinach (you can have it in a smoothie, maybe precut by blender helps) or cooked if you prefer.
- some fiber pills have different types of fiber to choose from.

This is a discovery/experimentation process to find a fiber that works well with you, but you have to find it.

Also, do this process by using a small amount of fiber. Even the one you're currently taking, stop eating so much of it.
Do 1/3 of it.. so like 3-4 grams. It isn't much, but we need to start somewhere (and be agreeable) and then slowly increase (like 10-20% every 4 days or week).

3. Get rid of gas-culprit in your gut:
- Well, this is really step 1.5 (should be done before step 2 ideally), but you may not find this solution in time. Ideally you would do this before experimenting with finding a good fiber source, because it can be confusing without getting rid of gas first.
Anyway, here's a few ways to get rid of stuff in your gut that could still be causing gas.

a.

Stool test:
You could actually have a parasitic infection or other bacterial infection that persists in your gut and is causing these problems. Ask for a stool test so the Dr. can find out which one it is, and they can prescribe the right antibiotic or antifungal to get rid of it. Or they may suggest a colonoscopy to find it.

A gut cleanse-

Ask your doctor for something that will do this, tell them you need it so you can know which fiber to use, or that you're resetting your gut for the elimination diet or for your probitic regimine. The doctor could prescribe a colon-prep saline solution. They may suggest to only take a portion (like 50% or 75%) of the liquid since you're cleansing and not actually doing a colonoscopy.

-I've used "renew life cleanse more" to clean my gut out a bit, when i have a persistent upset (even like this one consecutive days of gas with no apparent culprit).

-I've also used "Scram" by Healthforce when I couldn't afford my Xifaxan prescription, and it seemed like I had an infection as I was on my "safe diet" that previously had no issues for months and was suffering an unexplainable upset.

-I've been told to not do enemas, so I haven't done that.

-Ask an alternative medicine doctor best way to do gut cleanse if you prefer. Do something that can be done in one to two days and is gentle.

Once you have gotten rid of your gas causing culprit, you can now more easily find the fiber that agrees with you as you should have no gas or distension.

b. Stop eating sugar and starchy foods.- This should stop feeding the bad bacteria that are causing the gas, so you woudl be reducingtheir population in your gut.
c. Create a slightly acidic environment in your gut- Drink ACV with water or half a lemon/lime and 8-12 oz water every morning, and when you have gas upset. If you drink warm/hot water with lemon/lime it will be even more effective (kills bad bacteria that causes gas, they don't like the acidic environment)
d. Start consuming probiotics that include bifido and lacto cultures- ensure it has a significant strength.. I'd recommend at least 25 billion.

In my own journey, my gut was so bad, after doing the above steps and a regime of Xifaxan, the Dr. had told me to consume 150 billion CFU probiotic 3 times a day for 2 weeks. It really did help to reset my gut. But, I probably had one of the most severe IBS cases, I was VERY VERY sensitive, and lliterally could not eat most foods. I was milk intolerant (lactose, whey, casein), gluten intolerant, grain intolerant, soy intolerant, fructose, and fructan intolerant.. it was bad, so my regimen was aggressive. You may not need to be as strong in your probiotic dosage, but it should be significant enough to make a difference. Gut biome is 13 trillion bacteria. remember that.


I hope that helps you get better.
If you're on the fence on this, at least try this:

Next time it wakes you up, at least drink like 1 tsp of Apple Cider Vinegar (ACV) in 8 oz of water, increase the ACV concentration if you can handle it. And drink more than 8 oz if you can too. You can drink the lemon/lime water instead if you don't have ACV.

Especially if you have distension (that hurts), I'd recommend the hot/warm lemon/lime water (half a lemon/lime in 1 cup hot/warm water). This should really help relieve some of that distension, as it will kill some of that bad bacteria, and maybe help some of that gas to get out more quickly. so you can sleep!

Good luck.
 

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ohh since we're decreasing your fiber (until we find the agreeable fiber and the tolerable amount), here are other ways you can relieve your constipation without the Linzess.

1) Drink more diuretics or tea throughout the day. I like green tea, try 1 or 2 cups a day of the actual leaf (like 1-3 leaves /per serving). Leaf green-tea quality can be bought at chinese stores, ask them for it. Usually grocery stores only sell it in tea bags (taste really bad that way). Hibiscus is good too.

2) Drink more warm/hot water . Doesn't have to be tea, most hot water will help move things down there. Causing you to pee from the diuretics above will also help with bowel movement, because it helps to push the organs around there a bit too.

3) Drink plenty of water to counteract water loss in diuretics (just a reminder here).

4) excercise- try to excercise at least 30 mins a day if you can. This will also help cause bowel movement. Especially if you're consistent. Given the timing of your current bowel movement, i'd recommend trying to get your excercise in first thing you wake up, or right after work (between 4pm- 8pm). Usually if you do a somewhat strenous excercise, your bowel will move almost immediately afterwareds, and you'll have something out quite soon, Hence, try to finish your exercise a few hours before you go to bed.

5) Miralax- yes, i already mentiond this. But my point is, while your fiber intake is decreased in this trial period, MIralax maybe one of the most neutral laxatives to get things moving for this temporary time.

6) Sonnes No. 7 - this may help? I've seen it soften stool, but too much could also make the stool harder, so use small or moderate amounts if trying this.

Let us know what you decided to do! :)
 

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Also, I wouldn't rule out doing the elimination diet. Having constant gas is a symptom of something wrong. You could be eating something (aside from the bad fiber or linzess) that could be causing this. You should find out what it is. I'd recommend an elimination diet to do that... You can start with chicken broth and slowly add on foods (1 food every 3 days ). If food is agreeable you keep in diet, if not, you don't.

Anyway, you seemed not so concerned about the diet, so I didnt mention it earlier, but... a food you're eating could be helping the gas to be constant (and exces gas--> distension). .. So a true relief would be to find what is causing your gas.... usually found or prevented through an elimination diet.
 
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