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Repeated Bowel Movements/Fecal Urgency
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Repeated Bowel Movements/Fecal Urgency

Hello,

I am a 24 yo male, and have been "diagnosed" with IBS. I take 2 mg loperamide (immodium) twice daily and colestipol 2 grams at bedtime. These meds have controlled my symptoms to a point.

I must admit that I have become more and more worried about engaging in social activities as of late (especially in the morning and far from a bathroom) due to a problem that I can't seem to solve - fecal urgency/repeated stools. Pretty much every day for the last year I have awakened to the need to defecate pretty much immediately. The stool's "leading edge" is on the hard side, but it finishes soft. Typically, about 1-1.5 hours later, I have to go again. After this second BM, (which is usually soft pieces), I tend to have the "feeling" that I have to go until about lunch time. Then I am good for the rest of the day. This ultimately means that I have to wake up about 1.5 hours in advance of any committment (job, school, etc). I have told my doctor of this, and it doesn't elicit any response from him.

Now, I can handle having to go to the bathroom multiple times per day. However, what I cannot deal with is the URGENCY that accompanies the BM's. From the time that I feel I have to go to the time that it is IMMINENT spans about 5 minutes. I feel as if I cannot hold my stool if I have to go. I can't even imagine taking long car trips, for fear that even the distance between rest stops - if any - is too long. I mean, who can't hold stool? I know of diseases with fecal incontinence and fecal urgency, but isn't it a physiological ability that someone my age has?

I still have too many questions that I can't think of right now. Any comments?
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Avatar_f_tn
I would try adding more fiber to your diet to see if that helps.  Did you undergo any testing before you were diagnosed with IBS?
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The doc should have done a stool sample to see if you have a bacterial infection going on in your intestines.  Also, your doc should have drawn blood to check for things like heptatis, liver problems, viruses.  If he did a stool sample and bloodwork and it all came up clear, then if you are taking ANY medications, other than the two anti-diarrhea meds you're on now, review the side effects of any other drugs and if "dry mouth" or gastro problems is listed, the prescribing doc should switch you to another kind of drug.  

If you're not taking any other medicines at all, then when they say you have "IBS," well, you can have two kinds:  with diarrhea or with constipation.  It sounds to me like you've got it with diarrhea.  SOMEthing is causing your diarrhea.  If you can remember when all this started, like if it was fall of last year, then consider what all you were eating at the time, that is, if you changed your eating/drinking habits somehow, it could be you have an allergy to that food or drink...you could even visit an allergist and they can do tests to find out if there's any food you're allergic to.

Sometimes stress can cause this, so consider if you're under some sort of constant stress over whatever, and try to change it somehow, practice deep breathing, do some long relaxing walks through your neighborhood.  Also, sometimes if let's say you tore up your lower back somehow, well, spinal problems can cause nerves that control digestion to go haywire, but that's just if you have low back problems.  As to more specific "fecal incontinance" issues, a gastroenterologist is the specialist you should see to investigate various disorders that can cause that.  I don't know if the doc you refer to is a gastro man, but if not, you need to be referred to one.  That's pretty much everything I can think of.
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Avatar_n_tn
Ok, I have undergone many tests, including colonoscopy, fecal cultures....pretty much everything under the sun. I know everything came back negative. I had been seeing a GP and a gastroenterologist. Both came to about the same conclusion: IBS. It was much worse, diarrhea predominant, and I was stooling much, much more. I don't take any other medications besides the loperamide and colestipol.
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Avatar_f_tn
Well, then, your gastro doc needs to investigate what disease process may be causing this, which can include diabetes (ask you doc to check your sugars), an endocrine problem like Addison's, malabsorption like Celiac's disease.  And as I said before, might be a food allergy, usually milk or gluten is the culprit.  

Also if your diet doesn't have enough fiber foods like salads, whole wheat bread, or oat cereal, you'll have diarrhea.  If it's a muscular thing, which there is a way to measure that, something like a manometry test, then the solution aside from surgery is to practice tightening those muscles by squeezing in your rear tight a bunch of times, several times a day.  Exercising regular, relaxing, and drinking plenty of water every day may help.  

But I do think your gastro doc needs to not only look for the causes I mentioned in the first paragraph in this post (causes of diarrhea like diabetes, malabsorption, endocrine), but also do a REPEAT stool sample, urine sample, and blood sample, to again look for infectious stuff hanging out in your digestive tract...one time I had an older dog who just could not get rid of his worms, and one day the vet said his sample came out okay, and within an hour of that visit, I watched him go and in his waste I saw a living worm, it was creepy, so that's why I say the doc needs to run another round of tests.  

I also think the medicines you're taking are not enough.  I was given Hyoscyamine pills that dissolved under my tongue, gosh that helped SO much, and I also did the probiotic thing with Acidophilus milk and Activia yogurt from the groery store, also helped.  But for me, it was the cause, which was a medicine I was on, once it was taken away, the half-dozen daily for six-months diarrhea went away, altho I still have lots of problems from how the acid of the drugs ate up my digestive tract.  

You can't go on like this, it really is diarrhea, which can be defined by some solid waste followed by less-formed and watery waste, the way you described (altho there is explosive and all-watery diarrhea), and there's always a cause for it, and your doc should not let you just live like this.  Keep the questions and info coming to us, keep us posted.  Somebody else might chime in.
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Avatar_f_tn
Have you learned anything new on this topic? I'm having similar problems also with no conclusion from the doctors.
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Could be pelvic floor dysfunction too.  Just to throw out a thought. Can you ask your GI about anal manometry test? If pelvic floor dysfunction is confirmed, Mayo has an intensive 2-week biofeedback treatment program that seems to be pretty effective.
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Avatar_m_tn
I have the same problem as the poster and have had it for 25 years it had just got worse and worse I use Imodium (immodium) for occasions when I felt there was no choice but am afraid to use it much in case it stops working.
  For the last few weeks I have decided that as this was spoiling my life anyway I would try and use will power and just not go and accept any accident's as living in fear of them was not helping.
  I have felt uncomfortable nearly all the time and have had one accident but think that there is an improvement it's really hard but it was before when I planned everything around toilets and still needed one a couple of hours later    
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Avatar_m_tn
I have the same issue. It seems to have started as I aged, somewhere around my fifties.  It's an affliction that my mother and sister share as well. I don't like to do things in the morning, because I know that I need to give my bowels time to settle down.  Later in the day, especially after lunch I am on high alert for a possible 'get to a bathroom now impulse' which may or may not occur.  In the evening after dinner, I rarely have this issue.  So as the day goes on the problem diminishes.  But, as you know the morning is a gotta go now experience.  
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Avatar_m_tn
I have the same issue. It seems to have started as I aged, somewhere around my fifties.  It's an affliction that my mother and sister share as well. I don't like to do things in the morning, because I know that I need to give my bowels time to settle down.  Later in the day, especially after lunch I am on high alert for a possible 'get to a bathroom now impulse' which may or may not occur.  In the evening after dinner, I rarely have this issue.  So as the day goes on the problem diminishes.  But, as you know the morning is a gotta go now experience.  
George
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