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What to do now...

474 Views 1 Reply 1 Participant Last post by  Kathleen M. PhD
I have been suffering from severe abdominal pain for about 20 yrs. (now 31). I have had an exhaustive amont of testing done recently b/c the pain is almost a daily event. A colonoscopy showed some small yellow bumps (not ulcerated) in the descending and sigmoid colon. My dr. initially treated with asacol as IBD. I saw an improvement with the asacol for a 4 month period, but after further testing my dr. rescinded his diagnosis and took me off the asacol. Within 1 month the symptoms returned. The test that were conducted and normal were: ultasound of the abdomen, upper GI with small bowel, triple contrast abdominal scan. He said that he could find nothing to support the initial diagnosis, so changed it to IBS. I also took a lactose intolerence test that was off the charts; however, a very strict lactose diet has provided no relief. I have tried the antispasmatic meds without releif. After seeking a second opinion, that dr. read the previous drs. notes and concurred with one meeting. The pain is daily with severe episodes upto 4 or 5 times a week. A severe episode is more painful than labor and can last upto 2 hours. It seems to relieve with a series of bowel movements rendering me exhauseted. I will get dizzy, naseuas, have hot and cold flashes, and even get clostrophobic in severe cases. I do notice that I have an uncontrollable need to move or pace as if to help move it along. Is this normal for IBS or was the initial diagnosis more likely. All I really want to know is how to get rid of the pain!
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Pain is a major symptom of IBS and it can be daily and it can be severe and still be IBS.Generally for IBS pain if antispasmodics do not work the next thing to try is antidepressants. Some of the pain from IBS may not be spasm related, but improper signals being sent to the brain. Basically there is some threshold that pain signals should reach before you feel them. With IBS it is sometimes like this threshold is gone and every sensation gets sent to the brain as pain (like if you could feel every time the stuff inside your joints moved rather than only feeling pain when you twist or sprain it) Antidepressants can reset that threshold and lower the level of pain. Typically tricyclics are tried first, and then the newer SSRI's. Like for depression it can take some time to find the medication that works in your situation. The doses used are generally lower than what is used for depression.Mind-body techniques (Hypnotherapy, Cognitive Behavioral Therapy, etc) can also re-set those pain thresholds. For me CBT greatly reduced the amount of pain I was in and my pain was daily and severe.If you can predict when pain will hit (for me it was after meals) and you take the antispasmodics prior to the pain hitting sometimes that makes them more effective than waiting for things to get bad and then taking them. But not all pain with IBS is spasm-related so they do not work for everyone.K.
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