Help with an IBS flare-up.
November 29, 2009 6:15 PM   Subscribe

How do I deal with a IBS flare-up? (kind of gross)

I'm about 95% sure I have IBS. I know YANAD or MD and I have an appointment for a visit with a gastroenterologist, but that's not for several weeks. This is after a visit with my PCP.

Essentialy, what happens is that I will wake up one morning with an upset stomach and have diarrhea several times in a day. If I eat ANYTHING, bam, I have to run to the bathroom. These attacks usually last two to three days. I thought at first I was lactose intolerant, and I don't think dairy helps, but on Thanksgiving I ate food made with milk products and I was fine until today.

I have read older threads about how to prevent flare-ups and I will definitely put that information to use, but what do I do now, when I'm in the middle of one? I'm in a challenging grad program and of course the next few weeks are the most stressful time. I have a day job on top of that and, while it's the cause of a fair amount of stress, the pay and the atmosphere can't be beat in this economy. Yet I cannot spend the next three hours, let alone the next three weeks, on the toilet. I've even had to run out of class, which was embarrassing and could be detrimental to my progress in my program.

My stomach was absolutely fine from Wednesday through the time I woke up this morning. I wouldn't say I overindulged on Thanksgiving but I definitely ate food I'm not used to (the dairy). I was back to normal eating by Friday. I've spent most of today camped out in the bathroom or asleep. This doesn't help my stress level, as my homework won't do itself. I don't know what to do now.

What can I eat? How can I make an IBS attack less severe, so I can at least be functional? I am a woman in my early thirties and otherwise my health is pretty good.

Thanks for any help. I'm sorry if this sounds disjointed.

Throwaway email:
posted by anonymous to Health & Fitness (19 answers total) 8 users marked this as a favorite
Have you tried cutting out dairy entirely to see if that helps? Speaking from experience, certain foods are worse for lactose intolerance than others. The only way to truly know if it's the dairy that is causing these flare ups is to go without it.
posted by MaryDellamorte at 6:39 PM on November 29, 2009

You might want to read this book. The protocol has helped many people get through very difficult and challenging diseases including IBS.
posted by watercarrier at 6:49 PM on November 29, 2009

You could try adding fiber-- I have the same sort of "we think it's IBS" diagnosis, and the only thing that keeps me from flaring up is nigh-religious adherence to drinking a glass or two of Metamucil per day.
posted by fairytale of los angeles at 7:01 PM on November 29, 2009

I highly recommend the website and book IBS-Free at Last. After years of being misdiagnosed with IBS, I learned several years back that what I actually had was fructose malabsorbtion.

Long story short: besides lactose/dairy, there are other carbohydrates that cause gastric distress for some of us. For me, these include wheat, fructose, and soy. For the record, your symptoms sound quite similar to what I used to experience until I cut these things out of my diet. I'm now symptom free through diet alone.
posted by chez shoes at 7:25 PM on November 29, 2009

Oh, and if it turns out that you've got the same kind of sensitivities as I do - stay far, far away from Metamucil and prebiotics and/or inulin!
posted by chez shoes at 7:26 PM on November 29, 2009

does anyone else have symptoms that last continuously? I too am waiting a diagnosis but it has continued for well over a month
posted by mickbw at 7:32 PM on November 29, 2009

mickbw, my symptoms were constant for years. Here's wishing you a speedy diagnosis!
posted by chez shoes at 7:42 PM on November 29, 2009

Immediate advice: probiotics. Your gut may be too messed up right now for them to take much of an immediate effect, but I find that a good bifido-blend probiotic helps me a lot.

Advice for your doctor's appointment: I visited a gastroenterologist a year and a half ago who changed my life. For 20 years I couldn't figure out what I had (IBS, lactose intolerance, wheat sensitivity, etc.), and then my symptoms flared horribly over the course of a couple months. After doing a breath test I was diagnosed with small intestinal bacterial overgrowth (SIBO). Ask your GI doctor about this, as it is a pretty new issue/condition/syndrome and wasn't identified until a couple years ago. The treatment for me was a prescription for an antibiotic (rifaximin) that essentially wiped all of the bacteria (good and bad) out of my intestines, and then after I finished those meds, I rebuilt my intestines with good bacteria by taking a good probiotic (started with Align, then got a cheaper bifido-blend probiotic at my local co-op).

I take a probiotic on and off when I notice my gut starting to taunt me, and that's all I need now. I didn't have much hope at the gastroenterologist, but it worked out. Hopefully your doc will hit the nail on the head for you. Best of luck.
posted by Maarika at 7:43 PM on November 29, 2009

Seconding Maarika: IBS is often just a name for a set of symptoms. I suffered in horrible pain for years until I was diagnosed with colitis and then medicated. My life is so much better now.
The Gastro will probably sign you up for colostomy. Get it. The results could be of great help.

Dealing with your question of flare ups. I have found the following work for me. Stomachs are singular and unpredictable things, and people with their problems tend to approach it like witchdocters, so recommendations should by ymmv'd accordingly.

1. Drink plenty of water and only water, preferably warm or tepid. Nothing too cold.
2. Paracetamol and codeine painkillers - No NSAIDS!! (aspirin, ibuprofen etc)
3. No tight pants/belt.
4. Only plain food; bread (no butter, no nothing), bananas, white rice.
5. Small meals, nibbled frequently.
6. Absolutely no fats or sugars.
7. No running, exertion etc.
8. There is a drug called buscopan here that may help with your cramping. Never did anything for me.

Good luck, I really feel for you.
posted by smoke at 8:25 PM on November 29, 2009

Have yourself tested for food intolerance. I was suffering symptoms such as yours with increasing severity and increasing frequency. In September of this year, my naturopath did a vegetative reflex test and as a result I've cut out a number of foods from my diet (wheat, rye, corn, dairy, garlic etc...)

Until then I was plagued by gastric symptoms of increasing severity, and also by frequent migraines. I feel great now, simply from cutting out a longish list of foods that were problematic for me.

Now my focus is on finding out which of the 30 foods I've nixed can be reintroduced into my diet. The science of food allergies and food intolerance (especially together) is still a young field of research, and I am an experiment of one.

A book that helped me is this one Coping with Food Intolerances by Dick Thom.

I hope you find the help that you need. Find a sympathetic doctor, and be prepared for a lot of research. Conventional medicine will help you this much, and alternative medicine may help you further. Tread bravely and carefully.
posted by seawallrunner at 9:20 PM on November 29, 2009 [1 favorite]

The Gastro will probably sign you up for colostomy.

I think this should be "colonoscopy." Don't get a colostomy just yet!

posted by scody at 9:43 PM on November 29, 2009 [2 favorites]

1) Stick to basic, bland things. Think basic - crackers, noodles and soups, simple sugars that are easy to digest, etc.

2) Avoid fiber, foods that are greasy, spicy, or really acidic. Cut out coffee and soda for a while - caffeine can wreak havoc on your GI system. Alcohol is also a really bad idea.

3) Drink lots of water to replace the fluids you're losing from the diarrhea.
posted by chrisamiller at 10:00 PM on November 29, 2009 [1 favorite]

Oh yes, Scody. Ha ha ha, wrong Colo there. I do not (thank god) have a colostomy!
posted by smoke at 10:08 PM on November 29, 2009

I had similar problems for years. I thought I was gluten intolerant, lactose intolerant, and egg intolerant at various times. I took probiotics, fiber pills. The symptoms would come and go, and when I switched diets it would sometimes get better for weeks at a time. However it always came back and reached a nadir two Thanksgivings ago with almost a month of liquid poops and over 10% body weight loss.

I have discovered what works for me.

Lower the stress in your life, or learn how to deal with it better. Also start eating a regular diet regularly.

Your worries about school and the job are causing these pooping problems. When relaxing with friends and family, it doesn't matter what you eat(Thanksgiving)(and actually Thanksgiving in my family is a good meal with lots of nutritious foods put together in a traditional way, and a meal I try to emulate in a scaled down fashion). But Sunday came around and you started to fear the week ahead and all shit broke loose. You should follow some of the above advice; don't each too much sugar, alcohol, lactose, or gluten. But that just means eating a regular diet. And your biggest need is to destress your body and your stomach.

Eating good food regularly at this time in your life could mean spending more on food than you are used to spending. You are very busy right now; you don't have time to cook a balanced meal three times a day; milk and cereal, or a handful of nuts, a bag of chips and a soda doesn't cut it. The condiments and combinations that go into a meal matter, and make it digest well. Right now you should go out and eat a decent meal twice a day at least. Not a burrito, but a whole meal. Go to a place that serves breakfast and have a meal. Get the eggs benedict instead of the omlette. That is, get the eggs with the fruit, the veggies, and the bread instead of just the eggs. Enjoy it. Go to a place that has lunch and have a meal. Don't study while eating. Talk with someone or concentrate on how good your food tastes.

Stop worrying about your poop, and start doing something about your stress level. It worked for me!

Good luck!
posted by GregorWill at 1:15 AM on November 30, 2009 [2 favorites]

I know some good people whose intestines turn to madness if they eat onions or anything onionlike.
posted by krilli at 2:29 AM on November 30, 2009 [1 favorite]

It is always worth carrying around some imodium or something like it; then, when you feel your tummy starting to play up, you can take one then be poop free for a day. Always good on the short term.

Nth-ing the fact that IBS is just a catch-all term.

I think, summing up what everyone has said and adding my own thoughts, that what you can and can't tolerate is something that you will just learn over time. In the meantime, you just need a way to manage the symptoms. My suggestions:

Eating less
Drinking more water (helps with the dehydration and with making you feel less hungry from the above)
Taking some imodium
Avoiding aspirin and ibuprofen as these can make things worse
Trying not think about it.

Hope this helps.
posted by Nufkin at 5:38 AM on November 30, 2009

I'd look into the Specific Carbohydrate Diet:

I follow a variant when I have a flare. Pureed pumpkin, chicken stock, bananas, rice are my staples during a flare.

Some people respond well to fiber, but for me it's just fanning the flames and I have to avoid it and any small seeds or other indigestible matter.
posted by melissam at 5:44 AM on November 30, 2009

Nth-ing the fact that IBS is just a catch-all term.

No it's not. Sure, it's a syndrome (or collection of symptoms) but it's still a specific disorder with specific diagnostic criteria. It's not just a random label thrown on when they don't know what's really wrong.

The food triggers for IBS change drastically between people and what works for one person won't necessarily work for another. So while you can add or remove things from your diet in an effort to narrow it down don't get hung up on any one diet being the magic cure, it doesn't work like that (although lots of people will tell you it does, I agree it's all rather witchdoctorish). I'd suggest you keep a food/symptom diary to try and narrow down what's happening, it'll be useful when you go to see the Dr if nothing else. Also be careful with stuff like metamucil or imodium, they can help some people but they can make things much much worse in others so make any changes like that carefully and keep track of them in your diary. Bland food is the most likely to be tolerable until you can work out what your triggers are (mine are saturated fat and acidic fruit).

Environment also plays a huge role in IBS and other gastrointestinal disorders so it's likely that reducing stress will really help. Easier said than done when you feel that crappy I know! For me regular exercise is an important part of keeping down anxiety and reducing symptoms. Don't get too hung up on reducing stress, sometimes that just causes more stress, just try to do the best you can.

But in the long run you need to get diagnosed properly because if it is something else then the treatments could be very different (as you can see from the answers here) and you're on top of this with your Drs appointment. So remind yourself that you're on track for getting it sorted and that this won't last forever.

(I'm not a doctor, I am a digestive physiologist and have had IBS for 15 years)
posted by shelleycat at 10:59 AM on November 30, 2009 [2 favorites]

I added chrisamiller and shelleycat's responses as favorites because they are the most logical/consistent with my own experiences. What made the most difference for me was cutting out coffee (regular and decaf - I basically just switched to caffeinated tea) but YM really really WV (for example, pro-biotics make me debilitatingly nauseated, and I find dairy to be one of the few things I can reliably eat on particularly bad days). There's a lot of magical thinking around IBS, and a lot of advice along the lines of "Just stop eating X (and Y and Z and ABCDEFGHIJK) and you'll be CURED," which is mostly bullshit so definitely keep your Science and Logic Hat on when reading through suggestions.
posted by jennyb at 3:43 PM on November 30, 2009 [1 favorite]

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