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Discussion Starter · #1 ·
Hi,

I'm IBS-C and every GI professional I speak to always emphasises getting things moving, understandably. However for me, periods of increased motility (say like when I'm on reduced levels of anti-depressants) usually means increased pain (and other horribleness like exhaustion and depression). Increased in terms of frequency, duration and intensity.

This has puzzled me greatly over the years. And it's happening again: until starting Nortriptyline (a tricyclic anti-depressant), which has slowed my gut down, I'd had 2 straight months of consistent strong pain. Now that things are almost at a standstill the pain and horrible sensations have lessened quite a lot (so far).

And yet still when things do move - like when I do my morning enema(s) - pain, depression and exhaustion often hit afterwards for a variable period until seemingly, things grind to a halt again. So again it seems that reducing the window of time that things can be moving means reduced pain.

Questions:

- does anyone else experience this? I.e. very-little motility = reduced pain and increased motility = increased pain

- does anyone know what this scenario might indicate?

Many thanks,Pete
 

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I think one just has to be thankful that the symptoms and pain recede for a while. I'm not sure what it indicates - maybe only that reduced motility means reduced activity by the nerves that are involved. That's probably not a scientific explanation, but it's the only one I can think of right now. Anyway, I'm glad that you got some respite from the pain.
 

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I do in ways. I am D prone with painful left colon spasms. The drugs I am on reduces the spasms but turns me towards constipation. When my mobilty nearly shuts down the spasms/pain are much lighter or gone. The problem I face is then after a few days I have to come off them, and use a couple doses of miralax to get things going again. Once things get going the spasms start again.

Also important to note that for a spastic colon having it empty it is much easier to start cramping than a full colon. If your pain comes and goes it is spasms, if it is constant it is not.

Provided it is spasms... time to get you some help. My recommendations are these...

Magnesium Citrate -- this is likely the most gentile laxative going if used in a small dose. It also has the lovely function of directly calming intestinal/gut spasms/cramp. So a two fold effect.. it will help the pain, and keep things going gently. Start with 100-200 mg twice daily. I have increased to 3xdaily.

Heather's Fennel Tea -- The oils in this will sooth both the spasms and the whole track. The soothing power of this tea cannot be overstated. Find by googling help for IBS fennel tea. This can be drunk as many times a day as needed. Usually if in pain this will stop it within 30 mins.

As a side note Levbid antispasmodic has helped a lot, but makes me constipated... so using the Magnesium so far is a perfect double whammy for pain mix.

As you know antidepressants/anxiety meds can help a lot with this... especially in the calming down phase. For your particular issues I would talk to the doc about trying Remeron. Mild anti-anxiety med (neither tricyclic or SSRI/SSRN, but it's own animal). I have not tried it yet, but it is likey the most directly targeting one for colon/gut pain. You will likely gain weight on it however, otherwise very very minimal side effects.
 

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Discussion Starter · #4 ·
I think one just has to be thankful that the symptoms and pain recede for a while. I'm not sure what it indicates - maybe only that reduced motility means reduced activity by the nerves that are involved. That's probably not a scientific explanation, but it's the only one I can think of right now. Anyway, I'm glad that you got some respite from the pain.
agreed and I am thankful. However I'm also sad that I'm in such a position that a few days of reduced pain is something to be celebrated...
 

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Discussion Starter · #5 ·
I do in ways. I am D prone with painful left colon spasms. The drugs I am on reduces the spasms but turns me towards constipation. When my mobilty nearly shuts down the spasms/pain are much lighter or gone. The problem I face is then after a few days I have to come off them, and use a couple doses of miralax to get things going again. Once things get going the spasms start again.

Also important to note that for a spastic colon having it empty it is much easier to start cramping than a full colon. If your pain comes and goes it is spasms, if it is constant it is not.

Provided it is spasms... time to get you some help. My recommendations are these...

Magnesium Citrate -- this is likely the most gentile laxative going if used in a small dose. It also has the lovely function of directly calming intestinal/gut spasms/cramp. So a two fold effect.. it will help the pain, and keep things going gently. Start with 100-200 mg twice daily. I have increased to 3xdaily.

Heather's Fennel Tea -- The oils in this will sooth both the spasms and the whole track. The soothing power of this tea cannot be overstated. Find by googling help for IBS fennel tea. This can be drunk as many times a day as needed. Usually if in pain this will stop it within 30 mins.

As a side note Levbid antispasmodic has helped a lot, but makes me constipated... so using the Magnesium so far is a perfect double whammy for pain mix.

As you know antidepressants/anxiety meds can help a lot with this... especially in the calming down phase. For your particular issues I would talk to the doc about trying Remeron. Mild anti-anxiety med (neither tricyclic or SSRI/SSRN, but it's own animal). I have not tried it yet, but it is likey the most directly targeting one for colon/gut pain. You will likely gain weight on it however, otherwise very very minimal side effects.
Hi Leo, thanks for the response. I don't think it's true that if someone's pain is periodic that that means it's spasms, it could be any number of other conditions - diverticulitis, polyps, partial obstructions etc. etc.

I'll try the tea but mag citrate causes loads of strong pain for me - probably because it gets things moving. I tried Levbid and other antispasmodics and maybe they helped a bit but nothing noticeable & consistent unfortunately.

I haven't tried Remeron but if this Nortriptyline doesn't pan out then I'll suggest it to my PDoc - thanks.
 

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Hi Leo, thanks for the response. I don't think it's true that if someone's pain is periodic that that means it's spasms, it could be any number of other conditions - diverticulitis, polyps, partial obstructions etc. etc.

I'll try the tea but mag citrate causes loads of strong pain for me - probably because it gets things moving. I tried Levbid and other antispasmodics and maybe they helped a bit but nothing noticeable & consistent unfortunately.

I haven't tried Remeron but if this Nortriptyline doesn't pan out then I'll suggest it to my PDoc - thanks.
Yes true, I should have been clearer on the pain issue, what I meant was if you have periodic pain that is in waves with defined peaks, and have ruled out all but IBS, then we are dealing with spasms. It took me understanding IBS/Spastic colon to even know that spasms was what I was experiencing.

Very strange the mag cit gave you pains. It honestly is helping me with just that a LOT. I am assuming you went very low dose? I do get result of great help with pain, but no stool issues with just 100mg twice daily. Another factor is this is I am taking the levbid too, and also peppermint tea.. which both slow mobility. That with the Mag is now just keeping things going along. Seriously though the mag is helping big time in both making the guts feel "good" again, and keeping away the spasms/pain. So much so I am shocked.

As for the teas. Heather's Fennel is very soothing in every way. It will also gently help regulate normal colon function.

The peppermint tea is the absolute best for stopping the spasms or warding them off if you start to get the pinchies in the area and know it is coming. The peppermint tea as a smooth muscle relaxer will slow the mobility a touch, but no where near as much as say Levbid does.

If you think your pain is from your bowels moving that a whole different issue though.To me an empty colon in pain is a spastic colon when the pain stops if full (constipated).
 

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Discussion Starter · #9 ·
Yes true, I should have been clearer on the pain issue, what I meant was if you have periodic pain that is in waves with defined peaks, and have ruled out all but IBS, then we are dealing with spasms. It took me understanding IBS/Spastic colon to even know that spasms was what I was experiencing.

Very strange the mag cit gave you pains. It honestly is helping me with just that a LOT. I am assuming you went very low dose? I do get result of great help with pain, but no stool issues with just 100mg twice daily. Another factor is this is I am taking the levbid too, and also peppermint tea.. which both slow mobility. That with the Mag is now just keeping things going along. Seriously though the mag is helping big time in both making the guts feel "good" again, and keeping away the spasms/pain. So much so I am shocked.

As for the teas. Heather's Fennel is very soothing in every way. It will also gently help regulate normal colon function.

The peppermint tea is the absolute best for stopping the spasms or warding them off if you start to get the pinchies in the area and know it is coming. The peppermint tea as a smooth muscle relaxer will slow the mobility a touch, but no where near as much as say Levbid does.

If you think your pain is from your bowels moving that a whole different issue though.To me an empty colon in pain is a spastic colon when the pain stops if full (constipated).
I recall seeing a big discussion here about whether the gut is spasming or not in IBS. My take is that it's not that straightforward since if it was, antispasmodics and fennel tea would work for everyone. Peppermint tea does nothing for my gut and increases my reflux. Tried it a few times now and it's the same each time. It's a bummer.
 

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Discussion Starter · #10 ·
For me it!s exactly the same. Reduced pain when nothing is moving. If nothing is moving, i am in danger of an impaction. I am at my wits end.
yep, you're damned if you do and damned if you don't...
 
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