YANMD, but do I have IBS?

January 1, 2013 4:06 PM

YANMD, but do I have IBS? How do I cope?

I am wondering if my symptoms are simply IBS or perhaps something else. Essentially, I go through periods of being able to eat normal amounts of food at meals and then periods of not being able to eat very much without getting nauseous. During these times, I will often just switch to crackers, cereal, and other mild foods.

I spoke to the doctor about these things and got a blood test. The doctor basically told me that I probably have IBS.

I've started taking probiotics, and I've stopped drinking coffee. Both of those things seemed to do me good in the short term, although I'm not sure how much they help now. I still drink alcohol, but even that in small amounts now seems to bother me. I used to be able to drink lots of coffee, alcohol, and eat regularly in college. I took a relatively stressful job 1000 miles away from home 2.5 years ago, and these symptoms started appearing around that time, although overtime they have become more pronounced.

My cousin has IBS (Irritable Bowel Syndrome), my other cousin had Chron's which made it difficult for him to eat at times, my mom can't eat when she is stressed, and several of my family members have celiac disease (can't eat gluten). Needless to say, digestive issues run in my family.

Basically, all signs seem to indicate IBS, but I'm not sure how to cope. Do I have IBS? Were you diagnosed with IBS? How were you diagnosed? How have you learned to cope?

posted by uncannyslacks to health & fitness (17 answers total)

What kind of blood test did you have done? Have you had the gluten antibody test?
posted by humboldt32 at 4:27 PM on January 1 [2 favorites]

Ugh, your dr is useless. Get a referral to a gastroenterologist - preferably a good one. IBS is basically the equivalent of saying, "Yup, seems like you got a bad stomach, dunno why, I give up".

There is lots more you can do before you get to that point, including, but not limited to more blood tests, stool samples, colonoscopy/endoscopy etc etc. I have colitis, it was a journey of over two years before I finally got a diagnosis, with a lot of exhaustive bullshit in between. Thankfully, I ended up with a great GP who didn't say, "whelp, you'll just have to live with this." I didn't, and I don't.

I'm not saying you have colitis - or anything else - and I'm not saying you don't. But if you really want to investigate your options you can go much, much, much further than this.

To second part of your question, how did I learn to cope? Well, my medication helps a lot now, but it's not infallible. For me, even after diagnosis it took a few years to change my habits - and I'm far from perfect even now. Learning how much I could eat; what I could eat; when I could bend the rules; that it's okay to say no; to refuse food; to take time off when I'm not well etc etc etc. This all took a long time. But if I look back to where I was before and immediately after diagnosis I am *so* much better now. Like crazy amounts better, and I don't notice most of the "diet hygiene" I practice now to stay healthy; it's just part of what I (don't) eat.
posted by smoke at 4:31 PM on January 1 [6 favorites]

I have IBS. It was getting worse and worse. I mean to the point where any 'normal for others' meal probably would result in severe diarhea. It affected every bit of my life.
The first thing I did was eat blander foods. That helped a little. Less fat, that helped some.
Then I found out I was lactose intolerant. So I eliminated fresh milk. Most lactose intolerant people are able to have yogurt and cheese. I found out through trial and error that I had no business with bovine dairy products. I on a whim decided to try camel milk. I began using it in April of last year. I found that my stomach is far less noisy, and it has reduced the diarhea to almost nothing.
I have something like normal vowel function for the first time in decades.
I get my camel milk from Oasis Camel Dairy in Ramona California. It is a freeze dried powder they import from The Netherlands. It is not cheap. But it is worth it.
Just so you know, camel milk is AWEFUL in coffee. Take it with chai, and a little brown sugar.
It's quite good in chai. And camel milk has a lot of health benefits.
Now, if you like ice-cream, there are totally dairy-free ice-creams. SO is excellent.
It's made with coconut milk. Don't bother with hemp milk. It tastes like burnt wet newspaper. It made me ill. You might be different.almond, rice or soy milk are good options for in your cereal.
Regular coffee creamer has casein. If casein is not an issue for you, fall on your knees and thank The Lord!
There are next to no totally dairy free coffee creamers. Apparently, I get to play Mad Scientist as soon as I can lay my hands on some pure powdered coconut milk and pure soy powder.
The people at Oasis are looking into trial sizes on camel milk powder.
For myself, it was money well spent.
Better than any single medical intervention or combination of interventions.
Have you had a colonoscopy? If not, make sure you do, in order to rule out celiac and Crohns.
posted by Katjusa Roquette at 4:44 PM on January 1 [2 favorites]

Incidentally, I do have a good gastroenterologist. She did a full work-up. And she's pretty amazed with the results of my experiment.
posted by Katjusa Roquette at 4:47 PM on January 1

You should consider eliminating various foods from your diet and keeping meticulous notes about how you feel. Given that there's a celiac sufferer in your family, gluten seems like a good first ingredient to remove.
posted by blue t-shirt at 4:48 PM on January 1 [2 favorites]

Generally it would make sense to eliminate one thing at a time so you don't have difficulty ascribing the symptoms (or lack thereof) to any one cause.
posted by blue t-shirt at 4:57 PM on January 1 [2 favorites]

I'm honestly not sure what kind of blood test I had done, although they said they would check for celiac. You guys have motivated me to call the doctor again tomorrow and try to get a recommendation or another appointment.
posted by uncannyslacks at 5:11 PM on January 1

 Do I have IBS? 

No one here can give you a diagnosis. No one can even venture an opinion on what you may or may not have. We also can't comment on what your doctor did, you haven't given any relevant details. Ignore anyone who tries.

IBS has specific inclusive diagnostic criteria, the Rome III criteria . Look at those for accurate info on how diagnosis of ibs is done.

Keep in mind that dietary triggers for ibs are highly individualised so anyone telling what you should or shouldn't eat doesn't know what they are talking about. You will get all kinds of misinformed advice like this. If you're not happy with how your dr diagnosed you after reading how it should be done in my link above, find another dr. Don't ask random strangers. If you are happy with the diagnosis, work with your dr on how to manage this. Also consider seeing a qualified dietitian for food advice since it amounts to medical advice in ibs. There is a lot that can be done. But again it varies a lot between patients so you need care tailored to you, something you will not get here.
posted by shelleycat at 5:12 PM on January 1 [6 favorites]

I would see a specialist because nausea is a fairly unusual symptom of IBS. The diagnosis of IBS is primarily based on how you poop.

Nausea could also have to do with something more upper GI like the also-common GERD.

I feel this paper that came out last year is a good one of various gluten-related disorders if you want to know how they are diagnosed.

If you do turn out to have IBS, I highly recommend the FODMAPs approach to food sensitivity, which was developed in Australia and is far more scientific than any other approach I've encountered (I have IBS and control it with a low-FODMAPs diet).
posted by melissam at 5:31 PM on January 1 [1 favorite]

Get your doctor to refer you to a gastroenterologist (stomach/digestive doctor).
posted by radioamy at 5:39 PM on January 1 [1 favorite]

Essentially, I go through periods of being able to eat normal amounts of food at meals and then periods of not being able to eat very much without getting nauseous. During these times, I will often just switch to crackers, cereal, and other mild foods.

Yeah, this sounds more like GERD to me. The two conditions can co-occur, though. Specifically, what you're experiencing sounds like gastroparesis, or slow gastric emptying.
posted by limeonaire at 5:56 PM on January 1

If there is Crohn's in your family you should definitely see a gastroenterologist. This could be IBS, this could be the beginning of IBD, it could even be Celiac. Definitely do what you can to alleviate your symptoms (smaller meals, limit coffee, alcohol, any other trigger foods you've noticed), but GI issues can be serious and you should be in the care of a doctor who is invested in identifying the root issue.
posted by telegraph at 6:09 PM on January 1 [2 favorites]

One caveat - get tested for Celiac before eliminating gluten or you won't be producing the antibodies needed for the blood test. I know a number of people whose IBS turned out to be caused by non-Celiac gluten intolerance. I agree with everyone else though - you need a more thorough GI work-up to figure out what is going on.
posted by leslies at 6:57 PM on January 1 [2 favorites]

Gastroenterologist. Who may refer you to an allergist.
posted by Sidhedevil at 8:38 PM on January 1

Part of what people here are saying (but not directly) is that beyond blood work there may be dietary tests that are helpful -- eliminating a lot of suspect foods (like dairy, wheat, maybe starches generally) from your diet in a systematic way and then, say, adding them back one at a time to figure out what you're intolerant of. It could be that you have allergies, or it could be that your innards just don't like a subset of foods -- in either case, a long-term adjustment in your diet could make you a happier, more functional, person. That's worth a few months of hassle to figure it out!

Good luck.
posted by acm at 7:40 AM on January 2

nthing gastroenterologist. Don't do an elimination diet until you go to a GI doc, so that they can test you for celiac with a blood test, but the GI doc may have you do an elimination diet at some point anyway to determine what foods trigger your IBS. For what it's worth, I had similar symptoms (nausea, other digestive issues, with a bonus prize of constant heartburn!) that are now gone once I eliminated gluten from my diet. Since celiac disease runs in your family, it's at least worth talking to a gastroenterologist about that and other possible food intolerance.
posted by bedhead at 10:35 AM on January 2

As someone who has dealt with IBS for about 15 years now, depending on the severity, it's not as if your life will undergo a radical change. You pretty much learn what it is that makes you sick and adapt to find ways to still enjoy those things or similar things. As a somewhat dark, but humorous aside, before I realized that it was what I ate and drank that made me sick, in high school at times, in the middle of playing pick up basketball, I would have to simply make a run for the bathroom. It wasn't until years later that I told my a friend that it was the IBS and he told me that at the time he thought I was simply running out because I was losing. Heh.

So...feel free to share your problem with those you trust to avoid suspicions of being a poor sport!
posted by Atreides at 11:27 AM on January 2