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Discussion Starter · #1 ·
Any ideas would be appreciated. Have been on Prozac, Paxil, Zoloft, Lexapro, Celexa for beneficial effects regarding anxiety. For me, these are better than the tri-cyclics (Xanax and others). The only problem--and it's a bad one--is that my IBS (mostly constipation, discomfort, bloating type) which was tollerable control 70% of the time becomes constant after a short while on an SSRI--even at lower-than-therapeutic doses.Anyone know of some way to diminish the IBS side effects? The drugs really help with aniety but I just can't deal with the IBS problem.
 

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Lamesan, I take a number of medications that are both drying and potentially constipating.I also have had Emergency Surgery for the big one of bowel impactions so I have to be very careful with what I eat and drink.I use miralax mostly to help keep my bowels going. It's is prescribed by my doctor.You have to up your water intake and figure out which foods produce a BM for you and structure your eating around things that you know will kepp your bowels going.I make sure I have a BM at least once in 24 hours or else I move on to bigger methods to produce a bowel.I was doing pretty okay for a while but then I got this bad spasm and I had to go to the ER andpoof there goes my daily regularity because the crazy doctor shot me up with Dilauded and created this whole medical trauma which required demerol and phenegran and steroids. so here I am today not in any pain yet, but not having a BM.So to avoid another hospital trip I'm eating only bran flakes today and I've had some stool softeners and I'll use a suppository if need be and hopefully I can over ride the tendency of narcotics to put the gut to sleep.I suppose just one medication wouldn't have been too bad, but I had an allergic reaction to the first medication and it was all down hill from there as then I got other medications to deal with my body condition.So with me, since I tend to the constipated side, I have found that the effects of SSRI's are workable with prudent attention to diet and whatever you put into your body.Also, exercise helps a lot with constipation.Walking and swimming in specific.Kamie
 

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Usually of the SSRI's Zoloft tends to be one that is more prone to cause diarrhea, and usually tends to be better tolerated by IBS-Cers, but you have that on your listBut everyone is different and everyone has a different tolerance level. It may be that something like Miralax or an OTC stool softener or dietary adjustment may be really needed for you to handle the medications.Can the symptoms be controlled with something like Cognitive Behavioral Therapy ??(which can also be used to treat IBS, BTW).For some people proper therapy can either reduce or eliminate the amount of drugs needed to treat symptoms. These days some HMO's seem to be more willing to go the the drug only route as it can be cheaper. Some of the most sucessful clinical trials seem to use both CBT and drugs so if you are only doing one, maybe adding the other could help.Diet-wise take a look to see how much fiber you get every day. Usually the amount people should get is in the 25-35 gram range and I think usual Western diets tend to be in the 10-15 gram range.Adding fiber will help some people as long as there isn't an underlying transit problem.I do not know if Zelnorm is OK with the SSRI's but that may be another avenue to investigate (a new drug for Constipation Predominate IBS).K.
 

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Well, I over came the dredded narcotic gut sleep.I used Miralax, stool softeners, Bran Flakes (post brand with no soy)Yogurt milk and pears. Softer and riper.So things are getting back to regularity since the medication fiasco over the last few days.I also finished the steroids today so hopefully that will help too.So, there is hope with the sleepy gut thing.The answer is quick attention and prudence and a whole lot of good luck.Kamie
 

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Discussion Starter · #5 ·
Thanks for the replies. I think I'm getting enough fiber. Seems that I am just too sensitive to the SSRI's. With Lexapro (the newest of the group)I was only taking 1/20 of the suggested dosage and it still racked me over the coals. I am seeing a psychologist, but when kmottus speaks of CBT is this talk therapy or is it like behavior modification?
 
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Hi Lameson.... nice to meet you.... I've had similar experiences in the past with various SSRI's. Unfortunately they are the only medications that I can tolerate at all. I have gotten some relief of IBS by using acidophillus and by engaging in relaxation therapies as well as cognitive behavioral therapy to help me manage my anxieties.... to the tune of getting to the root of the problems, getting out of the denial stage, addressing the problems and working towards healing myself. I agree with Kmottus on this.Achieving relief of IBS for you is probably going to be a combination of many therapies..... medication, hypnotherapy, possibly biofeedback therapy when you are ready for it, and regular cognitive behavioral therapy with a caregiver whom you trust and feel comfortable with... particularly one who has experience in treating patients with both IBS and behavioral health disorders.Hope this helps,Best of luck to you, Warm Regards, Evie
 
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Misty... I take Celexa... you may need to add more fruit fiber and liquid to your diet to offset the D while you are taking Celexa.Warmly, Evie
 
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Brain fart here... sorry, I forgot to mention yogurt... I eat it about 3 times a week to maintain good bowel action. And your hormones could also be playing a roll here. If you are around my age (menopausal) it may be dynamically fluxuating levels of estrogen and progesterone. Talk to your gyn and research use of natural progesterone and estrogens. When my estrogen levels wane... the D kicks up.That's all folks....
Evie
 

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there's been no antidepressant that hasn't increased my constipation, but I tried lexapro for a few days and had disastrous problems with diarrhea. If you're seeing a licensed psychologist they might use talk therapy and CBT in combination.tom
 

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I have tried over the years to take the SSRI'S for anxiety and IBS...I tried prozac, paxil, celexa, effexor and many others but they made my stomach alot worse...I was more shaky and running to the bathroom alot more...I was then put on Elavil and I didnt have any side effects of that drug..I know the SSRI's help alot of people but I wasnt one of them...I though I was loosing my mind by taking them
 

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CBT is a specific form of therapy. Focus is on changing thought patterns and altering behaviors. It can be done in combo with other things, but sometimes it is done by itself. Some therapists use it alot, others do not use it much at all.CBT tends to be a fairly short-term thing when that is the primary thing you are doing. Usually when I hear people say "talk therapy" I'm not sure what they mean exactly, but usually I think more of a longer term go for a year or more kind of thing. Anyway, CBT is talking, so it could be called a "talk therapy" but it is a specific subset of that. I mean some of the "talk therapy" vs just using drugs debate is about CBT as one of the "talk".The CBT trial I was in for IBS was a 3 month stint. K.
 

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Discussion Starter · #13 ·
Thanks K. My therapy is not CBT in that it is more directed at general anxiety and not targeted to IBS. In a sense, from reading the IBS problems others have had, I've been pretty lucky. I've had IBS for 30 years or more, but most of the time I was mostly OK, with periods of problems. In the last year, the IBS has been pretty bad--as bad, or worse, than it's ever been--but the SSRI's have been the trigger. If I stop taking them, gradually my symptoms disappear (although all this experimentation has really sensitized my gut and it takes a couple of months). Worst case: I deal with my anxiety with lesser or no drugs.
 

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Lamesan, by the way I have had IBS for over thirty years and HT put it in remission.This is a thread I posted a while ago.Ponderings of an IBSer I was just thinking of expressing some of my thoughts on IBS and having it for thirty years. I have pain predominate IBS and alternating C and D. Although I can say had and really mean it,as I am doing so much better at about(85%) and I believe still improving thanks to this BB and Mike's tapes. I believe my IBS started from a trip to Mexico where I swallowed a small amount of cloroinated water out of a swimming pool and a half hour later, I was very sick with ameobic dysentary and spent the next month seriouly close to death. No Joke. They also pumped tons of penicillin into me at this time. However, ameobic dyentary is known to cause inflammation in the digestive tract. I recovered from that and I don't remember when or how soon I came back from Mexico, I was suffering from severe abdominal pain and alternating c and d. It wasn't to long before they started the first tests on me and that that testing would continue on and off for a big part of my life and cost thousands of dollars. The first tests were stool samples and upper gi tests all negative. The next test was a lower gi, also negative. Blood tests and all the regular tests from a normal MD. I was ten. In those days no one had a clue about IBS and they called it spastic colon or nervous stomach. I missed a lot of school and was always trying to catch up in my school work. Since the good doctors couldn't figure it out,I was sent for therapy and put on librium and told it was phycosomatic. I struggled for years through school,some working and trying to explain to friends why I was in pain alot and could not do things. Dating was a problem. They thought I had a stomach ache and it would go away and I should just quite being a big baby. Funny because my boss said that to me also, ten years later as well as a lot of coworkers. More testing. Basically the same kinds of tests over again. When your in your teens and your seeing some upstate NY md in a small town in those days testing didn't amount to much. Still no advise from anyone on what to do. My parents were very supportive and my mom is a nurse, which was very helpful and supportive. However,sometimes my moms own concern bothered me as she could not help and I could see that in her eyes while I layed there in complete agony from the knife jabbing sharp pains coming from my gut. When I got these pains I would hyperventilate and all kinds of thoughts raced through my head. For me this was already establishing itself into my thought patterns on a day to day basis's and I didn't really know much about living any other way as I hit my late teens. I was having episodes at least two to four times a week and that continued until I join this bb two years ago, although I would have some remissions they always came back and for a while my IBS went cyclic and bothered me most in the winter months, but in the summer improved somewhat. But it came back. Meanwhile, I continued to try to figure some of it out for myself, in ways I could manage it or do things to reduce it. Late teens to late twenties. More tests. "Maybe an ulcer,but we don't see it." New drugs, and from there librax, donnatol,prescription tagament,and a few others I don't even remember, but prozac was one as well. No noticable long term improvement. Mid thirties. I got serious and went to the best GI doc in town and told him to test away on everything we could think of that might be applicable. Also worried it could be something else still, although nothing showed up before he tested me and after he tested me. More drugs. Bentyl and valium. Sent to therapy told to relieve stress. I knew this wasn't the cause and thought because the pain was so severe that something had to be wrong in there, it just couldn't be possible to have this much pain and not have something physically that they could see wrong. I just didn't get it. I did know stress agravated it but not to the extent I do now or the kinds of stress either environmental, physical,or phychological and at the time I did not know how to reduce it enough with the management tecniques I was using and I used a lot of them. I tried all the food aspects and nothing other then some common sense on most things. Although it made sense what was going in had something to do with it, but in reality looking back now, it was common sense issues of eating to much to fast,fat,spices ect. etc.. There were some weird signals before an attack. My skin would turn whiter, my eyes would twitch and my hands would sweat. Sometimes I woould get dizzy. My therapist had migranes and knew nothing about IBS, other then realizing some of the symptoms sounded somewhat like some symptoms she would get with her migranes and that it was not in my head (phycosomatic or crazy) and I should go back to the doctor. It wasn't helping me to see her so I agreed. Although she didn't explain serotonin to me, nor did my doctor take the time to either. I feel if someone would have explained some of the mind-gut connections earlier I could have save a lot of time and effort. I know some are realitively new, but I think they had some idea and either it was to complicated to explain to me or they just didn't have the time. I think at this point one of the best things a doctor can do is explain some of this to new patients. I didn't have any other issues I was healthly otherwise and was playing soccer for twenty years and going professional until I blew my kneecap out. I believe I personally have a classic case of IBS. For me I believe it is faulty neurotransmitters that are not talking right between my brain and my gut. Just some thoughts and thank god for hypnotherapy, which I want to add some of my thoughts on as a side note. Of course most people know I work with Mike now, but some probably do not. After meeting him on the bb here and the success I had I decided to work with him as I feel he has one of the most effective treatment tools for IBS. I am drug free and very happy with the results. I want to say something about hypnotherpay in general and what I believe and have seen for myself and these are my own personal comments from my experiences with it. Although, many others feel the same way now. It is the deepest from of relaxation I personally have ever found. It has tremendously reduced the pain for me from severe to very mild. I think this has worked two ways. It has steered my thoughts and attension away from the pain when I want and I also believe the relaxation aspect of it is releasing endorphines to my gut. This has been a big achievement and will save me trips to the ER. When I wake up in the morning I no longer have IBS on my mind first thing. I no longer dwell on it. I don't worry to much about going out or bathrooms any more. I know longer turn white or have my hands sweat. I can relax my gut at will. My whole body is more relaxed in general and I didn't realize how tense it was before. I breath better and more deeply. Which I have found useful if I feel any twinges of a potential problem. I sleep better and more deeply. Day to day problems don't bother me like they use to. I can eat things I couldn't before. I feel like I have beeen rewired so to speak. My BM's have improved substantially. There are symptoms I don't even remember and that is unbelievable. Anyway just some thoughts of an IBSer pondering. I don't know if this helps anyone and I also don't want to say hypnosis is a cure or the only thing people should be doing to manage IBS, but it is one majorally effective tool that isn't understood by a lot of people or used enough by doctors in the IBS world and why I sound like a broken record sometimes. However, I hope no one gets tired of hearing about something that really works for the majority of people with IBS as there are just to few of the things that do. http://www.ibsgroup.org/ubb/ultimatebb.php...c;f=17;t=000002
 

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I don't think I was clear.CBT is a general thing. It can be used for anxiety, depression, OCD, phobias, as well as pain management and IBS and other physical problems.CBT is not specific only to IBS. It is often used for anxiety, but not all therapists who are doing "talk therapy" for anxiety will use CBT. There are a variety of approaches to treating anxiety. Some therapists have better luck with one approach over another, just as some patients have better luck with one approach over another.CBT is pretty popular for anxiety at this time, which is why I brought it up, specifically.Generally CBT therapy they set you up for a few months of treatment and not much longer than that, if that is the primary thing being done. No matter what disorder it is for, either IBS or anxiety or whatever. It has a reputation for being effective in a short amount of time and I think a lot of the HMO's push for it over the more usual "psycho-analytical" go to someone for long-term because of cost savings more than anything else. But then some HMO's seem to push more for just give them drugs approach because it is often even cheaper than therapy, even if you have to give drugs for years vs therapy for 3 months.
 

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Discussion Starter · #18 ·
While I didn't say it, yes, Thundnerhill, I did try Buspar. It was pretty gentle on my gut, but was not as effective on anxiety and obsessing on things as Prozac.HT seems worth looking into. Also thanks for the other references, Eric.K, my HMO makes my choice of therapy easy--nothing is covered. Actually, I've been very happy with my shrink, whose methods are pretty eclectic. A lot of issues have been resolved in the last year I've seen him. HT, interests me from a relaxation standpoint especially. IBS wasn't something we discussed, as (long story) it wasn't bothering me as much as other things. As I said before, I feel lucky that my IBS severity seems linked to the SSRIs, which I can stop taking.
 

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Lamesan, a couple things, with hypnotherapy for IBS it needs to be gut directed clinical hypnotherapy and even with CBT its preferable if the therapist has experience with IBS.Also, CBT works on a concious level and HT works on a subconcious level, both levels have an effect on IBS and both are safe and recommended by most IBS doctors and both have their own benefits.If I can help in anyway let me know I have been researching this for a long time now.
 
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Tom... sorry to hear about your experiences with antidepressants. If I couldn't tolerate at least one class of them.... I'd be in really tough shape and you guys wouldn't be able to stand me here either....
I think the concept is that we are all individuals and we all need to find what works best for us as individuals. My therapist DOES use both CBT and talk therapy as well as hypno and visualization exercises.Eric.... I've had IBS since I was a child (and I am now 50 years old)......... I trace it to an viral infection when I was about 6 years old... BOILS... my sister who was 21 at the time had the same infection. I remember incredible diarrhea at that age... and it was so bad that I had to use a "pot" in my mother's bedroom on the first floor because I couldn't make it to the second floor bathroom.Something that is also very interesting is that the sister who had boils at the same time that I did... went on to develop Multiple Sclerosis the very next year. Seven years later.... I developed an anxiety disorder that went untreated for 30 years.Thirty years later... I developed clinical depression. Finally I was diagnosed and treated for anxiety/depression. What was so interesting was that my first psychiatrist when I was about 38 years old told me that within 10 years scientists would be talking about how what my sister had (M.S.) was directly related to what I had... (anxiety/depression)..... And well... in the last year I was diagnosed with an autoimmune disorder (actually the predicessor to M.S. and Lupus). At my age it is unlikely that it will develop into M.S. but Lupus is still a looming possibility.Also... at the age of 38 I had a serious febrial illness where I lost 15 pounds in 3 weeks time. My doctor was about to place me in the hospital and start IV's when I finally began to force myself to eat and drink small amounts. I can recall during that illness lying in bed and screaming to my husband to please not leave me alone..... It was horrific as far as the "physical anxiety" that the febrial illness caused.Three months later I developed a rash around my eyes that resembled roseola. Shortly after that I fell into severe clinical depression. So I still swear that viruses and bacteria are at play here.... even if the symptoms that they cause are behavioral.My IBS worsened considerably since then... and it worsened a thousand fold since my supra-cervical hysterectomy 3 years ago.Eric... I just want for you to know that without a doubt I believe, as you do, that there is definitely a brain-gut connection... and the cause is more than likely bacteria or virus.... maybe both.My two cents worth, Evie
 
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