[knothappy]

does anyone take a pain med such as tylenol 3 or darvacet??? my dr refuses to give any...i need something for pain and the ibs meds do not do a thing..we all have a patients right to be as pain free as we can..feel like calling the ama....i also cannot get refered to a pain management clinic and you need one to get into one.

 

[IBSD88]

amitryptaline is a low dose anti depressent which is a little constipating and used for pain management, it just makes things a little more bareable it isnt going to take the pain away totally but we IBS'ers cant expect that these days :-(most doc's are happy to prescribe that.sadly in the US you get access to more drugs as the safety requirements are a little less but actually getting your hands on them sounds like its harder

 

[Kathleen M.]

It may be worth getting a different GI or general doctor to see about pain management; however, pain management clinics quit often focus on getting you so you don't need the narcotics rather than just handing them out to everyone at whatever dose they want. They may just have you do mind body stuff or other alternatives to control the pain and that may not be what you want.The problem with IBS and narcotics is you may trade short term pain relief for a lot more pain later. If you are unlucky enough to get your pain nerves in the gut sensitized to pain after a few months of consistent narcotic use then you will be in much more pain than you have now, and it will be a lot harder to control, because they will put you back on the meds you say won't work. Doctors have to take in the potential harm into the equation in deciding how to treat pain. Chronic conditions then become harder to treat because they aren't talking 2-3 weeks worth of risk but what may happen months or years down the road. While the patient may want to be pain free all the time the doctor does have to look at how much harm that may cause. Having you be in much more pain than you have now in a year from now may not be in your best interest.A few doctors will do low dose narcotics to control severe diarrhea, but that usually is only when nothing else works.

 

[Diana63]

I do not know if i am reading your email right are you saying that antidepressants are not good to take,i maybe reading it wrong,I am in a desperate way with pain and other severe symptoms,so really need to see my GP.Antidepressant has been suggested but i am in two minds,dont know what to do,probably at a 30-40mg level as 10 or 20mg did not help,but so undecided.Thank you.

 

[Kathleen M.]

Antidepressants (Tricyclics from 10-75 mgs so 30-40 mgs is not unusual and for depression they give you 100-250 mgs a day) are typically used to control pain in IBS.Narcotics are the ones that can cause increasingly severe pain problems for some people after they take them for awhile. Narcotics are NOT the same thing as antidepressants. Narcotics are typically used for pain after surgery, cancer pain, and severe injury pain. They usually try to avoid them for chronic use, but for some things they are the best option.Narcotics (codeine, oxycodone, morphine, etc) can cause something called Narctoic Bowel Syndrome. Antidepressants are used to TREAT NBS, they do NOT cause NBS.If you do not want to take medication for your IBS pain you might want to get the home hypnotherapy tapes or find a Cog. Behav. Therapist or hypnotherapist trained to treat IBS. Pretty much your only treatments for IBS pain are antispasmodics, antidepressants, or mind-body therapies. Some doctors will try narcotics if all else fails, but they must watch you for the onset of NBS (you get a lot of bounce back pain when the narcotic wears off) and will have to transition you to antidepressants to control the pain until it settles down to normal IBS pain levels.Narcotics are more often used for people with severe diarrhea with IBS rather than severe pain.Is that ANY clearer??ETA: In case you think 30 or 40 mgs (not sure which antidepressant you are on and that can effect dose a bit) is somehow an extremely high or unusual dose for IBSers I found this.http://www.ncbi.nlm.nih.gov/pubmed/1907693...mp;ordinalpos=7

Nineteen patients with IBS were given amitriptyline 25-50 mg

so 10-20 may not really be enough for a lot of people, but usually they do start at really low doses and work up to what you need for symptom relief because the lowest effective dose for an individual will typically have fewer side effects than making everyone start at 50 mgs.