Recent Symptoms

I have been experiencing the following symptoms on and off over the past five weeks. I recently had a colonoscopy which was negative. I have No fever and am scheduled for a CT and lab work this next Tuesday.

1. Bloating and pressure throughout the digestive tract.
2. Constipation or at least the feeling of such.
3. An almost constant dull ache that seems to move about the bowels.
4. Some gas and associated pains.
5. I had my gall bladder removed three years ago.
6. Eating seems to trigger the whole process.
7. I am better at night when I can stretch out.

Any suggestions.

Thanks!

Are you, by chance, a Gleann Abhann knight?

You're actually one of the rare people post-gall bladder with constipation. I reckon, of the people who have problems without their gall bladder, only about 10% suffer from constipation. The other 90% of us (yep, includes me) seem to have diarrhea and/or acid reflux.

I went through a bout of C for a little while, though. Mine was directly connected to a low fat/low calorie diet. Too little fat and your guts don't want to work right and you end up with C. At the time I found some information related to my problem. Too little bile can cause constipation (whereas too much, my normal problem, causes D). There's actually an old-timey remedy for constiaption that's supposed to help people like you, called bile salts. You'll have to look for them online, though, because I couldn't find a regular pharmacy that carried them. I never tried them; I went off my diet instead and went back to the opposite end of the spectrum; I have to take medicine for D.

Make sure you avoid bananas, which are naturally constipating. All juicy fruits, especially prunes and apples, tend to have a laxative effect, although you have to watch that they don't give you worse gas.

You should also ask your doctor about having a breathalyzer test. It's still somewhat new, so he might not have access to one where you live. You essentially breath into a machine and it tells the doctor if you are breathing out the wrong sorts of gases--which indicate that you have a bad bacteria problem. While most bad bacteria (or bacterial imbalance, it's sometimes called) cause diarrhea, some can cause constipation and I think all of them cause gas--the likely source of your cramping and pain. If he can't test you or doesn't want to, then you can try taking probiotics, which are good bacteria. You can get Digestive Advantage or Culturelle in pretty much any drug store in the bowel products section. Like using fiber, they may cause excess gas to start with, but you should adjust and it should go away. Try taking one or two a day for a month and see if they help with either your constipation or the gas pains. They can't hurt you, so there's no drug interactions and no side effects except initial gas (and not all people even have that).

If the OTC stuff doesn't work, get your doctor to test you for motility; your lack of a GB might not be the problem at all. My mother, her brother, and their first cousin all suffer from a slow stomach. The cousin's got so bad it quit all together and they had to take it out; my uncle's is starting to get bad like that as well. But my mother has a more classic case, with her stomach just being a bit too slow. She tends to suffer from heartburn as a result, but depending on the slow part of your guts, you might have constipation instead. My mother takes Reglan, which speeds up her gut funtion.

Oddly enough, caffeine is a gut stimulant. Most people with IBS can't tolerate the acid in coffee or the gut stimulation (I, for one, need no extra stimulation!), but it might help crank your gut up if your constipation is somewhat mild. And a lot of people with gas pains and constipation have found that yoga really helps. The stretching and positions helps release trapped gas, and exercise of any kind (including just walking) can help stimulate the bowels to empty.

I have to be careful what kind of fats I eat. I don't eat a lot of red meat, namely because I'm a chicken person, but I do eat meat every day. Fish are a good source of good fat, as is olive oil, guacamole, and nuts. I can also tolerate dairy, if I'm careful with milk (it has to be 1% lactose free and nothing else). Yogurt is usually something that most IBSers can tolerate. If you hunt, you can get some that's 2% or even cream-on-top, which is full fat. Stoneyfield makes a good organic yogurt and has a few options in full fat. Fage is hard to find, except in upscale grocery stores, but I think it's the best. It's a Greek yogurt, so it has a different taste. I don't think it's quite as sour. They have a 2% and a full fat option.

Something you might look into is the "French" diet. It emphasizes full-fat foods, but is typically light on red meat. It also calls for fresh fruits and veggies, which are good for fiber, and bread. It eschews sugars and bad fats (for the record, dairy is considered a good fat to the French). No fast food for them. While I have to be careful about eating fresh fruit--I do better if it's cooked--I've been okay with everything else I've eaten while trying to persue a French diet, even though fat supposedly makes my condition worse. I've very definintely found that bad fats, like the partially hydrogenated oils that fast food is fried in, makes me worse, but meat fats and dairy fats and olive oil and similar are okay.

A diet like that, which is selective about fats, might be useful to you for both maintaining your gut regularity and helping you to lose weight or maintain health. French people, after all, have a longer life expectency than Americans and Brits, so their diet must work. And contrary to popular belief, alcohol is not a required part of the diet, although you may want to substitute red grape juice for some of the health benefits. Oddly enough, getting some fat (and lots of fiber) fills you up with fewer calories than eating low fat foods, which are typically high in sugar.