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I have IBS but I get both constipated and diarrhoea too one day one thing next Few days another and back and forth ! I have BPD, treatment resistant depression and PTSD I live in the UK and have nothing to show for it the NHS services and gastro clinic are unable to help me and don’t ven get me started on the abysmal mental health services. I have a very restricted diet to the point I don’t know what to eat and I feel I’m being kept in Cycle of anxiety-stress driven IBS. I dunno how much longer one can go on for I’ve battled with my mental health for years and these newer exacerbated gastro issues only makes things worse and yet still no support … it’s so fckd up the way this system and world seems to be for people like me over here . I feel alone can anybody else relate ?
 

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I wanna say that I already keep food diary … follow low fodmap etc. I’ve started drinking rice water (Dioralyte relief Raspberry) daily I drink yarrow tea and pukka turmeric tea. My diet is very basic the NHS GP & dietitian are unhelpful and they don’t create meal plans or seems to know what to do to help me. I just wanna be able to eat normal foods and portion sizes like I use to I’m okay not being able to eat spicy food but I feel I can’t eat anything and that effects my mood further and leaves one feeling suicidal … it’s a horrible way to be i had to cancel a trip with my friend this past weekend now I feel I can’t go out and socialise which I don’t do alot as it is due to my mental health issues. But now I can’t go out because either I’m in discomfort due to constipation or I’ve had diarrhoea and fear going out in case I have a flare up it’s terrible. I take Imodium/ loperamide it makes me constipated so feel like I can’t win. Wish there was a step by step guide on how to live with or rather treat this issue.
 

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I have IBS but I get both constipated and diarrhoea too one day one thing next Few days another and back and forth ! I have BPD, treatment resistant depression and PTSD I live in the UK and have nothing to show for it the NHS services and gastro clinic are unable to help me and don’t ven get me started on the abysmal mental health services. I have a very restricted diet to the point I don’t know what to eat and I feel I’m being kept in Cycle of anxiety-stress driven IBS. I dunno how much longer one can go on for I’ve battled with my mental health for years and these newer exacerbated gastro issues only makes things worse and yet still no support … it’s so fckd up the way this system and world seems to be for people like me over here . I feel alone can anybody else relate ?
Nello,

Let's get you some help ASAP!
Yes, I have felt at breaking point too and I totally agree with you that IBS is also causing more depression. The doctors always thought it was the other way around for me too, they were wrong.
But in your case, you do have other mental health conditions that need to be taken care of. I can mostly only help with the IBS and some mood help.
Let's start with the feeling of "no hope."

My IBS started 9 years ago at the age of 26 and i was single, in the middle of dating people. All of that was off the table for some years, even social life with friends because of the unpredictability you just mentioned from IBS. I was even called a "snowflake" at one point, because I may or may not show up to some friends event and I could always cancel at last minute (they knew I could get sick easily and thankfully accepted this, but it was still sad and made me look bad). So, I know this disease is making things worse.

Yes, there were times I felt there was no hope, and I was at breaking point, and I wondered why I should live longer, when it seemed no one liked me because I smelled, and I could do nothing about it, because I would even fast for days on end (and eat on weekends) and still sometimes I smelled and was cast aside, shunned. Those days were very depressing.
At least for me, it helped that I was a Christian.
What that means is that I know that I know I don't "own" my life. That is, I didn't choose to come to this world or be created, and I can't choose to take my life either, my breath, my life doesn't truly belong to me in that sense. It belongs to the one who gave me life and I didn't have the right to take it away. So, with that logic, ending it was never really a choice, although I'd cry and argue to God, if my purpose was just to work and suffer in isolation every day, and why He would be so cruel, when I knew Him to be otherwise. I would remind him of the many things I'd like to do and people I'd like to serve and how my illness was inhibiting me from doing these things. That's how I coped with those thoughts. I don't know if that helps you.

My recommendation on how to get better for someone with IBS- A (alternating between constipation and diarrhea) will be in a separate post, so as not to confuse you.
 

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I wanna say that I already keep food diary … follow low fodmap etc. I’ve started drinking rice water (Dioralyte relief Raspberry) daily I drink yarrow tea and pukka turmeric tea. My diet is very basic the NHS GP & dietitian are unhelpful and they don’t create meal plans or seems to know what to do to help me. I just wanna be able to eat normal foods and portion sizes like I use to I’m okay not being able to eat spicy food but I feel I can’t eat anything and that effects my mood further and leaves one feeling suicidal … it’s a horrible way to be i had to cancel a trip with my friend this past weekend now I feel I can’t go out and socialise which I don’t do alot as it is due to my mental health issues. But now I can’t go out because either I’m in discomfort due to constipation or I’ve had diarrhoea and fear going out in case I have a flare up it’s terrible. I take Imodium/ loperamide it makes me constipated so feel like I can’t win. Wish there was a step by step guide on how to live with or rather treat this issue.
Nello,

In terms of IBS-A, oscillating between constipation and diarrhea, I have had that and I've had the exact same reaction, where loperamide will cause hard stools and even consipation.
It feels like you're going to far along a see-saw, where you're stool is either too loose or won't come out and you're in pain... right? That's what I had too.

So, why?

One of the reasons, is that your stools are not regular, your gut is not stable. The real, or underneath why could be many reasons I don't know exactly. But let's get to solving this regardless.

You need regularity.

What that means is both timing of how often you pass stool and what consistency it is.

How do we achieve that?

A few different ways without loperamide HCL.

First:
Do you have regular meal times? Do you eat regular amounts (not like binge and then fast)?
This needs to be established for some regularity.

Secondly:
Foods, what foods to eat?
We'll talk about that in a bit. Let's move to #3, on dealing with these immediate "flares/digestive upsets."

Thirdly:
How to deal with the immediate "flares/digestive upsets"- onset diarrhea and debilitating constipation.

1) If you're constipated its because you lack fiber (aside from having taken too much loperamide [or even just 1 pill]).
a. I would advise to stop taking loperamide, it moves you too far on the see-saw, and we'll keep doing this for years unless you use something more gentle.
b. Find an agreeable and sufficient fiber ASAP.
Some people are sensitive to certain fiber foods. The ones they're sensitive too could cause them abdominal pain or excess gas.
Find a fiber that does not cause negative effects on you. You will find this by trying small amounts of these fibers.
Even a fiber that agrees with your system taken in a high dose the first time could cause problems, especially to a delicate an upset system like yours (you're suffering from flares).
Some fiber suggestions (try them, they may or may not work for you, you have to test it):
-Miralax (for the short term, will promote regularity, but not advised to be taken in long term --[longer than 2 weeks?]0
- Fiber pills
- Metamucil (psyllium husk doesn't agree with me, I get a lot of gas from it, but it agrees with other people, so try it - again small amounts first)
- celery - raw or cooked (most people respond well to cooked vegetables over raw vegetables when their sensitive. try it in a soup first, if you just want something that works).
- spinach ( I eat this every day in a smoothie).
- Other green veggies?

Fibers to AVOID or be cautious about:
- Cabbage, bok choi
- broccoli
- asparagus/artichoke (fructan vegetables)
- kale?
The above vegetables are very good and healthy vegetables, but if you're currently not sure what to eat, I'd suggest trying the vegetables listed in " avoid" at a later date when on the elimination diet and adding foods. Veggies with "roughage" can cause a lot of gas and discomfort. I would avoid fructan containing vegetables as well, just to be careful, and then test it when adding foods during your elimination diet. Fructan vegetables include: onions, garlic, leeks, artichoke, asparagus... etc. Look them up. Don't use fruits as your daily fiber source, stick to vegetables (fruits have significant sugar, and you may be sensitive to some of their sugars).

c. Take your agreeable fiber daily. Start with a small amount. Then, either weekly or every 4 days increase the fiber 10% until you achieve a stool of desired consistency. If you already have the stool consistency you're looking for with current amount, no need to increase fiber, unless you want the health benefits, that is fine, just do it slowly, so your system can adjust without negative effects (gas, upsets).


As what to eat everyday, that's another issue. Let me put it in another post what I've found.
 

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I forgot to finish on how to deal with the immediate "flare ups/ digestive upsets."

Ok, so for constipation:

Unless you take something that will go all the way in the other direction, I don't know how to deal with it other than promote regularity by eating the fiber everyday.
For the immediate releif, yes, those things that give you diarrhea will make you pass stool more quickly. I would use half the dose of "Renew life Cleanse more" to get unstuck if I was inpatient or in pain. A more gentle solution is "Health force Intestinal movement" it has similar herbs but at a lower strength than the renew life, so doesn't usually cause diarrhea right after use, but does get thigns moving.

You could also try a or a few fiber pills to get unstuck.
Its been a while since I've had the constipation part, so really I just eat my spinach smoothie everyday and its just a problem I don't have to deal with anymore. Its possible that eating your agreeable fiber a few times, may help that immediate constipation to be softer.

For diarrhea:
There's a few more solutions for the immediate crisis of on-set diarrhea.
-An acidic drink (no sugar, use pure stevia if you want sweet):
- 1 tsp of Apple Cider Vinegar in 8-16 oz of water (strength can vary, stronger is more effective, but not everyone likes the taste and acid of too strong).
- half of lime or lemon in 8-12 oz of water (in warm or boiling water its more effective to having a reaction, but even room temperature water has effect).
-The Acidic liquid will help kill some of the bad bacteria that is causing/aiding your diarrhea upset episode. This will in turn, make it a less dramatic episode or possibly even prevent it.

- Saccharomyces Boullardi
- Buy this probiotic yeast alone. Do not buy it with FOS or other ingredients. You maybe sensitive (most IBSers are) to the OligoSaccharides (its againts a FODMAP diet anyway). It is often sold with the FOS, so beware. Check your local pharmacy for a version that is pure.
- Taking this probiotic as soon as I start to get diarrhea has made a HUGE difference for me. It totally replaced loperamide for me. I take 1- 2 capsules depending on the strength of the diarrhea. As you mentioned loperamide would overshoot and cause constipation. But Sacchromyces, would just make me more regular and I'd feel so much better.

- Probiotics:
- Some mention that Bacillius Coagulus? helps in the immediate diarrhea as well.
- Long-term good probiotics (ones you should take regularly) also help in the immediate crisis too. I have one that is a mixture of bifido and lacto bacteria. If I have a meeting that day and have a loose stomach I end up taking one or two pills for sure of that probiotic (mine are usually 50 billion or above).


-Sonne's No. 7 - (this was my first solution in year 1 of my IBS. It helped me some, but wasn't the fastest or best solution. Regardless may still help to know about it)
Sonne's No. 7 thickens the stool coming out, so makes it kind of easier to come out and have some consistency.

- Don't eat sugar/ starchy foods while having diarrhea or immediately after. We're going after NOT feeding the bad bacteria/yeast that are helping the diarrhea to happen. Instead focus on the good veggies you can eat and meat. Bad oils can cause upsets too. Verify whether you can accept avocado oil, Olive oil (extra virgin is best I hear?), and coconut oil. Use them only as needed, never in excess.

If Ihave days of diarrhea, then I'll resort to cleaning my gut, because days of diarrhea may indicate that there is something there that is persistent. So i may take my "renewlife cleanse more" to remove anything else, and start my elimination diet as well as ensure daily high probiotic consumptoin. .. But I've been pretty well for almost two years now, so I haven't had to do most of this, except follow a lifestyle, I'll explain in another post! I know.. (its basically the same things as above, a low-carb, high veggie (veggies i can tolerate)/protein diet with a slightly acidic gut to keep good bacteria in place of bad bacteria, and my daily fiber intake).
 

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I forgot to mention another thing for consecutive days with diarrhea.
It could be an infection/parasite.

Best to get the doctor to test the stool, they would have the correct antibiotic/antifungal to help.

But there's also a product I used called "Scram" by Health force, it has a whole bunch of herbs that would help kill some stuff. However, it was expensive. For me in particular, Xifaxan and Nystatin were the most helpful (and one time I was given something specifically to kill C.Difficile, I don't know what the name of the drug was, but it was for that specific bug). Again, check with your doctor on what your infection may be.

They can do stool test, blood tests and colonscopies to find out.

But you can always try and kill or reduce the bad bugs by not eating sugar/starch and keeping a good environment (slightly acidic) in your gut for the good bacteria and good yeast (Probiotics).
What is the good environment, its slightly acidic.
here's a way to remember that. Doctors will often tell you to take a probiotic with Lactobacillius Acidophillius found in lots of yogurt.
Acidophillius stands for "acid loving." It doesn't mean you want a SUPER acidic enviroment and then you have gastric reflux, NO. You just want a "slightly acidic" enviroment.

For example, I love chocolate, and unfortunately, that is a bit basic. I get somewhat of an upset if I eat too much chocolate or drink hot chocolate (even without sugar). I do have to drink Apple Cider vinegar water to counter.


Ok, the plan for becoming normal:

See the post I wrote for this person. I summarized the steps to take in general. This is what worked for me, and most likely, it will help you as well. The specific diet of what you should eat is something you have to discover yourself as everyone is different. But I'd recommend starting with a chicken/bone broth diet (ONLY this soup) first, and then slowly adding on, every 3 days a new food that agrees with you (don't add the foods that don't agree with you. Especially if you keep a good diet with fiber, keep a slightly acidic environment in your gut, and take your daily probiotics, you should be able to revisit those foods again, and check if you can accept them. Over time, you should be able to eventually eat the foods that at one point you couldn't eat (the probiotics or your improved gut would be helping you digest them).

I list a plan how to get normal here-
 

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Finally,
please note that in the post to Glenn in "F*ck this disease" thread (i posted link in last post) that I mentioned exercise.
In your case, exercise will have even greater effect, as your mood is a more critical problem for you as well right now.
Excercise >1.5 hrs increases endorphins by amount equivalent to some drugs. I personally experienced this.
However. exercise even for 40 minutes improved my mood quite a bit.
And exercise for 15 minutes (but enough to make me sweat) also sets my brain to focus, and work during the day and puts me in a positive place.

Don't skip exercise, find something you like, even dancing or tae kwon do/karate works, just do it.
 

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I forgot to make it clear on all this advice, that if you are going to do the chicken broth or honestly eat meat, its best to get the antibiotic-free meat. That's what I did. Only the last year or so with inflation and supply chain issues did I start more consistently eating meat that wasn't antibiotic free (availability issues, other people's houses, restaurants).
But for the road to recovery, why give yourself a dose of antibiotics as you take probiotics, its like wasting the probiotics and taking longer to recover.

The other thing is when you make the bone broth, you want the highest quality, so use bottled spring water unless you have a very good water purification system at home.
Probably distillation I hear is one of the best, but not sure if it gets rid of chlorine as well. You may want to combine your systems (filter+ distillation? ).

Where i was living, the water came out brown and then the other place I moved to, you could taste the chlorine in the water.
I never used either in my broths. I always used bottled spring water (gallon) for the broth.
And for drinking I would also drink from that (only spring water)...
I hate doing that, but those places, we didn't trust the water quality.

At my current location I do just use filtered water with a Brita filter. But I'm also at my most improved state when I arrived here anyway.
Be careful with your water quality. It can have chlorine that would change your pH, and I don't know what other things may slip up or even you maybe sensitive to the acceptable quantities of whatever your water plant actually finds acceptable. Best to have some sort of purification system in place.
 
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