Amitriptyline for Ibs pain? Pleas advise - first time on antidepressants

I have had so many problems with my colon this year. I had c diff again in February probably from just being in the hospital without taking my florastor. Then after that I've had problems that mimic proctitis which I was diagnosed with two years ago and now ibs. I can't confirm whether or not I haveproctitis hntil I get my test done in December.

Anyway I had horrible colon spasms for a week. I'd have gas and feel like I need to poop but nothing. It was horrible and I wanted to kill myself. Had an a-hole GI who gave me hyoscyamine but I couldn't handle the side effects and he told me to just stop and go to the ER. I was seeing a therapist at the time because I've been having depression and anxiety for years. She recommended an antidepressant. I asked my regular doctor for that and now I am on Amitriptyline.

Was on it for 10 mg the day I stopped the hyoscyamine and I also added peppermint capsules, pepogest, and it helped a lot. I finally felt normal again. However, I was still depressed. Idk if it was the Amitriptyline 10mg or peppermint that helped but either way I felt like the anti-depressants helped the IBS but not the depression.

So I decided to up the dose. I figured it was time anyway since I've been on the 10mg amitriptlyne for a month and if anything it would just made me gain weight. Which I have no problems with since I'm tiny and have had problems eating thanks to this ibs and proctitis history.

Fast forward to now and I decided to go off the peppermint while upping my Amitriptyline to 20mg a night. I will eventually go up to 25 mg and I refuse to go any higher. I'm currently seeing how I'm doing without the peppermint because I really don't want to become dependent on it. Since the hyoscyamine didn't work for me I'd really rather use peppermint as a last resort that I know will work...

So today will be my third day taking the Amitriptyline 20mg and yesterday I was soooo constipated. Then today I went 3 times so far. I didn't have tummy pain but my butt hole felt so swollen. I had some mucus which I get when I get constipated. But no blood whatsoever that the eye can see. Anyway, Is this normal? I feeling like this feeling of swelling is making me go to the bathroom a lot today. It's not even watery either. I mean I guess this a happens after missing a whole day of pooping but seriously, I don't poop that much! And it's all formed too. If anything, it's just mushy. I've had this happen before but couldn't pin point why my butt felt so swollen. It makes my stool thinner which I know could mean inflammation but I'm hoping it's more just irritation than that....

I'm also worried about going off the Amitriptyline. I've read stories about how even people on 10mg experience withdrawal symptoms after being on it for less than a year. I know this drug will alter my body when I go off it but I don't want to be worse off when I get off it and then end up having to take it for the rest of my life. I'm really just hoping it can just "rewire" everything so I can function normally again

Post Edited (Poophappens) : 10/4/2015 6:52:39 PM (GMT-6)

Im also on amitriptyline for ibs and my symptoms sound quite similar to yours. Ive never had diarrhoea or urgency but do have the mucus and some blood, ive had a bunch of tests and things are ongoing but im starting to think its just ibs plus either a fissure or internal hemorrhoids because of the pattern of bleeding i have.

Anyway, Im here to talk about the amitriptyline. Yes it is an antidepressant, however; it has fallen out of fashion when treating depression brcause in order to do so the dosage needs to be huge compared to the prescription for ibs, and there are more effective anti depressants nowadays. Historically people who had depression were on the likes of 150mg which as you can see is more than ten times what youre on now. Both my GI and colorectal consultants use amitriptyline to pretty good success but only in doses up to about 30mg, ive never seen any more than that prescribed for ibs (of course i could be wrong!)

What I'm saying is this, please dont worry about 10mg not clearing up your depression. Its likely that if you do have ibs and not proctitis, and you stick to 20-30mg you will notice a difference in your bowel symptoms. You will maybe even notice a decrease in your anxiety, maybe due to the pills maybe just because you arent worrying so much about your health.

When it comes to the time where youre thinking about coming off of amitriptyline you wont have anything like the withdrawls with other kinds of antidepressants. There is no dependency with amitriptyline, so if you are sensible and reduce your dose marginally over time you wont even notice it. Dont listen to people whining on the internet ;) Out of everyone taking this drug youre going to find a small percentage who have a negative experience but what youre not seeing is the thousands who are perfectly happy and so have no reason to go online and talk about it.

It really helped me, in fact it cured me completely for about 2 months and then my symptoms slowly crept back in, but ive read of this happening sometimes. Im just looking at it as a short term solution while i find a more long term arrangement :)

Yep i had a sigmoidoscopy and the colorectal surgeon wasnt worried, he saw some slightly red patch so he took a biopsy but it was normal, so he said that any slight irritation was likely caused by the prep. At the moment Im waiting to see my GI to talk about pillcam endoscopy to check my small bowel, colonoscopy is the last resort because its the most invasive and he thinks its unlikely he'll find anything of note in my colon. That being said of course it will be investigated in the future if need be. I also want him to check my rectum because i believe i may still have a fissure, or perhaps some internal hemorrhoids

Ive read a lot of people say the same thing, that the amitriptyline stopped working and they had to increase the dose, but i have no intention of increasing it since where does that end? Do you keep increasing it forvever? Nah. So what im doing is weaning off it, then i plan to start it again and see what happens. To be honest my symptoms are really not that bothersome, my only concern is finding out whether or not i do have an inflammatory condition. If not, i can put up with some mucus etc and I'll be okay with that. I really couldnt complain about it since others have a much harder time than i do.

I understand when you say youre worried about it getting worse, i think everyone worries about this from time to time. Work on trying to accept your condition for what it is just now and you can deal with what happens in the future when that time comes. You wont feel sincere right away, but practice thinking things like 'Well so what if it gets worse, Ill cope with it' and trying not to get sucked in to examining it. Practicing this mindset seems fake at the start but as time goes on you will start to accept it.

I think its important that you think about dealing with your anxiety and depression, because the impact these two condition have on your gut is enormous. Prioritise these and you might find your bowels will ease up a bit. I myself was agoraphobic, but i would say I'm about 80-90% recovered at this point. I believe wholeheartedly that this anxiety disorder contributed to my ibs symptoms, it would be an almost unbelievably coincidence if not. Mind your mind, as they say. Dont get brought down by believing you cant change your thoughts or feelings, with work you can and you will.

Thats good youve scheduled your procedure. If your surgeon notices any redness he will biopsy the area (completely painless since we have no sensation in our bowels) and this will show if there are any abnormalities on a cellular level - so crohns or ulcerative colitis.

I dont have much stomach pain really. Sometimes i have a slight cramping, almost like a vague menstrual cramp feeling, but its not enough to be bothersome. I currently take the mini pill so no longer have a period and this has helped enormously because i used to have awful bowel pain with it.

I was on 25mg every night so i started cutting them and taking half each night. I did that for a week and now i take half every second night until in a week or so i will stop completely. Ive had no withdrawl effects whatsoever. Only a slight increase in symptoms, for example i used to have heartburn which the amitriptyline cleared up completely, and now that im reducing the dose its creeping back slightly. I was expecting this though since ive only been taking this drug approximately 3-4 months. After a little while off of them i will start taking half again and work back up to the 25. This is purely an experiment for myself to find out what happens! I should have consulted my dr about this but its impossible to speak to any consultant in the hospital here. You can only make face to face appointments which can take at least one month to get to.

On the topic of peppermint, if it helps you i would continue to take it. Maybe try some teas and see what effect they have? I can't imagine you would become reliant on or immune to peppermint, its not a medicine really after all. I say carry on if it works!