[onyx]

A few nights ago, out of the blue, I had a serious case of burning D, at a level I've never felt before. I've had episodes before with simliar acidic D, but this one, was simply intolerable. I was on my bathroom floor crying, begging the universe to stop this burning pain. It literally feels like I'm passing pure undiluted hydrochloric acid through my rectum. I'm not exaggurating. I've had IBS-D for 7 years, and have learned to deal with much discomfort, but this, I simply can't take this. It's basically been 48 hrs. now and I still have it and I don't know what to do. I'm trying to eat bland and using baby wipes to try to keep the area clean but I'm in so much pain and I'm really scared this won't ease up. I fear I will get serious anorectal damage if this keeps going much longer. Any advice on how to manage this? And anyone have any idea what causes it? I still don't know if it's stomach acid or bile or what that causes the burning but I will do anything to stop this so please let me know if you have any ideas. Thank you.

 

[Kathleen M.]

Usually it is bile.You might try adding a bit of psyllium or oat bran if you can tolerate either, or try some calcium carbonate with meals but get one without any magnesium on the nutritional label. (sometimes they use a magnesium compound in the coating, but it if isn't enough to have to list the mgs of magnesium on the nutrition facts it should be OK).Do you have and A&D ointment or butt paste or other diaper cream? If not try getting some of that. Once you are cleaned up put on a light coating on the anal skin and the skin around it. Also if you have time recoat before you have a BM, but some people don't have the time with diarrhea.If it continues and things that bind up bile (the fibers and calcium carbonate) aren't enough to control it you might see the doctor to see if they'll let you get a prescription for Questran or other bile binders.

 

[onyx]

Thanks for the advice/info Kathleen. As usual you're a life-saver. I'm still in the throes of this flare-up - can't take much more of this. I did find some diaper rash stuff - Desitin, which has zinc oxide in it, so I'm applying that and it is soothing. I have tried the calcium treatment before but it didn't seem to help much, but maybe I'll try again. I do have a few more questions if you'll indulge my curiousity a bit more.1. I'm already on questran/cholestyramine, however I wonder if maybe I should ask my dr. about upping the dose. I take 1 scoop/4 grams a day now, but I think the max dosage is much higher than that. Do you know if IBS sufferers ever take higher doses?2. On the subject of bile, if I don't have the classic gallbladder attack symptoms (upper-right-quadrant pain, nausea after meals, etc.), do you think my gallbladder might still be responsible for this burning D I have? Or is it more likely that it's my intestines which are responsible by not re-absorbing the bile quickly enough, so that it's reaching my lower colon/rectum where it shouldn't be?3. Lastly, is there anything like a "low-acid" diet which I can try at least in the short term to get through this? Thank you so much for your help.

 

[Kathleen M.]

Usually classic gallbladder pain is when it can NOT release bile, not that it is releasing more than you recycle. I don't know if there is a good way to tell why it is out of balance in some people. I think with Questran often dose is more about what works than this disease is only this dose and that problem is only that dose.http://www.endowsec.com/pated/edtgs04.htm I think would count as low acid.You might want to also limit fats as fats make you produce and release more bile.