What is the diference between IBS and neurogenic bowel?

[Corriel]

Hi all, I apologize in advance for TMI but I recently discovered that MS folks can have neurogenic bowel and it makes me wonder if my IBS is in fact neurogenic bowel.

About five years ago (before my MS dx) I had problems with my gall bladder but most of my apin was on the opposite side and relieved by vomiting or a bowel movement. My surgeon said that it was IBS and that post gallbladder removal it would likely get worse.

She was right but it seemed short lived so I kind of forgot about it. Fast forward a couple of years and I still have a lot of diarrhea and several times in the last year I have had episodes of fecal incontinence followed by minor constipation. There has been none of the pain or nausea that I had years ago and I thought at first it was tied to food sensitivities but the foods I identified (mainly dairy) do not always seem to be the trigger.

My neuro does not seem concerned so I am planning to make an appointment with my GP to see about meds or testing but in the meantime I cannot seem to find any info that differientiates IBS from neurogenic bowel and have no idea if treatment varies depending on the cause of my issues.

Any info you can provide is greatly appreciated,

Corrie

[Sailorsong]

Please let me know how things turn out. I would be interested in finding out if your result turn out the same as mine.

Dennis

[Corriel]

Thank you so much for the info on the med! I think I need to give the bottled water a try too because my last "event" felt like it was started within a couple of bites of food.

At the time I thought maybe the ice water I drank prior to the food being served was giving me indigestion because I gulped half the glass and found it very cold.

Off to do a bit of research. :-)

C.

[Sailorsong]

Here is some infromation about Dicyclomine.

Dicyclomine is used to treat the symptoms of irritable bowel syndrome. Dicyclomine is in a class of medications called anticholinergics. It relieves muscle spasms in the gastrointestinal tract by blocking the activity of a certain natural substance in the body.

As you can see it isn't a binding agent like Questran, but blocks muscle spasms. IE Neurogenic bowel. Maybe your GP would be willing to let you try that one? Like I said I don't get constipated ever and have been on this medication for years (3-4).

One other think I might suggest is the next time you make homemade vegetable soup try using bottled water. My thinking on this is that maybe during the cooking the vegetables are absorbing the chlorine from the water making it more concentrated.

  I think the same thing hold true for ice cubes. I have been going to Pizza Hut for years and always order the same thing. I narrowed down to the ice cubes because some times before I even got my pizza I would have to run to the rest room before the pizza even arrived. So it was just having my Pepsi that would trigger the IBS. I think with ice cubes the freezing process concentrates the chlorine as more than just in normal water.

Dennis

[Corriel]

Thanks Dennis! I saw my GP a few days ago and the onky med he was willing to try was Questran. Since its primary function is a binding agent he was concerned it would mess up my meds so he won't prescribe it.

His onlysuggestiin was to tell me to avoid fatty foods. When I told him homemade vegetable soup even gave me issues he just shrugged so it looks like I have to figure this out myself.

Like you, I have about a 15 minute window. My fave place to have lunch with former colleagues is a Greek restaurant where I have ordered the same thing for over 10 years. 90% of the time I have no issues but the rest of the time is a different story. Needless to say I don't do those lunches that I used to. :-)

I usually just get water to drink there too and its the same as I drink at work and home so I circle back to the food but none of what I order has been identified as a sensitivty so I am officially stumped.

My next move is to play with fiber supplements that are IBS friendly and see how that works.

Corrie

[Sailorsong]

I have the same problems - except the constipation. Sometimes I even wish that I would get constipated. I went through lots of diet restrictions and could never quite figure out what would be a trigger or not. My official DX is IBS.

Several years ago I was put on Dicyclomine 20MG 3 x  a day. And it help some, but I found that if I took it 20-30 minutes before I ate instead of just 3 times a day it worked a lot better.  

But I was still having problems until I discovered that it I was having problems mainly when I went out to eat. I could actually order the same thing as take out or eat there. I would have no problem if I did the take out, but if I ate at the restaurant I would barely make it home (15 minutes) before an accident happened. The only difference was what I had to drink. At home I was on well water, but at a restaurant it was city water. It was the chlorine in the water/ice cubes that was triggering things when I went out. So now when I go out I order drinks (sodas) without ice cubes (at least when I remember to do that) and can make it home without any sudden urges.

Dennis

[Corriel]

I have wondered too how effective Immodium is prior to eating but wanted to do what I could to reduce any potential incidents.

I spent six months last year determining and treating food sensitivities with acupuncture (a controversial therapy called NAET).

I have eliminated all of the foods for 90% of the time that were identified and was advised that I could have them in small amounts occasionally. Sometimes these foods affect me and sometimes they don't so I'm not sure just what is going on.

A naturopath recommended removing all foods that are inflammatory but it is essentially the elimination diet for determining food allergies for life and I just couldn't restrict myself that much. Interestingly enough some but not all of the foods that they wanted me to eliminate turned up as sensitivities for NAET.

You make a good point about nutrients though. I do vaguely recall that the naturopath wanted me to take a lot of expensive supplements to "calm" my gut (I also have GERD). I will see if my doc can check on some vitamin levels too.

For now it looks like I am going to have to return to the elimination diet which is beyond icky. :)

Thanks!
C.

[essdipity]

Wow Corrie, that's what I'd call very extreme. I don't know, though, whether taking Imodium right before you eat will help matters. I've always understood that it should be taken as soon as there is an 'incident,' and after each subsequent one, within strict daily limits. It sounds as if you always have incidents, and Imodium is not designed for such heavy duty.

I'm ever the pragmatist, however. If this doesn't work, on to the next thing. I'm assuming, given that you've had this problem for quite a few years, that you've tried eliminating various types of foods, one at a time, to see what happens. With all kinds of health issues already, it really sux to have to deny yourself foods you may love, but that could well be necessary. Keep good records and allow enough time for things to normalize before drawing any conclusions. Then try the next food type.

It's best that you do all this under the direction of your doctor, whether GP or otherwise. If this one needs a fire lit under him, light it, or move to another doc. Your body can't possibly be absorbing nutrients properly with that constant elimination, and I'd bet you're deficient in quite a few. Digestion does vary widely with people with and without MS, so 'normal' can mean quite a range, but no matter what you are way out of range.

Whether or not this is a MS issue is not so important, since the treatment is likely to be the same regardless. What *is* important is safeguarding your digestive health.

ess

[Corriel]

Hi ess! I use a lot of Immodium when I eat out but the two most recent episodes of incontinence were after taking a couple of Immodium Liquigels a few minutes before I ate so I gues it isn't always effective.

I have gotten to the point where I take three Immodium at once and then one every time I eat if I have a day long function. That helps with my regular diarrhea and I still have normal bowel movements that day but the next day I have trouble going.

I am usually pretty regular (3-4 times/day) but it is almost always a rush to the bathroom and taking Immodium every day is not something I should do so I hope my doc can help me out with a different med.

Thanks!
Corrie

[essdipity]

With IBS can you take Imodium? If so, then that's what I'd recommend. Not every day, of course, but when things have gotten rather extreme.

I've found that for me, I'll probably never know what causes certain issues, whether or not they could remotely relate to MS. But if I find a reasonably satisfactory remedy that I know won't cause other problems, well, I just go with that.

ess

[Corriel]

Thank you!

I had an acupuncturist tell me once that IBS is not a disease, it's a symptom. Might be a sensitivity/allergy, might be an illness.

Hopefully my GP will help me get it sorted out so that I can treat the symptoms appropriately.

Corrie

[jensequitur]

My neurogenic bowel manifests as slow motility - extreme constipation that I have to take stool softeners for.

[Corriel]

Thanks Kyle! Fingers crossed for when I see my GP he has a tendency to not touch anything MS related so as not to step on my neuro's toes.

If it is simply IBS he can help but hopefully if it not clear cut for him he will refer to me to a gastro doc to figure things out.

Corrie

[kwarendorf]

Hi C -

Many neuros, sadly, are only interested in treating MS itself and not the resulting symptoms. If something is happening outside the CNS, even if it is caused by MS, they tend to minimize.

This is not a good thing. I think you are wise to pursue symptom remedies through your GP.

Kyle

[Corriel]

Thanks ladies! I had a colonoscopy after my gall bladder was removed and they ruled out colitis, crohn's and ulcers so the gastro doc concurred it was IBS but again it was all prior to my MS diagnosis and if it is IBS I want to treat it properly.

It was manageable to have diarrhea frequently and I could live with occasional incontinence  but would like to treat the right thing, if that's even possible.

Next step is to talk to my GP to see what he suggests. My neuro seems to only be concerned at what he calls major flares so I won't get anywhere going that route.

Corrie

[HVAC]

I think it will take a really good gastro doctor to figure out. I would find out who your neurologist refers to or GP. They took my gallbladder out and it turned out to be something else. They thought I would stop throwing up. I am into second and third opinions these days.

Alex

[bbassel]

The only issues with my bowels are once a week or so bowel movement. At times I have been. Constipated but not recently.

I am on pain meds which slows down the bowels but I was having this situation before the pills.

That is all i know unfortunately.

Barb