How to control chronic diarrhoea?

[ArnieandBob]

You would like to think that after suffering from IBS for over two decades I would know the answer to this but I don't and it drives me insane.

Despite avoiding my trigger foods (dairy, certain fruits and veg and artificial sweeteners) and following a very boring low fodmap diet I still have almost daily issues with my bowels. Fibre is my nemesis, just a tiny bit too much and it really upsets my digestive system, I tend to keep low on the fibre.

I go to the loo anything between 1-3 times a day. No two days are the same for me. I can have a day or two of passing 'normal' looking stool and then it will change to much looser (and sorry if tmi!) but sludgy/mud-like stool (often starts as normal and gets looser each time I go). I have lots of gut symptoms throughout the day including excessive gurgling, bloating, gas and gas like pain. I hardly ever have a calm gut and the mornings are awful. I also suffer from a lot of acid and nausea.

I have resorted to taking Imodium a few times a week to try to control the sludgy stool but tbh it doesn't do much, all it does is slow my gut down, the stool will stay the same. I have tried all the standard IBS meds such as Mebeverine but they have very little effect. I listen to gut directed hypnotherapy every day too but that has little effect either.

I have had colonoscopies, endoscopies, a bile acid malabsorption test and lots of scans and all ok and so they can offer no more help.

I am at such a loss though, I don't want to keep waking up every day, needing the loo as soon as I wake up and spending the rest of the day feeling dreadful within my digestive system. I can't function well for the first half of the day worrying I need the loo to clear it all and then spend the rest of the day frightened to eat in case I trigger it off again.

Surely there must be something that can help and give me back the normal functioning gut I had before all of this started?

Btw, I promise I am not a poo troll just a normal 51 year old menopausal woman trying to get through the day living in fear she may crap herself if she leaves the house 😩

Thanks for that, I'll read it later.

I have tried 3 different probiotics and took all for several months but they all made me worse. Maybe I just haven't found the right strain for me and I need to just persevere by trying a few more.

I don't eat bread or wheat based products only gf but not much as even that seems to upset me. I can't tolerate a y seeds or nuts which is such a shame as I love them.

Thanks, I'll look back more than a day and see what happens. I can only really tolerate turkey and fish but no fruit so will probably need to go kind of carnivore and work from there. Urgh! Needs must I suppose.

Maybe look into the AIP diet

No, I think my stress is a huge factor in it all. I do take a vitamin d daily but have read taking it with calcium can help so I may try that.

That's really interesting. I will have a read up, thanks.

I have just started following a woman on IG who is on this diet, she has endometriosis as do I and it's really helped her with the pain. I need to get to grips with the diet and see if it'll help me.

Daily Imodium and cutting out any kind of brown bread / whole meal pasta etc .i can only tolerate crap white bread.

You could try low dose amitriptyline. It helped me, but I have been diagnosed with bile acid malabsorption now so on questran.

I have the same problem as you at a similar age. I'm not sure of the stress link myself. I went through a stressful period and my tummy was fine. Once it ended it got really bad again! Maybe it was a delayed reaction. But I have never been less stressed than I am now, yet my IBS has never been worse.

Menopause has definitely made it worse for me though. Also lack of sleep is a huge trigger so I try and get as much sleep as possible. But then my sleep is terrible due to the menopause so that could be the link.

I don't have any good suggestions. Just sympathy! As I know how awful it is. But am also reading all the other posts for suggestions.

Have you tried Enterosgel? It is expensive but would be worth trying to see if it helps. It works miracles on my bile acid malabsorption and if it's a "bad" bacteria left from food or a virus, it will help that too. Probiotics really help me (good ones from a health food shop, not just yogurts/drinks) and it might be worth trying different brands. Sorry if you've already tried these things. If your doctor has done tests which were negative, my doc has always said that (obvs used carefully) it's fine to manage it with loperamide. Could also be worth trying something like Colsevelam from doctor if they'd let you try it. I used to use slippery elm tablets from health food shop many years ago and that helped a lot too. Hope you can find a solution, I know only too well how hugely stressful it is.

Op, very sorry to hear this. Almost identical problem with the loo and with nausea the worst symptom for me. I was prescribed a 'paediatric' daily dose 0.5-1mg of Loperamide (imodium) which in the words of the gastric dr was to help the gut/brain relationship. It has helped. I also take daily peppermint capsules for nausea which works well.

Mebeverine, Buscopan...rubbish. You mention your trigger foods but not things like spicy food/onions/garlic/pulses/alcohol/caffeine etc, but you probably do all that.

I did take it for 6 months or so but it made me so dizzy that I was advised by my gp to stop as I have to drive for work.

Thank you for the advice. I did try Enterosgel, I did the full month as recommended but sadly it did nothing for me other than burn a hole in my pocket lol, wish it was cheaper as I would give it another go but it was costing me around £15 per week.
I will look into slippery elm, my nan used to swear by it but I've never tried it myself.

Do you have endometriosis on your bowel and is that what’s irritating it?

Immodium, probiotics, buscopan, and being honest, just not eating if I'm in a flare.

Sorry to hear you struggle too, the nausea is a horrible thing to deal with isn't it? I resort to wearing travel wrist bands and stick an aromatherapy nasal ring on the try and quell it.
I used to take the liquid version of imodium and that worked better for me as I could take smaller doses, it was prescribed by my gastro but my gp says she can't prescribe it to me so I will need to go back to the gastro to see if she can re-prescribe.
I totally avoid onions, garlic, spicy and rich food etc. I haven't touched alcohol for about 15 years and only drink water. It's a boring life living with IBS!

I often find that I am fine if I don't eat, it's eating which often sets me off. Sometimes I just wish there was a tablet I could take which would give me all the nutrients that I need then I could just get on with my life without any issues.

I couldn't get a bile malabsorption test, because of long wait (or pay £££ myself,) but the Doctor agreed to prescribe it anyway to see if it made a difference and it has.

Op, is a BAM test for bile malabsorption? I ask because 12 years ago I had bowel cancer and I had a third of my bowel removed. Ever since I had unpredictable and uncontrollable bouts of diarrhoea which made life extremely stressful especially when travelling .
I was told I would just have to learn to live with it and I was prescribed high doses of codeine but the only thing that actually worked was codeine linctus which is illegal in some of the countries in the Far East that we visit.
Anyway, long story short I begged the doctor to see if there was a possible cure, and I had a (private) scan and it turned out my bile absorption was virtually nil. I was prescribed Cholestagel and this has completely solved the problem. The gastroenterologist said it should have been picked up years ago, but none of the doctors, the GPs, the surgeon who removed my bowel and the oncologists ever mentioned it as a possibility.

Oh god same.
I Iove food, but if I'm out and about I sometimes just can't risk it, that tiny twinge in my stomach can turn into, "I need the loo immediately", within 5 minutes.
I've sweated my way through a few toilet queues, or had to speed walk so many times.
It's miserable.

Ha, typo! Stress and anxiety levels, that should have read. Posted whilst waiting for something to load on my laptop. 😂

@38thparallel is Cholestagel the tablet form of Colestyramine/Questran?
I don't mind the powder version, but a tablet would be even better. However I am not going to rock the boat with my Doctor regarding my current Questran prescription because I believe that it's the cheaper option and tbh I am just ruddy grateful that I am getting it. ( And a bit scared that they may decide to stop prescribing it )

@Laska2Meryls I'm not sure to be honest. I tried googling it but it was all technical pharmacy terms.

And a bit scared that they may decide to stop prescribing it.
That would be awful if that happened. Sudden attacks of diarrhoea are the worst and the possibility means one can never really relax when out and about, or travelling or sightseeing.
I can’t understand how a doctor could allow that to happen when there is treatment available. The gastroenterologist told my GP practice that I was to be prescribed cholestagel so I’ve had it ever since.

You sound like me. Probiotics make my stomach much worse. The only thing that has helped my IBS diarrhea is taking calcium supplements. I used to buy expensive ones but I found out that TUMS works just as well.

I take about 3 chewable tablets if I have to work from the office.
good luck!

That is exactly my experience. Not much fun, is it?