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Severe cramping IBS?
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Severe cramping IBS?

My daughter has been experiencing occasional intense and severe cramping - similar to IBS symptoms.  She will feel cramping/gurggling in her gut for an hour prior to episodes of diarreah (diarrhea), which lasts 3-4 hours.  These episodes are not everyday or regular.  She will sometimes have episodes once a month, or sometimes once a week.  Recently, the episodes are closer together.  Note that recently, she has had some stress to deal with, too.

She is 20 years old, and has episodes of severe cramping with diarreah (diarrhea) since she was 16.  The episodes are increasing in severity and duration as she gets older.

The cramping is such that it leaves her shaking, dizzy and exhausted.  Typical diarreah (diarrhea) OTC meds don't help much.  She has also tried peppermint tea - but is not convinced that it helps.  We cannot seem to narrow a food trigger.  She exercises regularly, and eats a fairly well balanced diet.  Constipation is not a problem for her.

Is occasional bouts of diarreah (diarrhea)/cramping typical of IBS?  
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IBS can certainly be considered.  However, I would also consider other GI diseases as well.

If the symptoms are chronic, a colonoscopy should be considered.  Diseases like a mass, inflammatory bowel disease or colitis can be excluded with this.  Stool tests can be sent for culture and analysis for malabsorption.  I would also consider a blood test to look for celiac disease.

If the tests continue to be negative, optimizing treatment can considered.  Increasing the amount of fiber, tricyclic antidepressants or Rifaximin can be all discussed with her personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com
8 Comments
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Avatar_n_tn
I have suffered with IBS since I was ten years old. I am now 56 and I can tell you that yes, diarreah (diarrhea)/cramping is typical for some sufferers.  When I'd finish with one of those bouts, I'd be covered with sweat and so exhausted, I felt like I'd just given birth.

I have more constipation thanddiarreah, but I have had the bouts with diarreah (diarrhea)/cramping although I haven't had but two or three of those bouts for over a year now and they weren't nearly as bad as they used to be. The constipation is much better as well.

I discovered a diet that did wonders. It's extrememly restrictive, but I found I could slowly add some foods back into my diet until I discovered my triggers. Have your daughter try cutting out most fats, and all animal fats, dairy, gum, carbonated drinks, caffeine, artificial sweeteners, as well as processed sugars and high fiber foods. She should stay off of all of this for at least two weeks, but ideally for a month. Then she can start adding in one or two items a week - from the same group - to identify her triggers.

I discovered my triggers are: animal fats (I can tolerate small amounts two or three times a week - egg yolks don't seem to bother me at all), milk (but not cheese, yogurt or butter), carbonated drinks and caffeine (strong trigger - especailly when mixed with the carbonation). I also generally try to stay with natural foods: butter instead of margarine; sea salt instead of processed, iodized salt; pure peanut butter without anything added. etc. I don't have too many problems with high fiber foods, but I'm more of a constipated type so she may have problems there.

I hope this helps. Believe me, even though it was so resicted, it was easy to be on that diet at the beginning because I felt so much better! And now I know what to avoid or limit to keep feeling better.

Selah1292
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Avatar_n_tn
One more thing, in rereading your post, it looks like your daughter hasn't yet been diagnosed with IBS. I strongly suggest she be evaluated by her physician to be sure that's her problem. These symptoms can be from so many different things. She can probably still do the diet - but make sure there's nothing more serious wrong with her.

Selah1292
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Avatar_n_tn
I have had IBS attacks, just as you are describing, since 1996.  In 1999, I had all the necessary tests to rule out other diseases and IBS was the conclusion.  I get severe spasms (I always called them contractions, as compared to giving birth), gurgling and actually can feel everything moving downward.  This can last on average of 6 hours but has listed up to 9 hours. Once it even continued for 23 hours.  Once the "movement" reaches the bottom of my colon, I have explosive diarreah (diarrhea) for the last few hours of the attack.  
Recently, I've tried a  few things to help these attacks end sooner:

1. During the attack, I drink massive amounts of water.  This seems to shorten these attacks to about 3-4 hours. It helps everything move quickly down and definitely helps in the dehydration factor in all of this.

2. I started a regimen of the new Digestive Health Yogurts.  One a day for the last few months.  This also has made a difference. I get them at the grocery store and now it seems all the major brands have some sort of digestive health yogurt.

3. I've also been able to identify some of the triggers and for example, oil mixed with anything fried is surely a trigger.  So is cream cheese and butter.


4. I still have attacks but now they are very far apart.  Also when I start having that pain on my left side, either under the breastbone or further down, I up my water intake by 100 % and that's saying alot because I generally drink 10 full glasses everyday.


Hope this helps.
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Avatar_n_tn
Thanks so much for your comment.  

Your symptoms sound very much like my daughter's.  It has been most confusing, since most of what we read about IBS includes 'everyday' symptoms.  She does not have pain/cramping every day, and feels fine most of the time.

The diarreah (diarrhea) is not particularly the problem - not to say it's not.  It's the painful cramping that stops her in her tracks.  Calling them spasms sounds more correct.

We thought about the Digestive Health Yogurts... thanks for mentioning that.   We are definitely looking for a way to prevent the episodes -instead of treating the aftermath.

Like you, she thinks oil may be a problem.  But not by it's self.  And not all the time.

I will suggest that she pays close attention to the gurggling, and drink plenty of water when it starts.  We certainly had not thought of that.  

Do you take an antidiarrheal at the onset of the episodes?
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Avatar_n_tn
Hi jewels,

1. No, I do not take the anti diarrheal at the onset.  Reason:  Everything MUST come out to stop the spasms and I want it all to come out as quickly as possible.  Years ago, I tried the anti diarrheal and it really didn't help.  It actually prolonged the spasms.  That was not good at all!
The Dr. had given me a script for Nulev (generic: Hyoscyamine) 0.125 MG Tab's to stop the spasms while in the middle of an attack but it didn't help at all and again, just as with the anti diarrheal, I wanted to make sure that nothing interfered with everything leaving my system.  That being said, I do take the Nulev before eating a meal that I think might trigger an attack (ie going to a new restaurant, eating something spicy or fat-laden, etc.).  That seems to help prevent an attack, SOME of the time.  I take 2 pills 1 hour before such a meal.

2. I agree, the diarrhea's is really not my biggest problem either, it's those horrible spasms.    I don't get the diarrhea until the spasms are in full force and have continued for several hours.  Actually, when the diarrhea happens, I know I'm finally getting near the end of the "attack"

3. I do not have cramping everyday either.  When I first started having these attacks, I had them twice a year, then every few months and recently, before I went on the yogurt/water regiment, it was every week to two weeks.   The water has been a godsend.  To get these attacks down to 3-4 hours, it's almost like a miracle.  Typically they were 6-9 hours (or more) since 1999.

4. Another important thing that I do:  Each time I have an attack, I write it in my date timer.  I write the severity of the attack, the length of the attack and what I had before the attack.  I note if there was any blood in the stool (most often there isn't).  This is how I was able to find some of my trigger foods.  This was also a good record for the Dr. to review.

5. The day after an attack, I am very weak.  I make sure that I drink lots of fluids and eat things that are not heavy.   The most dense thing that I consume the day after is toast and sometimes not even that.  Jello, juice, etc. until that sore stomach feeling is gone.

I hope all this info helps and that your daughter sees some improvement.  I think the writing will help identify what works and what doesn't and what triggers she might have.

Let me know how she's doing.
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Avatar_n_tn
I have had IBS since I can remember (I'm 27 now and can't ever remember NOT having it, although I wasn't actually diagnosed until I was in college!)...I never really had a problem with the constipation...mine is definitely on the other end of the spectrum!  And just like what BP309 posted, I don't feel better until EVERYTHING has left my system!!  So I don't dare take anything to stop the diarrhea...like someone else above mentioned, it seriously IS like giving birth - it comes in "contractions" building from an all-over pain in my lower abdomen to a sharp piercing pain in my left side and I can feel everything in there gurgling...it's awful!  The pain gets so intense during an attack that it literally takes my breath away!

What I've found that really helps is reading while it's going on...it takes some of my focus off the pain if I do that and makes the episode shorter...when I was younger and didn't know what I had or how to deal with it, the attack could last upwards of 4 hours, but now they normally only last 30 minutes-1 hour...but after it's over, it does leave me all tired, weak and shaky and my stomach feels on edge the entire rest of the day!  Another GREAT thing that my doctor recommended this past year that has really helped lesson the frequency of the attacks is taking Citrocel...it's just a fiber supplement (but it has to be that brand...it's a very specific kind of fiber I guess!), and it helps regulate the system (even if you're like me and constipation is NOT a problem)...my attacks are far less frequent now than they were!  And even if it doesn't work, you have nothing to lose, b/c Citrocel has been linked to lowering your chances of colon cancer...so even if it doesn't help your IBS it may still be saving you from that!  

Anyway good look to everyone in this forum...I feel your pain and hope everyone here can gain something that helps them cope with this painful condition!
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Avatar_f_tn
I have had IBS ever since I was little. Now I am 35 years old. IBS to me the spams feel like labor contractions. When I have an attack I go through the constipation stage until my bowel is emptied. I have an attack everytime my bowel has to empty. I am just new on here, so I am not sure what to do, so I thought I would post my information that I have on IBS. Right now the doctor prescribed me Librax(Apo-Chlorax) I only take it for the spasm if I need it, sometimes I just suffer it out, because I know once my bowel is emptied, I would feel much better. I also get the spasms up my rectum, and my doctor prescribed me Protofoam, and that works miracles when I have the pain up my rectum. I pretty well have to stay away from fibre, because it makes my IBS worse. Doctors say to take lots of fibre, but in my case I can't. I also watch what I eat, popcorn, corn  a big no no. I drink only water, pop I feel it's not good for the bowel, it will cause gas, and make your bowel go into a spasm, Milk makes my bowel worse, what I drink on my cereal is lacteeze milk, and I find that doesn't bother me as much. I can eat yogurt, small portions of cheese. I don't eat alot of greasy foods. I can't eat salads, green salads, almost kills me with pain. I can eat macaroni salad, potato salad. Stress from my past marriage of abuse caused my IBS to be chronic. I am also dealing with alot of other health problems. I have GERD, Bile reflux, I didn't get the bile reflux until I had my gallbladder out in 1995. I feel IBS/GERD goes together. I also feel once you have IBS your whole digestive system is messed up. I hope I was a help to others, I feel for anyone that has this problem. Anyways good luck to everyone who has to deal with this health problem. IBS has caused me not to be able to work. I feel bad about that because then you financial problems. I have also been told by doctors that I am going to try to explain myself, and that is, in a normal bowel, you have to go to the bathroom, and your muscles will push the bowel movement down without pain, but with IBS the muscles that are pushing the bowel movement down go into spasms, and that's where the bad pain is. I was also told by doctors that IBS doesn't cause cancer of the bowel. I was so pleased to hear that.
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