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IBS, Colonic Inertia or something else?.... help!

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Irritable Bowel Syndrome
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Posted 3/1/2011 6:01 PM (GMT 0)
Hi I've been posting on the ostomies group, but wondered if anyone in this amazing forum can offer some advice.. you're all so experienced and knowledgeable.

Last June I had peritonitis caused by perforated diverticulitis, then a sigmoid colectomy, temporary ileostomy and then reversal in October. Since then I've had awful problems with bloating, constipation and the feeling that nothing is really working. When I say 'bloating' I honestly look 7 months pregnant 90% of the time, haven't worn a pair of jeans for 8 months and can't eat much in the way of fibre, meat or anything esp solid!! I used to be a really fit triathlete and was training for an ironman. Right now I feel absolutely terrible and find it really hard to do any training at all - not like me at all.

I don't have any pain as such (no cramping etc), other than the discomfort associated with the bloating and nausea that goes with it. Find it hard to eat and lying flat in bed at night can be hard sometimes. Feels like the bloating is pressing into my chest. Going out for dinner is miserable and I stand and stare into the fridge and wonder what on earth I can eat!

I've had a gastrograffin and barium meal, which showed no blockages anywhere. tomorrow I'm having an xray for the transit marker test (I had pills over weekend) and they're looking for CI but consultant suspects IBS.

I'm scared that it won't show up anything and I'll be left with no real diagnosis.

I guess my questions are:

1. Can peritonitis or surgery etc cause IBS when I didn't have it before?

2. Does it sound like IBS or CI ?

3. What are the treatment options? my consultant is talking about stimulant laxatives (Movicol doens't work) and colonic irrigation .... but surely that's not a long term option?

The way I feel right now is that I'd rather have the ileostomy back. I felt really well when I had it and it didn't affect my life... I could run, cycle and go swimming. Right now I'm hanging on by a thread and feel awful most of the time.

Does anyone know if they would let me have the ileostomy back if I got a diagnosis of IBS rather than CI??
HELP!! feeling pretty miserable.
Thanks
Posted 3/1/2011 8:28 PM (GMT 0)
Welcome Ironmum,

I just talked to a GI expert about all this and some I knew already.

IBS is a specific condition, with a specific cluster of symptoms of a specific part of the body. Although other functional disorders can effect the entire gi tract.

It is not just GI symptoms though.

So in answer to this

"1. Can peritonitis or surgery etc cause IBS when I didn't have it before?"

NO, not unless you had it before.

"2. Does it sound like IBS or CI ?"

I am not sure if your having CI Problems and that you need to work with your doctor on.

The issue here is they have changed your plumbing with surgery and that is what is causing your symptoms. This can effect how the bowel absorbs water for one.

IBS is a functional disorder of the large intestines where the functioning of the bowel is not working properly when you still have your large bowel and nothing can be found on basic testing to be wrong. Its not IBS when something else going on explains symptoms.

It may help if you can to increase fiber perhaps and make sure you drink enough water, but ask your doctor about that as well.

Its also not likely that most IBS treatments for the most part will help with your problem/problems.

This is something you will have to work closely with your doctor on.

Hopefully the sitz marker test will give some info on how fast the system is working.

Let me know what that test shows.

Hope that helps.
Posted 3/1/2011 9:02 PM (GMT 0)
What a lovely considered and helpful response. thank you so much!

I find that things are worse if I increase fibre or have fruit and veg (salad not so bad). Things like prunes or porridge just makes it worse and I blow up like a balloon. I'm better if i stick with low residue stuff and white bread, rice or mashed potato etc. Mostly soft food, soup and mushy stuff. I haven't had any red meat or chicken for months as it just bungs things up.

I've always been a big water drinker (as an athlete I'm very aware of fluid intake) but find it hard to drink much right now as just feel full all the time. I really do make an effort to keep drinking though but again, find it makes very little difference.

I'm hoping and praying the marker test will come up with something.. but worried if it doesn't the consultant will wash his hands of me. I can't do it for much longer.. struggling to work and have no quality of life.

Thanks again for your reply - really appreciate it and will let you know the outcome.
Posted 3/2/2011 8:23 PM (GMT 0)
Ironmum - I am sorry to hear of your illness. I am equally sorry that I am not able to offer any answers to your questions. However, I would be grateful if you could keep us updated on your progress please. I know you many not want to go through it but I am interested to see what happens if you go back to having an ileostomy as I have been considering this for myself. I suffer from chronic nausea and stomach discomfort and like you my quality of life is very low so I have been thinking that an ileostomy might give me relief.

A freind of mine was very unwell after his partial colectomy and the doctors discovered that the join was leaking, I assume that you have been checked for this.
Posted 3/2/2011 8:32 PM (GMT 0)
Ironmum, hopefully it was helpful to you. Not sure what state you live in but I have resources also and you can always email me. Again let us know about the test.

idkwia

what were you diagnosed with?
Posted 3/2/2011 10:48 PM (GMT 0)
Thanks it was very helpful. I'm actually in the UK - near London. Thanks idkwia - all the joins have been checked and there's no leak.

Will have results of the sitz marker test tomorrow then am going to get a second opinion.
Posted 3/2/2011 11:39 PM (GMT 0)
Ironmum

Let us know when you get the results of the test and so you know I have connections in the UK as well.
Posted 3/3/2011 10:35 PM (GMT 0)
Well it turns out the transit test was 'normal'.. so no diagnosis of CI. Consultant is basically saying he doesn't know what is going on, has given me a diagnosis of IBS for now.. and referred me back to a GI.

I don't know what to feel anymore. I had a life or death situation 8 months ago and nearly died of peritonitis. I'm now clearly much better, but still don't have the quality of life I had before and am not the same person. Dont' really know what to do next..
Posted 3/4/2011 6:31 PM (GMT 0)
Like I said Ironmum, it can't really be the clinical definition of IBS. However, many people continue to have GI symptoms after surgeries. Hopefully a GI doctor can help get things sorted for you.

How far is London from South Manchester ?
Posted 3/4/2011 6:39 PM (GMT 0)
Thanks shawn12.. thing is I didn't have any GI problems before surgery. The surgery was performed because I had peritonitis caused by perforated diverticular that I knew nothing about. Only 6 days before I had done a half Ironman triathlon! I wasn't having any issues - or none that I considered seeking treatment for. I don't feel anything like the person I was 'before' and things certainly don't work properly. Sorry just feeling a little frustrated here. I've had a couple of friends (one a GP and the other a gynae consultant) suggest that I go to St Marks which is a specialist bowel hospital in North London. South Manchester from where I am is about 5 hour drive.
Posted 3/5/2011 1:00 AM (GMT 0)
Ironmum

My brother had his out for diverticular infection as well. He doesn't have IBS, but does have bowel problems.

There is an expert in South Manchester but that sounds to far to go.

I understand the frustration and who wouldn't be.

St Marks looks like a good place.

Let us know and good luck, hopefully they can help you there.
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