IBS? Ulcerative colitis? Something worse?

[Spinstar]

I'm 51 and keep getting recurrent bouts of diarrhoea that wake me from deep sleep in the early hours of the morning with an urgent need to 'go'. I think I've had about 5 episodes now since mid December and the latest two have been accompanied by upper abdominal acid-like pain.

At first, I thought it was just a bug I'd picked up but after a few episodes now, I'm wondering if it's something more? I've not had symptoms like this unless I've got a gastroenteritis bug but can't imagine one would recur like this for 3+ months now.

Could it be purely perimenopausal hormones? It doesn't seem to follow any pattern around my cycle (still menstruating but a bit less regularly and got a few other mild perimenopausal symptoms.)

I've had no blood in my stools and I've also had days when I've seemed fine again. I'm not losing weight and I'm still hungry although less so because of the pain and fear that I'll be up in the night. I'm no more stressed than I ever am and not at all prone to anything like anxiety or mood disorders.

Up until it started, I was largely eating a healthy vegetarian diet and more prone to constipation than diarrhoea. Now I can only eat the blandest foods and I'm still in pain and waking with diarrhoea but the diarrhoea isn't all that bad - ie it doesn't go on all day.

I've never had IBS or any allergies. I've always thought of myself as having a 'cast iron stomach' and it takes a lot to make me sick, although I've recently had a nasty flu/chest infection virus thing that hasn't fully cleared after 3 weeks. However, the diarrhoea and pain pre-dates this by months.

Does anyone recognise these symptoms? Why would I suddenly get something like this now? Does it sound like a bug picked up from somewhere and why would it recur but not persist daily all the time? I've been fine enough between bouts. Is it related to hormones and my age and nothing else?

The day before the first episode, we visited a NT place attached to a farm but didn't go to the farm part but I did have a cuppa at the cafe and the next day, had the first episode of early morning, explosive and urgent diarrhoea. However, if it were a bug picked up from the farm, wouldn't it persist rather than clear up and then recur?

I've looked on the internet as I want to rule out anything really nasty and I'm reluctant to see a GP as I don't want to initiate unnecessary investigations or a nebulous diagnosis of IBS, which i know many women get diagnosed with, when doctors have no other explanation. So that's why I've come on here to see if anyone goes, "Oh yeah. That's obviously....xxxxx"

If doc say pain relief OK there are Paralief adult suppositories that don't go through the stomach.

Sunshine, I'm open to any suggestions as to what's wrong with me. I was tested for coeliac's whilst still eating bread regularly and it came back all fine. I don't know if it might be Bile Acid Malabsorption, as I only had diarrhoea right at the very start for 10 days but I think I may have had a few similar bouts of 24 to 48 hr lasting diarrhoea across the months leading up to mid March when this all kicked off.

I was also using ibuprofen across that time for another bout of less serious flu in February and a shoulder socket injury, the day before the first ever bout in mid December. I'm still not sure if it's related to use of ibuprofen thought he consultant felt it couldn't be that and I've used ibuprofen across the last few years with no problems anyway. It's just really weird.

Whatever's going on seems to be spreading upwards today rather than most things that start in the upper guts and then move downwards. Really don't know what this is about at all. The pain's a bit less bad than earlier morning and I've managed to eat rice, mashed potato and chicken with some bioyoghurt.

The more I investigate bowel/digestive disorders, the more I come across stuff that indicates if they can't diagnose anything easily specific, you get out in the category of IBS, especially if you're a woman (younger women particularly). I think there must be as yet undiscovered bowel-related disorders that medicine may not even have a name for yet. The whole treatment thing for so many IBD issues seems to be treat the symptoms but then the medication can then go on to cause other medical problems and perhaps the underlying root cause goes undetected for life and untreated too.

Sadie, thanks for the info. about pain relief suppositories. I need to have another consultant appointment I guess, before I dare try anything but it has been a very very long 9+ weeks now of no treatment and no medical relief.

If the chest pain is central, sort of where your bra cups meet, and then through into your back, then that could be gastritis and you could have reflux causing the cough and sore throat. I have a friend who has had a long standing cough, which she'd put down to her asthma but was in fact caused by reflux, due to Helicobacter Pylori.
If you are having apples then they are better cooked/stewed, you can buy (baby food ) ready made stewed apple, the pectin can be very soothing to an irritated gut.

I can relate to a lot of this. I had an extremely bad case of gastritis which was caused, in part, by extreme anxiety. I was given a PPi (lansoprazole) for 6 weeks and refered for cbt. It turns out I'm wheat intolerant and my symptoms (especially for anxiety) have reduced, disappeared since cutting out wheat. This was on my Dr orders though.

If Rennie isn't working you need to try something else. I personally would try nexium for a month and see if it helps and cut out anything you think aggravates it.

You have my sympathy x

SirVix, the pain has been, latterly, central upper gastric, extending right round the back/ whole of upper chest area. I don't know if I've been tested for H Pylori but assume this must be something looked at in my upper gastric biopsy results - well I hope so, as I don't want another gastroscopy any time soon!

It didn't mention H Pylori on any blood or stool sample tests at all.

Owllady, I wish I could see a medic ans ask whether I could take any meds at this point and if so, what. But I think I'm not going to get another appointment for 2 more weeks - which will mean by then about 12 weeks of untreated, undiagnosed, illness and pain - drastically affecting my life and my DCs lives. I know people do wait a long time for diagnosis and treatment for all kinds of things - but as I'd happily pay anything to get this all diagnosed and treated, I'm really frustrated. I've never in my life had any illness lasting longer than 2 to 3 weeks and I've always got better from everything I've ever had.

Really don't know what to do about what to eat. It seems like any divergence in what I'm eating, decimates the digestive system again making life even harder to manage. But after 30+ yrs,up till getting ill - on a wholefood vegetarian diet, I'd love to be able to get back to eating at least vegetables again without this ending in severe gastric pain.

I am working today and just hoping I can ignore the pain and symptoms. Meanwhile, I've emailed the consultant's PA who works for him in the NHS and privately, just asking if she knows when I might get any biopsy results and be able to see him again. I'm sure she probably can't know but I feel like I need to keep pushing for some medical diagnosis. I think I'll phone the NHS GP later on too to ask if my CT scan results are there yet (I'm expecting those to be OK) and any biopsy results.

If someone had said to me, back in early March, that I was about to get ill for 3 months - and counting - and my entire life was about to change - I'd have laughed because I was so fit strong and happy back then. I'm still partly in denial, I think, that I can be so ill and have been ill for so long. I has a healthy, happy, busy life and a strong, healthy body and was feeling in control of everything, as much as you possibly can be. Now, I feel like I've no control, one moment to the next, of how I'll be, no control over pain (although I apply various techniques to relax and feel less pain), no control over the future and worst of all, no control over my DCs future happiness, if I can't get completely better soon.

I'm not sure if it would be a help, not read this book, but have just ordered it for my ex who has functional bowel disorders and all sorts of gut issues, looks really good

www.amazon.co.uk/Gut-Giulia-Enders/dp/1922247960/ref=sr_1_1?ie=UTF8&qid=1432628087&sr=8-1&keywords=giulia+enders

Did you tell the consultant about the first incidence of diarrhoea following the visit to the NT property? Have you had stool specimens examined, sorry I did read most of your posts but might have missed the odd one out. H Pylori test I thought was tested by drinking orange juice and then testing your breath after a certain amount of time. It doesn't sound as though you have had this.

I think if there was a viral or bacterial infection initially, It could recur as I have been experiencing a much milder version of your symptoms following norovirus 8 weeks ago. My guts and stomach are really still not right, I have started good probiotics again but really can't eat everything still. Plus I have had the odd day of indigestion, nausea and feeling unwell, really just mild versions of the original virus.

I think you should go back to your GP and go through the history again, pointing out the original episode of diarrhoea shortly following your visit to that cafe. Ask for more investigations for this, stool samples, H Plyori etc and ask about taking Gaviscon or something else. Keep pushing your GP and consultant, make a nuisance out of yourself.

In the meantime have loads of nourishing soup, rice, apple sauce, bananas, chicken, fish, carrots etc, plain yoghurts although I know you are doing this already. Try probiotics if you haven't done already.

I am taking this www.chucklinggoat.co.uk/product/raw-goats-milk-kefir/ at the moment, and I feel as though it is doing me good! It is better than over the counter probiotics, but OP I would call them before trying it as you might need to start with a smaller amount each day and then build it up, as your gut is very sensitive now. It can cause diarrhoea for a day or so, but then it all settles down and your gut is much happier. I crave sugar less when I'm drinking it regularly. I even like the taste of it now...

Oh boy! Have severe diarrhoea again today for the first time since all this started and I don't know why? I returned to eating bland foods and only had a tiny bit of cooked carrot yesterday - otherwise eating only the foods that bunged me up. Now I'm more or less incontinent, feel really really sick with a headache again and have 'tummy bug' cramps - but know this is just the same condition returning again.

I seems to have a life of its own, completely beyond my control.

Griselda, thanks, I've ordered that book. Sounds interesting.

Vvega, still unsure about trying any meds until I get the go ahead from the consultant but certainly wish I had some sense of light at the end of the tunnel. Not sure how to manage work and domestic necessities when I can't predict when I'm going to have to be in the loo or double up in pain. I really, really HAVE to get back to full working capacity soon but there's no sign of consistent recovery and today I'm worse again with the original symptoms that started this nearly 10 weeks ago.

Charlotte, the only times I've been to my GP, he's told me he doesn't know much about bowel disorders and just to ask the consultant. I hope the consultant remembers the original facts of my case and I'm still wondering if there's something that just hasn't been picked up - some more obscure protozoa or bacteria. I've had 2 lots of stool samples tested but for the usual stuff like Ecoli, salmonella, can't remember what else - but not for H Pylori.

SirVix, as I now have severe diarrhoea yet again, I daren't take anything that might provoke this even more but if only I could get a medic to suggest something that would work, I'd pay anything for this.

No word about another consultant appointment. I might call my GP surgery and see if any results have been sent there yet. Really in despair as even a v v bland diet isn't holding back the diarrhoea and it's crippling my ability to work.

I'm sure I've read before about constipation causing diarrhoea. It's not something I have any experience of, I just like reading medical stuff anyway, will see if I can find a link. It may not be what's going on here though.

It seems odd that a small amount of cooked carrot could cause this much trouble, so I wonder if it might be a coincidence that your symptoms have changed at the same time? Many conditions do involve swings from one extreme to the other.

Could you phone your consultant's secretary and see if they can fit you in sooner? Otherwise speak to the GP. You could try Immodium if you have some, might slow things down a little. Also Buscopan might help with the cramps. Apologies if you've already tried those.

Are you taking any probiotics? They might be worth a try. People underestimate the importance of guts in general, and of gut flora. Both are extremely important to health, and a bacteria imbalance can have all sorts of effects. I've only really read about people in my position, and I think the evidence is less clear-cut for people with colons, but I'm now on prescription probiotic sachets and they have made such a difference!

I've Googled and it's called bypass or overflow diarrhoea, and is linked to chronic constipation and faecal impaction. This link explains it and has a diagram. It is under Are there any complications of long-term (chronic) constipation?

If you're having continence problems too then this could be a possibility.

Spinstar, I was one of the people on the other thread you referred to. Sorry it is going on for such a long time for you.

I had diarrhoea after a mild bug and it isn't shifting at all, although I have just had a normal week after being very very careful with what I eat (so no milk and no spicy food).

What I have done - which can't hurt trying - is mainline probiotics like no one's business. I was recommended Biokult and am now on two a day + a glass of kefir. I'm also taking two tablets of digestive enzymes ever since and that helps with not getting a stomach ache after I eat too.

Spinstar, I've gone through your whole thread and really feel for you - it sounds awful.

I clicked on the thread because I've been having unexplained pelvic pain for the past 8 weeks, and since a pelvic scan last week revealed nothing (thus erasing my nightmares of ovarian cancer) I decided that it might be bowel-related. This linked up with a few symptoms I've had such as gut-churning pain in the morning and burping/farting in the afternoon, plus increased frequency of poos.

So I got some probiotic tablets from Boots and have been taking them twice a day, plus eating oatmeal every morning for the past 6 days (for the fibre). I know it's quick but I do honestly feel a lot better - no morning pain today and only a few twinges in my abdomen.

It sounds like your situation is probably more complex than mine but I'd recommend probiotic tablets and increased fibre at any rate - from what you've said above, it will probably help.

I hope that's useful!

I aksed my GP and the consultant at the start whether i should/could try probiotics and they said take nothing at all whatsoever until you've had the investigations and diagnosis. Almost 10 weeks later, I'm no further forward.

One of my questions for my consultant is can I and should I try probiotic powders (I've been having bioyoghurt all along anyway) - and if so, which sort - as I've read on the internet that it depends what gut issues you have which sort to take. Obviously I still need to get another consultant appointment.

I emailed his secretary yesterday and basically said when will I get results and when can I see him and I'm willing to pay privately again to speed things up. She said she'd pass on my message but no reply yet and my past experience is I'll just have to keep waiting.

Footle, I called the GP earlier to ask if they've got any of my results yet and they said there were about 40 letters waiting to be opened so my results might or might not be in one of those and to call back tomorrow.

Martha, thanks for the link. I wondered if it could indeed be diarrhoea due to previous constipation but it 'feels' more like the original condition, as - to give TMI - my poo is foul smelling like 'infection' type colour and consistency along with the original accompanying abdominal pain, soft tummy (so no feeling of constipation in there now), sore throat/headache/white thickly coated tongue, feeling of malaise again now too.

I really really need some medical advice at this point about diet and probiotics but I know my GP won't give an opinion or want to see me till the results of the investigations are out. It's 13 days since my CT scan and no results yet and it's 8 days since my gastroscopy and colonoscopy and maybe the biopsy results for this take longer.

It's a pity you can't have even a private medical system where you phone up and ask to see someone today and pay double even , just to get some advice and results but it doesn't seem to work like this at all.

I just feel as if I have an untreated condition that's flaring up yet again, despite careful diet and resting a lot more and that if it remains untreated, it'll only keep getting worse. I know other people wait much much longer but I still find it unbelieveable that after almost 10 weeks of a life changing illness that is adversely affecting my DCs, my business/income, my entire daily life, no one yet has diagnosed me or suggested a treatment and I'm still feeling so so ill.

Needless to say, DCs are very very down and upset again as I'm clearly not well at all today and can't do any of the things they'd wanted me to do after work today - and so yet again, I feel guilty and pretty desperate.

OK - so the consultant's PA has just emailed to say the biopsy results won't be back for ages yet but for better news, my CT scan was definitely all clear. I guess that rules out tumours, which is great - but not IBD etc and still gives me no idea of how to manage my condition.

Seriously, how can I keep on running my business and looking after the DCs and home, if I'm too ill more days than not - to do much at all? How do any others here manage a fluctuating illness, whilst being a sole parent and full-time self employed?

Spinster what a horrible time you've been having. I had a raft of similar (but not identical) symptoms for about 8 months before finally feeling better.

I had my gallbladder removed in apr 13 and was fine for pretty much a year, then I started with a range of bizarre symptoms such as wildly fast palpitations, constant nausea (like morning sickness), shakiness/ anxiety like symptoms, fuzzy head/dizziness, stumbling over words, loose bowels but not watery diarrhoea, stomach pains particularly central where my gallbladder pain was, fatigue.

Blood tests were mostly normal however b12 was low and i was anaemic. Had tablets for those but gastric symptoms didn't really improve. Endo was clear and stool sample was clear.

The hospital consultant signed me back over to the GP basically saying it was an unfortunate side effect of having my gallbladder removed as now bile drips continuously as opposed to collecting in my gallbladder and being released when needed. He recommended Omeprazole for the central gastric pain and tbh it's been a revelation. If I try to cut the dose or miss a few days of tablets my nausea is back with a vengeance, I get loose stools etc etc.

I would ask your GP to try a PPI medicine like Omeprazole/Lanzaprole and see how you get on with it. I started on 20mg, was reduced to 10mg but had to go back up to 20mg as symptoms were coming back. At first the GP advised to only take when needed but I find taking it regularly, either morning or night, is the only way to stop these horrid symptoms.

Good luck OP. When you google gastric symptoms it's astonishing the number of people who suffer and have no real diagnosis as all tests come back clear.

Sorry, wanted to add that there are still some foods that trigger an upset tummy so I avoid normal tea, chocolate and booze . I also can't eat and drink at the same time or I get very foul wind and cramps so I try to leave at least half an hour between eating and drinking. It's so bizarre.

Thanks Hey. I hope the docs can suggest something that helps but that may still be several weeks away. I'd never wanted to be on lifelong medicine for anything and have almost never taken anything in my life except occasional paracetomol and latterly, ibuprofen, which may have set this off in the first place.

The thought of being on anything on which i become reliant, is awful but probably better than daily unpredictable life-ruining symptoms. Don't think they'll start me on anything though until all results come through and I've seen the consultant.

It's nearly 10 weeks now since I drank anything other than water and I hadn't in any case had alcohol for the last 18 yrs, so I don't miss that - but I really miss sauces and flavourings, garlic, onions, tomatoes, mushrooms, cheese, peppers, olive oil, salad - things I used to eat daily and assumed were so healthy! I miss chocolate and crisps too but could live without those.

It's really the worry of not getting vitamins like Vitamin C and enough calcium that gets to me. I'm now on a much much less 'healthy' diet and if this is for life, then where am I going to get the healthy nutrients from? My GP told me that vitamin supplements aren't well absorbed and no point in taking any - but now I'm going to become prone to all kinds of other issues if I can't eat the foods in which good minerals and vitamins are found.

I'm now expecting to re-start the sudden waking with explosive diarrhoea every night now, as it seems I'm back in that cycle - which then doesn't help much in giving me time out from all of this in the night.

I am beyond despair.

H pylori may have been tested via biopsy during your gastroscopy, the results of this test would have been available the following day and your GP would have been informed if it was positive. This would have been done if you had signs of gastritis at the time of the procedure.
I still think you should try and bulk out your stools, maybe have porridge as oats are quite soothing for your digestive tract and having some substance will help your bowels to regulate themselves.

Thanks Snowfire. My consultant's PA said there were no biopsy results out yet so I don't know if there's been any report of testing for H Pylori. I hope this was done, as many of my symptoms are the same as you get with that condition.

I've thought of trying oats but I read somewhere on the internet that these are contraindicated for various bowel disorders. I keep reading contradictory stuff however and it's all v confusing, when one doctor on the web is saying eat no fibre and no fruit/veg and no gluten/lactose and another says - eat all these but in smaller portions.

I guess I could try oats and see what effect they had. At the moment, different symptoms seem to come and go irrespective of the fact I'm eating, almost without exception, a v v bland diet day after day. The recent addition on a couple of days of apple and carrots may or may not have made things worse but 2 days after stopping those was when the diarrhoea came back - so I'm still in the dark.

I know this is 'clutching at straws' but if there are any doctors on MN reading this, can you suggest any medical academic reading - books, articles, journals - I could do on the latest, cutting edge research into IBD/IBS and related disorders? I'd love to be able to have a higher level discussion with my consultant and find out where exactly research has got with the guts and digestive system.

My lay person internet reading so far and 2 discussions with my consultant have led me to believe that understanding if still in its infancy. Any newest research coming out of a small obscure lab anywhere that might look further into how to get the guts working properly again?...and why are so many consultants specialising in GI disorders white, middle aged men?

The problem with IBD, Spinstar is that everybody has different trigger foods, I have Crohn's disease, and the foods I can't eat will be different to the next person with Crohn's. I can eat mushrooms, but I know that some people can't. Also, what works for one person won't necessarily work for the next.

Hi spin, I've read the entire thread and hope you're feeling calmer now that the results of those scans have come back all clear.

I'd push for an ultrasound of your gallbladder. It's a non invasive scan and will tell you if you have gallstones.

Your symptoms sound exactly like mine, only I went down to 6 and a half stone before my diagnosis. Couldn't eat a thing without throwing up and having diarrhoea - survived in dry biscuits and sugary drinks at the end - felt excruciating colic if I moved or carried anything, or even wore a tight bra. Even breathing was difficult.

The pain in the upper and lower left side, reaching round to the back like someone stabbing me, the feeling of acid, the yellow stools all point to a gall stone being stuck in your bile duct.

I'd insist on having an ultrasound and taking it from there.

I understand you are the sole parent and that must be hard for you with your dcs especially when one has a disability, but I think you are making things a lot harder for yourself psychologically by turning this into a major catastrophe...... You absolutely must stay positive, and stop talking worst case scenarios with your dcs. Even with NT kids, it's TMI for them. Talk with a friend if you need to download your fears. There just fears, not the truth, and the kids don't need to know.

Sometimes we need to accecpt that we need help in our lives, and this may well be a wake up call to you to enlist some people to help you with your life and kids.
No man is an island, and my feeling is that you've done yourself no favours by "being strong" and not getting help before this and being "invincible, reliable" mummy who never goes to the GP.
You're human and your mortal, so get help and start to widen your circle! It will teach your dcs more than you can know to see you asking for help from those around you.

Please keep things in perspective, and get an ultrasound for gallstones. Remind your GP you are jaundiced, and insist on an ultrasound.

Please stop over sharing with your dcs and talk about your fears with another adult and with us.
I think it's important that you are very careful not to lay your fears on them, it's not fair, they can't do anything to allay your fears, and their stress levels must be sky high. If you have to tell them any medical details, please wait till you get an diagnosis.

Sorry to lecture, but I had a mother who was a hypochondriac and she used to wind us up to 90 when we were only kids, by telling us her FEARS about what was wrong with her, so perhaps I'm over sensitive to the catastrophic outlook..

You need to get support from people in real life.
You know, you may think it's good to be self reliant, (and it is to a certain extent) but I would argue that it's not a good role model for your kids to always "push through" on your own- you're not invincible, no one is, and you don't live in the great Wild West Wilderness, with no neighbours or people around you. Be gentle on yourself and get help. You need to develop trust I think that people will help you. They will you know, just look at this thread!

I do feel you may have gallstones and an ultrasound will diagnose that simply and quickly, with a simple laproscopic op to whip it out and put a stent in your bile duct.

I'm sorry if I come across as being a bit stern about the over sharing with your dcs.

Good luck with it all.
The very best of health to you, and happiness for your family.

Shadowfax, it's frustrating not to know what to eat as it seems I'll have to spend weeks and months trying to add one new thing and then see how it goes and then stop eating it, if it doesn't work and then recover from it before trying another.

Venus, thanks for your support and your thoughts. I'll ask my consultant about the gallstones thing - although I'm not likely to see him for another 2 weeks or so I think. Would my CT scan not have picked up anything like gall stones by the way? It was a full abdominal 'contrast' CT scan and I assumed it'd pick up anything and everything.

By the way, I don't at all off load onto the DCs and I act as normal and Ok as possible most of the time. They had no idea of my worst fears and they still have no idea that my condition may be lifelong. However, they've been making their own assumptions and witnessing changes in what I'm able to do day to day compared to before. This is then making them very stressed and worried and they can often 'see through me' if I'm putting on an act.

I say to them that they can see I have better days and then some worse days, so I'm sure 'it's not something bad' - whenever they're worrying. The only time I had to discuss what they needed to do in an emergency was when I was so ill for the first two weeks that I really thought at some points I'd need to go to A & E and then we did discuss things like who to phone if I couldn't get help for them and what they might need to do. That was v scary for all of us but then they saw me getting better than that awful 2 weeks, although obviously nothing like well.

Now their concerns are focused on how we're going to have our family holiday when I can't do much at all - rather than being concerned about how our entire future may change. Thankfully, they don't really see beyond a few weeks time, most of the time.

As far as getting more support for me, i totally agree. Ironically, this is probably the worst time in my entire life suddenly to acquire friends. I am barely able to go out except for essential reasons - food shop and school runs. I haven't seen school mum acquaintances for 4 months at all now as even the basic occasional meet-ups aren't possible for me now. Every social thing revolves at least around coffee/tea and often food and I'm on this ridiculously restricted diet of water and bland foods. I find it really really hard to talk for long as my stomach hurts and i feel sick and I've got a sore throat and I find not speaking and just resting quietly is what helps most - but that's useless for acquiring friends! The incontinence doesn't really help with socialising either!

There's no one I know well enough that I can just call up and 'chat' to and as I've said up thread, the house is the most messy and dirty it's ever been and it'd shame me to have anyone round. But in any case, I feel so so unwell most of the time, that I'm desperate just to 'stop' when I've done a minimum amount of work and domestic support. DC with SN wanted to spend about an hour talking to me yesterday evening and I did what i could to listen and respond but felt infinitely worse by the end, as I was trying to act as if i weren't feeling sick and in pain.

The thought of 'socialising' is really the very last thing I want to do right now. It would take a while to develop an acquaintance into a friendship and that's what I'd need to do to have anyone local who I could count as a support. I've not developed friendships over the last years as I've spent all my time working to earn a living for the DCs and as so many of their peers have SAHMS with plenty of money and time on their hands, our lives have just been incompatible.

Obviously now, when it's a bit late in the day, I can see how I should have done better at making time to invest in friendships and I am very much on my own now but not sure how to change this when I'm feeling so ill. I'm at 'survival level' right now with work and income and have no energy left over to start making friends as my top priority has to be managing to work enough to keep our lives going. The 'flaw' in the system (my self-sufficient life) has only been revealed when it's too late!