Could this be IBS?

[Pushkinia]

Sorry if this is TMI. I have always had regular bowel habits but just before Easter I started having bouts of diarrhoea. Over the Easter weekend I had quite bad diarrhoea and developed external piles, which became thrombosed and very inflamed. I managed to get a F2F GP appointment (after some e-consults) and was sent to hospital, as the GP felt it was too severe for primary care. Hospital didn't agree so I was sent home and told to use ice packs.

Since then my bowel movements have been alternating between normal, soft and sticky and diarrhoea, anywhere from 3 - 6 times a day. I've had some bleeding on bowel movments as well, although the suppositories seem to have stopped that now. After every movmenet I get a dull ache in my anus/rectum that lasts up to an hour.

I haven't changed my diet and my diet is rich in wholegrains, salad, vegetables and pulses. I've increased the amount of water I drink. I haven't been constipated, although that's the only thing the GP thinks about when piles are mentioned! Can piles result from diarrhoea?

It could be IBS or an inflammatory condition like crohns or colitis. A whole grain and veggie diet can be hard to tolerate when inflammation/irritation is up. So, go back to your GP and make an epic fuss - exaggerate and tell them you are struggling to control bowls/lots of pain/whatever. They need to do a blood test for inflammation, and then you need to be referred either to gastro or a dietician, or both. You may need a colonoscopy to see what’s up. It’s really important to get this properly looked at as inflammatory conditions do get worse if not treated.

... yes piles can result from diarrhoea

@partyatthepalace
Thank you for all the information. I have a F2F GP appointment on Wednesday morning. I’m really not happy with the sudden change in bowel habits or the pain and, whilst the external piles have shrunk, leaving what I think are 3 large skin tags, the discomfort on sitting is still there. I’ll mention blood tests if she doesn’t suggest it herself. The hospital suggested referral if things didn’t improve, so I’ll ask for that as well.

Definitely go back to your GP. I had one bout of blood and diarrhoea and my GP organised blood tests within the week and then a referral to the gastrointestinal unit at the hospital.
All was ok, but the GP said that any further episodes and I should go back.

Change in Bowles habit should be investigated. I would push to get samples tested first (they can test for blood and inflammation). Really you need a colonoscopy. A variety of things can cause change in bowel habit but IBS should be an exclusion diagnosis, only given once other things like IBD and Polyps are ruled out. How old are you OP?

@ThePontiacBandit
I’m 54 on Wednesday. I had one bad case of external thrombosed piles in my twenties, which was down to diet, so I improved that and have had very few problems since. The bowel changes are really not like me. I put it down to work stress, which is why I was thinking IBS but I would prefer to get it checked out properly.

One of the (less worrying) things it could be down to is diverticular disease. That can come on quite suddenly. Definitely wants investigating. I’d be pitching up to the GP with local guidelines if I were you! Don’t be fobbed off.

OP this could have been written by me, exactly the same thing after Xmas and the 'sudden change' has only just started to subside, including the ongoing was thrombosed but now happily sitting there piles. I have absolutely no idea where the change in habits came from, I can only think too much rich food around Xmas. However five months on and I too have been googling IBS. I just can't see what's changed to result in the recent 'calmness'. As a previous pp mentioned, inflammation would also make sense. I wish you some calmness in the upcoming weeks

You really need to get properly checked for anything bowel related. Everything more serious needs to be ruled out before you get IBS diagnosis

Thanks everyone. My communications with the GP have been frustrating because it’s mostly been e-consult with a text message response and, no matter how carefully I write “I am not constipated”, they see piles in the consult and keep prescribing laxatives! There’s one good GP, the one who referred me to hospital after giving me a F2F appointment and she’s the one I’m seeing on Wednesday. Thanks to all of your responses, at least I’m armed with information. I will ask that this is all properly checked out.

Whilst you are awaiting for your appointments I would recommend trying the the Low Fodmap Diet. I have had gut issues for over 20 years and that low fodmap alomg with giving up diary was the one thing which eased the diarrhoea.
Also don’t give up gluten incase they want to check for coeliac disease, you need to have gluten in your diet for it to show up.

@Isitbedtimeyet10
I’m sorry to hear you’re going through something similar. 5 months is a long time! I hope it eases for you soon.

I had a very similar thing 2 years ago; sudden chronic diarrhoea, often feeling the urge to poo, aching bottom after, feeling like my bowels, weren't emptying etc etc. In the end I got thrombosed piles and a fissure which made me go to docs.
My gp, sensibly, took it seriously and a colonoscopy ruled out anything sinister. Eventually I was diagnosed with ibs which I still find hard to get my head around but there isn't any other explanation! I still have diarrhoea often and try to find ways to destress to offset the symptoms. The fissure had to be operated on sadly and I use moist loo roll all the time now!
Push for the colonoscopy to rule out anything dodgy and go from there.

I’m updating for everyone who gave me such good advice.

I saw the GP today and I have to do poo tests for infection, inflammation and cancer, blood tests and see another GP in 2 weeks who’s more of a specialist in this area. I still have a huge pile (it’s not a skin tag, as I thought) and that will probably need referral but won’t happen until after all the tests are done and they’ve worked out what the bowel problem is.

I’m feeling better knowing it’s being looked into.

Oh OP, thanks for the update! Well done for pushing to get this investigated. These are the investigations they should be doing! Sometimes they can band piles (they put a tight band on to cut off circulation to them and they drop off) in outpatient clinics and some doctors will do them in Endoscopy so that should be easy enough to sort.

@ThePontiacBandit
I didn’t actually need to push for the tests. This GP listened, apologised for me not being listened to before (which was other GPs not reading the e-consults properly) and told me the plan, which was to investigate for everything, including cancer. She wants the tests completed next week but she’s off for two weeks, which is why she’s arranged for me to see another GP rather than wait. I think she’s taking it seriously and I’m so glad my surgery are now allowing people to book face to face appointments. This has already gone on too long.

Thanks for the info on banding. That doesn’t sound too invasive so I might cope with that!

Did you get to the bottom of this ?

Hello @Palpal12, it’s been diagnosed as IBS. Tests for cancer and IBD were negative, so the GP is assuming it’s stress induced IBS. I was offered codeine or Imodium, but I didn’t really want either, so I’m trying to control the symptoms with diet. I’ve cut out bran cereals and pulses, cut down on wholegrains and fruit, increased vegetable consumption. So far, it seems to be helping. I now only have 3 trips to the toilet a day (on average) and relatively few days have diarrhoea.