I don't want diarrhea on my wedding day

June 17, 2013 5:14 AM

I have been having major stomach issues that I need to solve. Really uncomfortable bloating and belching minutes after eating, nausea, cramps, etc. I'm getting checked out by a doctor, but I suspect it is my old friend IBS coming back after a 6+ year absence. I NEED to get this under control and back to rights ASAP but so far nothing is working. HELP!

My doctor is testing me for Celiac disease, gall stones, among other things, but in all likelihood it is my IBS flaring up again. I've had two other major flare ups in the past (one 2002 and the other in 2007) but I struggle with my stomach in minor ways fairly consistently. This flare up is by far the worst I have ever had, and is hitting at an incredibly inconvenient time since I'm getting married in less than 3 months. Almost every meal these days earns me a stomach ache and bloating and belching and feeling like hell, including when we went to the tasting of our wedding meal. I do NOT want to be a disgusting pile of gas and awfulness on my wedding day, so I need to find a way to shut this thing down NOW.

What can I do to get my stomach back to normal? So far I have cut out caffiene, cut out gluten, and am limiting alcohol. Are there any magic pills or foods or diets out there that will calm my stomach and put an end to this flare up? Anything I can do/take when a bad attack hits?


ps - I know that my IBS is triggered, at least in part, by stress and I am doing what I can to address that side of things. The problem is that my stomach problems are causing me more stress than anything else right now. I am getting more and more stressed out the closer I get to my wedding day with my stomach still being an issue. I am scared I am going to spend my wedding day feeling awful and having diarrhea.

posted by PuppetMcSockerson to Health & Fitness (27 answers total)

Try cutting dairy/lactose and any of the other complex sugars out there. Fructose can be an issue for people too. I find that my most uncomfortable digestive moments are when I forget that I am lactose intolerant...

As for emergency, must not poop unexpectedly times, experiment. For me, limiting meal size to far smaller than I am accustomed to and including bindy things like rice and psyllium husk works quite well.
posted by gjc at 5:21 AM on June 17, 2013 [1 favorite]

I had awful symptoms for awhile before I switched to the Specific Carbohydrate Diet. It has gotten things pretty well under control, but it is pretty limiting. If you want to hear more about my experiences with it, feel free to MeMail me!
posted by chaiminda at 5:21 AM on June 17, 2013

If you've already had the test for Celiac and you're just waiting for results, go ahead and cut out all gluten. Also cut out all dairy. See if it gets helps. Even if neither of those things is the direct cause of your digestive issues, your symptoms will probably improve without them.
posted by kythuen at 5:21 AM on June 17, 2013

I met a guy once who had symptoms like yours for years. One day he was talking to a pharmacist who recommended some over the counter digestive enzymes. One week later, problem solved. Give those a shot, if you haven't yet?
posted by backwards guitar at 5:29 AM on June 17, 2013

Get rid of the FODMAPs and see if that helps.
posted by seanmpuckett at 5:37 AM on June 17, 2013 [2 favorites]

IBS has all kinds of food triggers and they differ quite widely between people (this is well accepted scientifically). The FODMAP thing is gaining a lot of traction in the scientific literature and is clearly the cause for some people. Cutting out diary and gluten is a good first start given how often than cause problems for people, but remember that you can't cut out the gluten until after the celiac testing is done otherwise you can get a false negative.

So I'd suggest you go and see a dietician who has experience working with these kinds of issues. They can test you for FODMAP intolerance properly (which isn't done by an elimination diet despite what the general internet will tell you), can talk about common triggers and see if they are an issue, and can help you with a proper elimination diet to track down triggers if necessary (not the quacky internet do it yourself kind), and generally work towards figuring out what kinds of things are triggers and what kinds of things will help you feel better.

A food and symptoms diary is a really useful tool for all of this so I'd also suggest you start keeping one right now. Your doctor should find it helpful as well. Include all your symptoms regardless of body part and also your menstrual cycle since IBS is often linked to that.

There are also medications that work for some people with IBS depending on your symptom profile and physiology. Personally I was really hugely helped by antispasmodics for years until my disease profile changed. I can't remember the numbers but something like 30% of people with IBD have the kind that they can help (and they are useless or harmful for everyone else), and of those some small amount like 15% get really great relief and the rest get nothing. Another idea, reflux is a really common co-morbidity with IBS and can present as you are describing, so look into that too. And of course if you have something else, then treatment for whatever that is would be appropriate and should help. So seeing a doctor who knows their stuff is really worthwhile.

The internet will happily tell you about wonder diets or pills that work for everyone with IBD but that's simply not how it works (I have an MSc in digestive physiology, did my PhD in inflammatory bowel disease, and have had reflux and IBS for more than twenty years). Be horribly suspicious of anyone with that attitude, they clearly aren't up on the science. Working with trained professionals is the way to go here, and you should be able to get this under control in three months given a pinch of luck as well.
posted by shelleycat at 5:42 AM on June 17, 2013 [5 favorites]

I had really horrible issues with sudden, explosive diarrhea and my symptoms have really subsided by doing an elimination diet. I discovered that I have sensitivity to gluten, eggs, chocolate and nuts. By avoiding those things, I've not had a single episode of "running to the bathroom with a look of horror on my face."

Stress doesn't help this situation at all, so do what you can to calm yourself and see if there are certain foods that you can avoid that will help you out.

Certainly Immodium can help too!
posted by Ruthless Bunny at 5:43 AM on June 17, 2013

Try some probiotics. It's not as woo as you may think.

And for really bad cases, does Immodium AD or Pepto Bismol help? Clearly, you don't want to be relying on that everyday for every meal, but for some of the worst cases?

And how about some ginger tea?

Also, your wedding is three months away. You've got time, time to try some things and hope that this may pass. But I think it might help you to see a dietitian and I'd definitely ask your doctor for a referral to one ASAP.

(My sister has IBS. I sympathize.)
posted by zizzle at 5:44 AM on June 17, 2013 [1 favorite]

I see that you note that you know your IBS is at least partially triggered by stress. In this case, my thoughts are that it is probably the main cause right now. And right now, it is causing a cyclic response. More stress = more IBS symptoms = even more stress about the symptoms = worse IBS symptoms.

I would try to cut the cycle in the following ways:

1. Eat food that is easy on your stomach. Not too much fat, not too much spice, not too much sugar, etc.
2. Ask your gastro or regular doctor if there are any meds you can take to immediately calm specific symptoms, i.e. gas or diarrhea. In any case, prepare a Ziploc with meds, OTC stuff if that's all you are able to get. Pepto, Imodium, etc.
3. Consider a quick-acting anxiety solution like Xanax to relax you and therefore cut some of the stress that's causing the symptoms.
4. Consider trying probiotics.

I hope you are able to find the cause and solutions soon!
posted by rachaelfaith at 5:44 AM on June 17, 2013 [2 favorites]

Oh two things I forgot: When I say dietician I mean a properly registered one, not a 'nutritionist' because that can be anyone. Also, just keeping the food and symptom diary can go a long way towards identifying your triggers on your own. For me, it gives some feeling of control over the situation which also helps make me feel better, so it's worth doing even if nothing else.
posted by shelleycat at 5:44 AM on June 17, 2013 [1 favorite]

Best answer: Magic pills:

- Probiotic pills, to replenish your gut flora
- Charcoal pills, to reduce bloating

Magic ingredient:

Water:

- If you're getting the trots, it's very natural to want to limit how much water you're drinking. But don't.

Magic formulae:

- Avoid alcohol.
- Avoid artificial sweeteners and the products that contain them.
- I'm less of a proponent of avoiding dairy or wheat as whole food groups, much of which is based on cod science except for the minority of people who are genuinely lactose or gluten intolerant; rather, avoid rich foods - too much meat, too much creamy stuff, too much sugar, too much fat and too much processed carbs, like wot you find in many breads. The positive benefits many people attribute to removing a specific food group is often just down to eating better and less processed food.
- Eat plainly - plain fish, white meat, rice, fresh vegetables.
- Eat modestly, and early - there is something to be said for the idea that one should breakfast like a king, lunch like a prince, dine like a pauper because it gives your body time to digest your food before you go to sleep.
- Exercise - even if it is just walking; get your circulatory system working and burn some calories.
posted by MuffinMan at 5:48 AM on June 17, 2013 [5 favorites]

I think I remember reading that loperamide (Imodium) isn't recommended for treating IBS long term. Is it OK for an occasional situation where you really need to be free of urgent evacuation needs, like a wedding day? Its sort of like an opiate that doesn't cross the blood brain barrier and it really slows peristalis down a lot. Anyways no IBS here but when I have to stop diarrhea its what I use. Your doctor will know far better than me if its advisable for your situation.

Has your doctor run a stool culture? I knew one person who thought they had IBS but it ended up being some kind of parasite.
posted by logonym at 5:51 AM on June 17, 2013

When I've had episodes, my GI recommends Imodium. It's not good long term, but it staves the flood in the short term.
posted by plinth at 5:53 AM on June 17, 2013

Are you getting a sigmoidoscopy or colonoscopy to try to get a picture of the root cause?
posted by crazycanuck at 5:54 AM on June 17, 2013

Whether or not something like Immodium (or other OTC compounds) will help or really really hurt depends on the person and the disease profile. Given PuppetMcSockerson isn't even sure if this is an IBS flare right yet, I'd strongly suggest that anything like this is discussed with a doctor first.
posted by shelleycat at 5:55 AM on June 17, 2013

The symptoms you're describing suggest you might be suffering from small intestine bacterial overgrowth (SIBO), which can often be treated with a course of antibiotics. Be sure to bring it up with your gastroenterologist (you are being treated by a GI, not a GP, right?) as even GIs often don't have SIBO at top of mind.

If this is truly IBS, then I think your best bet would be to identify some safe foods over the course of the next few weeks (varies for everyone, but there's usually something bland that you can consume without causing symptoms) and only eat those on your wedding day. I mean yeah, it sucks not to eat the salmon croquettes with everyone else, but I just don't think you're likely to cure your IBS in three months (unless it turns out to be something else -- work with your GI!).

Imodium is safe for occasional use as long as you aren't having blood in your stool. You might want to try the "all symptom" version that contains simethicone in addition to loperamide, as that may control the gas as well as the cramping.
posted by telegraph at 6:02 AM on June 17, 2013

Response by poster: Are you getting a sigmoidoscopy or colonoscopy to try to get a picture of the root cause?
posted by crazycanuck at 9:54 AM

I had one 6 years ago, and yes, I am being scheduled for another one. I actually went through a TON of tests last time, including a gastroscope, barium swallow, stool test etc. During my last major flare up I was put on anti-spasmotics, which did seem to help, but I didn't like how I felt on them. I always felt drugged and kinda foggy and tired on them. I'm not eager to start up with them again.


As for Immodium, I've never been one that can take laxatives or anti-diarrhea meds. Even small dosages always seem to take me way out in the other direction. (ie. taking a laxative to help constipation results in terrible diarrhea) So those are out. One thing I DO take on occasion is Ovol, and that helps with the gas main when it is lower down. I don't like taking it too often, though.


No, not being treated by a GI but I will ask my GP about being referred to a specialist.

I will look in to peppermint capsules and maybe some probiotics.
posted by PuppetMcSockerson at 6:26 AM on June 17, 2013

Definitely give probiotics a shot, they've helped a lot when I've dealt with GI distress. My GI doctor recommended Align (which is pricey but there are coupons online) or Activia (assuming you can tolerate dairy).
posted by fox problems at 6:37 AM on June 17, 2013

Yes, please see a specialist for your colonoscopy and further testing. Please include a test for C. Diff.

I have ulcerative colitis, a form of inflammatory bowel disease, and probiotics help. I take Renew Life Critical Care 80 billion and also Florastor (s. Boulardii). Testing is currently being done on turmeric but it does look promising, so adding a supplement might have beneficial effects. I also take L -glutamine. Also, ask your doctors about buproprion (wellbutrin) which has helped a number of people I know with IBD, and not merely for the anti -depressive aspects.

I saw a nutritionist recently b /c I wanted to do a supervised elimination diet and she more or less admitted that it would be cheaper and more effective for me to simply do it on my own using this book. which I already had. It's a process, not an immediate fix, but if you are sensitive to any of the things being eliminated, you should see positive results within a couple of weeks.
posted by janey47 at 7:03 AM on June 17, 2013

I'd just like to second the idea that you get regular exercise, especially because this probably is a stress-linked episode. I don't know the exact mechanism of it helping, but it really, really helps me.

Also, on the FODMAP thing -- my older daughter has a fructose intolerance and gets a terrible stomach ache if she has sweetened milk, dried fruit, juices or smoothies, or too much whole fruit. But it's not a zero-tolerance thing, it's a matter of how much she has in relation to everything else she in her diet. So if this is the culprit for you, don't worry that you can never have fruit again. You can! You just can't have tons all at once.
posted by Andrhia at 7:07 AM on June 17, 2013 [1 favorite]

My stress goes right to my stomach (...area) and when this happens I just pound the ginger pills to try to keep things calm, and the psyllium husk. It seems to at least keep the symptoms to a bearable level. Good luck with all your tests.
posted by getawaysticks at 7:13 AM on June 17, 2013

Have you had your gall bladder checked? A quick non-invasive ultrasound could reveal gallstones which could be the problem.
posted by meepmeow at 7:21 AM on June 17, 2013

One word: GARLIC!

I have minor IBS, but holy hell garlic makes me fill up like a balloon! Try eating a garlic free day. (It's not easy). But it may help, and if you go garlic free until your wedding, it's not too long.

But I also have GERD. I take 20 mg Prilosec (OCT, Generic "Omeprozole") once a day. It can also help IBS. That's worth a try as well. Do maybe a week of it since it is a 24 hour product it can take a few days to kick in fully.

Are you drinking enough water? That will help with any dehydration and I find that adequate water helps my stomach overall.
(Also probiotic may help.)
posted by Crystalinne at 8:05 AM on June 17, 2013

The most judicious course of action is actually to refrain from taking much of any action just yet. You're already being checked out by your doctor -- altering your diet or introducing new medicines and/or supplements on your own will only cloud the picture and make it difficult for your internist or your GI (if one's necessary) to tell what's being caused by the illness and what's being caused by the cures. And even in less volatile circumstances, self-implemented elimination diets are too susceptible to noise to produce helpful information.

You should especially avoid probiotics, as you want your doctors to be able to look at your own native gut fauna, as opposed to one that's been messed with by the addition of foreign organisms. While there is a lot of promise to probiotic therapies -- especially fecal transplants -- the methodologies of all of the commercially available probiotic products so facile and blunt that there's more likelihood of they're being harmful than helpful. Pretty much all of the products contain bacteria of similar, but still different, species than ones found in humans, and we only even have these culturable analogs of a tiny fraction of the species that populate our GI system.

You have three months before your wedding to get this figured out -- it's far too early to be throwing everything at the wall and hoping something sticks. And even if you haven't gotten it figured out and licked by wedding day, your doctors will have plenty of treatment options to choose from to give you immediate, short-term relief for your special day.
posted by patnasty at 9:22 AM on June 17, 2013

A product called pepogest helps me with calming my stomach down. This may help regulate the spasms of your stomach. It is enteric coated so it will make it down to your lower intestine. I buy it at whole foods. The other one, that I get on the internet, is Intesol. It is a blend of peppermint, chamomile, and i think lavender oils in it. That one really stops the laxative induced diarrhea that i experience. I have chronic constipation. The constipation is also unexplained, my GI does not know what it is. I have had every test known to man and then some. Good luck. These herbal preparations have been helpful to me. I hope they help you, too.
posted by Jewel98 at 9:24 AM on June 17, 2013 [1 favorite]

Try eliminating fructose as much as you possibly can for a little while. I have fructose malabsorption and eating fructose (from honey, too much fruit, and oh the processed food) always messes up my stomach in the ways you describe. Since fructose is in everything, as well as in innocuous whole foods like honey and fruit, it took me forever to figure out that it was fructose triggering me until I inadvertently eliminated fructose by living in another country and eating a different diet. It's worth giving it a shot for a week or so - my symptoms took about that long to calm down, and then I could eat a banana here or there without setting everything off again. If that's the problem, you should see improvements fairly quickly after eliminating fructose from your diet. If that doesn't do it, the FODMAPS diet would probably be the next step.
posted by dialetheia at 4:29 PM on June 17, 2013

I had really bad stomach problems last year (constipation/indigestion/bloating mostly) and my doctor put me on Apriso, which helps with gastric inflammation. I understand that it is commonly prescribed for IBS. Have you tried that?
posted by radioamy at 7:43 PM on June 17, 2013