IBS newbie, need advice on diet.

Hello everyone. I'm 24 year old female, a student of veterinary medicine and have been diagnosed with IBS a month ago. Last week I had a colonoscopy that only showed what could be a mild inflammation in my terminal ileum and sigmoid colon. My doctor told me not to worry about it since it's probably nothing, but I am still waiting for biopsy results. She remains convinced that this is IBS. My main symptoms are rectal tenesmus, feeling of incomplete evacuation, occasional lower abdominal pain (both left and right) and I have about 3 normal stools per day. What bothers me the most is that I wake up early in the morning feeling like I'm going to have a diarrhea, but when I go to the toilet nothing comes out. Then after an hour I tend to have one normal stool, and one more after another half an hour (which is more loose, but not diarrhea). Usually I go again sometimes during the day. This probably doesn't sound bad to some of you guys, and I'm lucky I don't have any D or C, but this is a major issue for me since I have to go to classes next week and my school starts early in the morning. And the feeling of constantly having to go is so annoying, I can't even focus on studying for my exams. I'm currently taking mebverine and probiotics (been doing so for a month) but nothing seems to help. Could some of you that have more experience in dealing with this please share some advice on diet? Is there anything else I could do to make this situation better? Any advice would be much appreciated! Thanks.

What is your diet like? Are you getting enough fiber(25-30 grams) and enough water, 8-10 glasses daily? Fiber can help to firm up the stools. If you have trouble getting enough from food sources, you might ask your doctor about a fiber supplement such as Citrucel or Metamucil. I d't have IBS, but I am very familiar with the incomplete evacuation, I had many problems after gallbladder surgery, that being one of them. Another thing that may help, try to set aside a time to use the toilet with regularity. Don't strain, or try to to hurry, but relax, deep breathing may help but the idea is not to be sitting there for more than 5-10 minutes. Eventually, it becomes a habit to go and be done, and those feelings of incomplete evacuation will often go away.

It is true, high fiber doesn't work for everybody! When you mention being on antibiotics, it makes me think, are you taking probiotics to restore the healthy bacteria in the gut?

Waking up with cramping and pain sounds horrible- I really feel for you! I learned a technique in my Tai Chi class, the instructor taught us to rub the stomach first in a clockwise motion for 36 times, then counter clockwise. I know it sounds crazy, but when I get a tight stomach or upset stomach, I do this(either lying down or standing up) and it helps, along with deep breathing. (think yoga deep breathing)

RE:getting up earlier, it couldn't hurt. Sometimes, you can re-train the bowels to go by following a routine. Even drinking a glass of warm water has been known to help some. I wish you the best of health, let me know how you're doing! Ruth

Wow, your DR found inflammation on the scope and called your condition IBS? I think you need a new DR. ASAP. It sounds like you have inflammatory bowel disease and you will need medication in order to feel better and get better. Diet is not going to solve that problem. Please visit the Crohn's forum for more information!

AnneBoleyn said...
...Last week I had a colonoscopy that only showed what could be a mild inflammation in my terminal ileum and sigmoid colon. My doctor told me not to worry about it since it's probably nothing, but I am still waiting for biopsy results. She remains convinced that this is IBS....

If it walks like a duck and quacks like a duck it's probably a duck. Was what the scope showed "only mild inflammation" or was it something that might be mild inflammation?

The low carb diet will definitely help with your PCOS. Other than that I really don't have any experience with candida (except for the thrush I got on my skin while breastfeeding, nasty). Why were you taking abx?

Anne, sorry to hear you had H.Pylori, all those AB's are hard on the system! Have you gotten the results from the biopsy?

rufous57, still no biopsy results. I hope my GI calls me on Monday!
Bettsann, thank you so much, you are too kind! I'm convinced that my IBS condition has something to do with antibiotics since I've never ever experienced these kind of problems before. So I keep telling myself that maybe this is only temporary, but I know it takes a lot of time for your digestive system to heal. I will browse through alternative medicine sites and will definitely do whatever it takes to make this situation easier for myself, as I really have a lot of obligations right now. Thanks again for all of your support, it means a lot to me!

If inflammation is in your colon it is not celiac, but it's always good to be thorough. What is your doctor's treatment plan for the inflammation in your colon? Where was it? Visit the UC forum for more specific discussions.

I don't think you should conclude it is not UC. It is non-specific inflammation. Inflammation in the colon could be from a few things, but most often you'll end up with an inflammatory bowel disease diagnosis, and that will put you in the same bucket as people with UC and Crohn's.

Where exactly in the colon was this inflammation found?

No one with a diagnosis of Irritable Bowel Syndrome should also have inflammation, unless they also have a diagnosis of Inflammatory Bowel Disease concurrently. Many people with IBD are told they also have IBS. But no one with inflammation in the bowel should be told they only have IBS. IBS is a syndrome, meaning there is no pathology associated with it. If you have pathology, you do not [only] have IBS.

Inflammation in the distal sigmoid colon could be either UC or Crohn's. In the absence of rectal inflammation I think you're probably going to be talking about Crohn's. Have you swallowed a pillcam? That would be most helpful in imaging the small bowel, which cannot be seen in a colonoscopy.

The terminal ileum is but a small, small portion of the small bowel. The small bowel comprises more than 20 feet of intestine; the terminal ileum is just the last bit.

The article you posted is interesting. That author identifies three important reasons why pathological findings of "non specific inflammation" might be related to improper procedures during the scope or in communications between the GI and pathologist. It is on the 2nd page where he notes that IBS can also have "non specific colitis" that I found surprising. See this info from Mayo about IBS:

www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/basics/definition/CON-20024578

G.J. Mantzaris says, in the article you linked, that the histology of "non specific colitis" is unlikely to change over time for people with IBS. Meaning, I suppose, that this is a condition which will not progress.

So, you went to the DR because you have struggled with bowel problems, focused on tenesmus and frequent bowel movements and they have disrupted your life. Your DR has found inflammation in the sigmoid colon. You and your DR may decide that this is "IBS" and that the only treatment you should work with is dietary and perhaps an antispasmodic to relieve the tenesmus. That is absolutely something you should feel free to pursue. What I've been trying to communicate to you is that there are ways of treating inflammation in the sigmoid colon that could provide significant relief to you, should you decide to call your condition "inflammatory bowel disease."

In a few years you may find that nothing has changed in your bowel. Or maybe not; maybe in a few years the inflammation will have become different in some way. I'm not a doctor and I don't know how else to interpret what you've told us.

Here is more on IBS: www.aboutibs.org/

and differentiating IBS and IBD: www.ccfa.org/resources/ibs-and-ibd-two-very.html

Your DR should have already done a CBC to make sure you have proper iron levels (ferritin too) and a check on your vitamin D. If not, get those tests done. I assume you've also had an occult blood test of your stool. In the absence of a pillcam, you might want to discuss a fecal calprotectin test.