# Tenesmus/Urgency as Main Symptom?



## Lemon247 (Mar 4, 2012)

Okay, hello everyone, new member here. I'll put the main stuff in *bold* so you can skip past most of my ramblings.Without getting into all the sad detailed history (I posted that at another forum here if anyone wants to read it, I've gone back and forth now with 2 GI docs, one who is giving me Asacol for possible Crohn's (though he doesn't think so...only minor inflammation/irritation near terminal ilium and rectosigmoid areas) and another who just diagnosed me with IBS PI...yay.







*My main symptoms now (ever since November, on and off, and much worse over the past month) are:
the tenesmus/urgency to go even with nothing there (and the "fullness" that comes with it)
pressure/tightness around the rectum but also on either side of the anus (it's hard to explain...it's in the perenium and also each buttock on both sides, but inside...feels like bloating but sort of different)
minor abdominal pain/fullness (nothing too horrible usually, but it's there, and I have had something like this for the past 4-5 years a small scale)
and occasional gurgling but from my bottom. like something is digesting
**All of the above are way worse about half an hour after eating.* I did not and still have not had any diarrhea at all, maybe very occasional constipation, but it's more like I can't go to the bathroom for a couple days and then just little small hard stool. But no diarrhea (mostly normal BMs overall in fact), and no chronic constipation either really.The second GI a.) put me on a small dose of tricyclic antidepressants for the tenesmus/pain in my bottom (he says it will work as a "nerve block") & b.) is having me do some kind of hydrogen breath test to look for bacterial overgrowth in my small intestine. He dismissed the aforementioned minor inflammation/irritation on my colonoscopy/CT scans as not being conclusive or serious enough for something like Crohn's. I'm going to keep the Asacol going just in case, but also try to hone closely to the low-FODMAP diet and just see what happens.*But my main question after all this rambling is, has anyone heard of IBS with this kind of symptom (urgency/fullness in bottom but not really in abdominal area) as the main one?* Is this more common with IBS PI? (which I may not even have, but every doctor jumps on the China thing) My stools seem more or less okay. Oh, and *has anyone had any success with the tricyclic antidepressants for these types of symptoms?* I've read around the web how they are used for abdominal pain but that's not really what I'm dealing with here.Thanks in advance!


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## Lemon247 (Mar 4, 2012)

Anyone? Anyone? Bueller?For what it's worth, I'm on a FODMAP diet now and things aren't really a great deal better. I've got a hydrogen breath test coming up soon to test for SIBO.


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## jmc09 (Oct 5, 2009)

Im not sure why you are on asacol if you dont suffer from diarrhoea as thats an anti inflammatory used for intestinal inflammation and your problems sound nothing like that problem. I should know as this was my problem originally.I do think that drugs like asacol should be a part of ibs d treatment as it can help to prevent or control diarrhoea.As for antidepressants,they can also cause constipation so you are on a double whammy for what sound like mild symptoms.


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## Lemon247 (Mar 4, 2012)

jmc09 said:


> Im not sure why you are on asacol if you dont suffer from diarrhoea as thats an anti inflammatory used for intestinal inflammation and your problems sound nothing like that problem. I should know as this was my problem originally.I do think that drugs like asacol should be a part of ibs d treatment as it can help to prevent or control diarrhoea.As for antidepressants,they can also cause constipation so you are on a double whammy for what sound like mild symptoms.


GI #1 thought maybe the mild inflammation I have in my terminal illium (and rectosigmoid region) could maybe be helped by Asacol, though it seems like a shot in the dark honestly.GI #2 dismissed this, and he didn't mention anything about the tricyclic antidepressants causing C though I spose that's possible...remember I'm on a small dose (20 mg currently, with a max "ramped-up-to" dose of 50 mg potentially...when they prescribe them for behavioral modification properties, they usually are around 100 mg or more). He says visceral hypersensitivity is what is causing the pain and tightness/fullness/tenesmus (and believe me when it's bad it's not mild at all).I do have a Hydrogen Breath Test scheduled for next week to check for SIBO. Not sure what will happen after that, from what I've read, maybe a quick course of antibiotics if it's positive?


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## BQ (May 22, 2000)

> He says visceral hypersensitivity is what is causing the pain and tightness/fullness/tenesmus


This is very common in IBS.


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## Lemon247 (Mar 4, 2012)

BQ said:


> This is very common in IBS.


And I guess I should feel lucky that I don't really have any D or much C to speak of, but having constant feelings of tenesumus and tightness w/some abnominal pain after eating anything besides an _extremely _tiny meal is awful (so far, FODMAP-free foods or not doesn't seem to matter). I get hungry all the time but dread eating.


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## pip x (May 10, 2011)

Lemon247 said:


> Okay, hello everyone, new member here. I'll put the main stuff in *bold* so you can skip past most of my ramblings.Without getting into all the sad detailed history (I posted that at another forum here if anyone wants to read it, I've gone back and forth now with 2 GI docs, one who is giving me Asacol for possible Crohn's (though he doesn't think so...only minor inflammation/irritation near terminal ilium and rectosigmoid areas) and another who just diagnosed me with IBS PI...yay.
> 
> 
> 
> ...


Hi Lemon247 Your problem sounds so much like mine. I could have written your post. I have suffered this for the past 3 years if not longer. You have described the rectal/anal/cheek pain down to a t. I also do not suffer diaorreah but do with the constipation on and off. I am also on tricyclic antidepressants (amitryptiline) was put on 50mg per night and told to lower it when the problem eases. I got down to 30mg per night and now the same pain is creeping back again after about 2.5 months of nothing, so i guess its time to raise them again back to 50mg, but they do cause constipation no matter what dosage you're on. It doesnt work straight away and may take at least 6 weeks to get the full benefit from them. They are also very good for the abdominal pain you are describing. Have you tried increasing your fibre intake?. I ask this because it seems to make my pains worse. Worry is also my problem as the more i think about it the worse it gets. Now i try to ignore the pain, telling myself that it is nothing to worry about (think i would be dead by now if it were anything serious, i've had it for so long.) It does go eventually. I must have tried everything in the past to try to ease the pains, but i think the more things i try, the worse it gets. I also think that the more i try to empty my bowels especially with fibre, the pains get worse. I was diagnosed with internal piles quite a few years ago, when the pains were absolutely crippling me, but now i think that a lot of it is some sort of muscular problem in the rectum/anal area. I am thinking some sort of pelvic floor muscle problem. I also get the rectal spasms, which wake me in the night, although these are very few and far between thank god. I hope i have helped you a bit by knowing there are others who suffer the same. I am sure there are a lot more out there suffering this awful pain. btw what is IBS pi. Take care x


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## Lemon247 (Mar 4, 2012)

pip x said:


> Hi Lemon247 Your problem sounds so much like mine. I could have written your post. I have suffered this for the past 3 years if not longer. You have described the rectal/anal/cheek pain down to a t. I also do not suffer diaorreah but do with the constipation on and off. I am also on tricyclic antidepressants (amitryptiline) was put on 50mg per night and told to lower it when the problem eases. I got down to 30mg per night and now the same pain is creeping back again after about 2.5 months of nothing, so i guess its time to raise them again back to 50mg, but they do cause constipation no matter what dosage you're on. It doesnt work straight away and may take at least 6 weeks to get the full benefit from them. They are also very good for the abdominal pain you are describing. Have you tried increasing your fibre intake?. I ask this because it seems to make my pains worse. Worry is also my problem as the more i think about it the worse it gets. Now i try to ignore the pain, telling myself that it is nothing to worry about (think i would be dead by now if it were anything serious, i've had it for so long.) It does go eventually. I must have tried everything in the past to try to ease the pains, but i think the more things i try, the worse it gets. I also think that the more i try to empty my bowels especially with fibre, the pains get worse. I was diagnosed with internal piles quite a few years ago, when the pains were absolutely crippling me, but now i think that a lot of it is some sort of muscular problem in the rectum/anal area. I am thinking some sort of pelvic floor muscle problem. I also get the rectal spasms, which wake me in the night, although these are very few and far between thank god. I hope i have helped you a bit by knowing there are others who suffer the same. I am sure there are a lot more out there suffering this awful pain. btw what is IBS pi. Take care x


Interesting...you are the only other person I've seen on various boards that has said that, glad (maybe not the right word) that I'm not alone. It sounds like you and I probably have some form of visceral hypersensitivity where we are feeling our gut send out (well, from the brain) signals when other people wouldn't. Oh, and IBS PI = IBS Post Infection as described here.I'm on the exact same medicine. Still ramping up to 50 mg, I was told 5 days of a dose before moving up in 10 mg steps, currently on Day 2 of 30mg, so it'll be awhile till I get to 50mg. I was told I should try it for 6 months at that level before trying to ramp down. That sucks about them causing C in even with smaller doses*, but the most important thing is that it sounds as if the urgency/rectal tightness/fullness/pain to go away after a couple months, I'm totally on board. I was also told by a colorectal doc to go to pelvic physical therapy (w/biofeedback...it seemed kind of ridiculous), which I did once, though I haven't really kept up with it because I think that's a secondary issue exasperated by the IBS.Have you tried anything like the low-FODMAP diet? I'm going to give it a go, regardless of what the Hydrogen Breath Test (to test for Small Intestinal Bacterial Overgrowth) that I'll be taking soon says. Well, I'll try it for a couple weeks and start trying to introduce "bad" foods back slowly...I really don't want to try and go without wheat forever, and trying to avoid everything with corn or rice syrup in it is almost impossible nowadays.*EDIT: Maybe you could talk to your doc about getting on a different class of antidepressants? The information here seems to indicate that Selective Serotonin Reuptake Inhibitors don't have the constipating effect. Hey, I should have asked for that kind!


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## LuSmith (Dec 15, 2011)

Lemon247 said:


> Interesting...you are the only other person I've seen on various boards that has said that, glad (maybe not the right word) that I'm not alone. It sounds like you and I probably have some form of visceral hypersensitivity where we are feeling our gut send out (well, from the brain) signals when other people wouldn't. Oh, and IBS PI = IBS Post Infection as described here.I'm on the exact same medicine. Still ramping up to 50 mg, I was told 5 days of a dose before moving up in 10 mg steps, currently on Day 2 of 30mg, so it'll be awhile till I get to 50mg. I was told I should try it for 6 months at that level before trying to ramp down. That sucks about them causing C in even with smaller doses, but the most important thing is that it sounds as if the urgency/rectal tightness/fullness/pain to go away after a couple months, I'm totally on board. I was also told by a colorectal doc to go to pelvic physical therapy (w/biofeedback...it seemed kind of ridiculous), which I did once, though I haven't really kept up with it because I think that's a secondary issue exasperated by the IBS.Have you tried anything like the low-FODMAP diet? I'm going to give it a go, regardless of what the Hydrogen Breath Test (to test for Small Intestinal Bacterial Overgrowth) that I'll be taking soon says. Well, I'll try it for a couple weeks and start trying to introduce "bad" foods back slowly...I really don't want to try and go without wheat forever, and trying to avoid everything with corn or rice syrup in it is almost impossible nowadays.


Hey. I actually have the same full feeling/sensitivity problem and was wondering if you found you went a few times a day too! Im worried about the frequency


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## LuSmith (Dec 15, 2011)

Sorry, my phone posted early for some reason! Anyway I don't know what meds you're on or what diet you're attempting but the only thing I've been given is mebeverine which so far had not made a difference.







I wouldn't worry so much if I wasn't unsure of the amount of times I go, seems its more like a person with ibs to go often with ibs-d and I'd hardly call my stools very loose! Just seems like I can't go properly!


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## Lemon247 (Mar 4, 2012)

LuSmith said:


> Hey. I actually have the same full feeling/sensitivity problem and was wondering if you found you went a few times a day too! Im worried about the frequency


For the past few days I haven't been going near as much (maybe due to me trying to hone more closely to low-FODMAP diet? or the amitryptiline?) but before then I would have some days where I would be attempting to go at least 3 times a day or more...there wasn't much there but I was sort of a slave to the tenesmus because I always *felt* like I had to. So sometimes I could force something out but not much since I hadn't waited long enough for anything to be up next in the queue!







It's not a fun feeling, it's like constipation without any way to get relief.For what it's worth, my second GI told me that antispasmodics (like mebeverine) don't really do much in his opinion, at least at the low doses that are given to IBS patients (and if the higher doses were given the side effects would outweigh benefits).


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## LuSmith (Dec 15, 2011)

Did your second GI recommend anything that would help?? I don't know if mebeverine will work but I know it does for some but I feel it helps more people who have cramps rather than this full feeling. I'm so glad that someone understands what I'm getting at, my drs seem to just not care despite what I say but it sounds similar! I feel constantly backed up even when I probably am not ready to go. The thing is I can pass gas but when I do go when I have an urge I don't go as much as a normal person would but end up having to go more times throughout the day even tho i suffer the feeling like I need to!I guess this could be typical of some ibs sufferers then?


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## Lemon247 (Mar 4, 2012)

LuSmith said:


> Did your second GI recommend anything that would help?? I don't know if mebeverine will work but I know it does for some but I feel it helps more people who have cramps rather than this full feeling. I'm so glad that someone understands what I'm getting at, my drs seem to just not care despite what I say but it sounds similar! I feel constantly backed up even when I probably am not ready to go. The thing is I can pass gas but when I do go when I have an urge I don't go as much as a normal person would but end up having to go more times throughout the day even tho i suffer the feeling like I need to!I guess this could be typical of some ibs sufferers then?


Not sure I can say much with certainty since I'm still at the early stages of trying to deal with this, so I'm throwing everything against the wall in hope that it will stick.







You could ask your GI about trying out the tricyclic antidepressants in low doses. I've mostly seen it mentioned for abnominal pain and bloating, but I'm hoping it works for the tenesmus/fullness feeling also. In the meantime, you could also try the low-FODMAP diet over a couple weeks and see if your symptoms subside...if so you could then try linking your symptoms to certain types of foods.


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## pip x (May 10, 2011)

Lemon247 said:


> Not sure I can say much with certainty since I'm still at the early stages of trying to deal with this, so I'm throwing everything against the wall in hope that it will stick.
> 
> 
> 
> ...


HI I've tried mebeverine, colpermin, buscopan, probiotics, fibogel, and fibre tablets. Nothing has seemed to work with this kind of pain, other than the amitryptiline. I will just stick with this for now. I dont know about you but i feel better and have no pain really if i dont empty my bowels for a couple of days. I dont think that i have ever been one of these people who go every morning at a certain time, but, we keep hearing that we should be, which causes pressure and we end up taking all sorts to achieve the daily business. (my case anyway) I may not go for a couple of days and then i may go 2-3 times in one day. My GP has said to stick with the amitryptiline and take fibogel to ease the constipation, also if it gets too bad to take a senna for a few nights. These are all natural, so do no harm. I also try to drink plenty and to focus my mind on other things. I try to keep busy especially first thing in the mornings and if i do happen to empty my bowels i make sure i am busy immediately afterwards. This way i have no pain. Maybe this type of pain is a mind thing, hence the amitryptiline working. Ive also stopped eating nuts and anything with seeds in/on. Coincidence or not but i find that i have pain after i eat them. I read somewhere that these can also aggravate any existing hemmorhoids. Let me know how you get on with the FODMAP diet and the amitryptiline. Take care.Also I did ask my GP if there was another pill like amitryptiline but without the constipation effects and i was told that these are the best for all IBS pains. Anything else may give other side effects. Think it best to stick with the devil we know for now.


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## LuSmith (Dec 15, 2011)

I suffer these fullness feelings too, could you describe it as though a feeling you always need to go!? I don't know whether mine is literally hypersensitivity every time I have stool there as nothing seems to work and I always seem to have stool!!I can't take amitryptiline with my Sertraline







I wish this was an alternative for me as mebeverine isn't working! Can someone tell me what you can eat with the low FODMAP diet?


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## pip x (May 10, 2011)

LuSmith said:


> I suffer these fullness feelings too, could you describe it as though a feeling you always need to go!? I don't know whether mine is literally hypersensitivity every time I have stool there as nothing seems to work and I always seem to have stool!!I can't take amitryptiline with my Sertraline
> 
> 
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 I have the feeling as either needing to go or needing to pass wind. Sometimes as if something is stuck there, a sore feeling or ache inside. Sometimes it moves into the cheeks on either side, Very difficult to describe. I have also had the rectal spasms which wake me from my sleep, very painful but lucky that they are very few and far between. I have been suffering like this for over 3 years and tried everything. It always gets worse when i start thinking and worrying about it, which i guess is why i am on the amitryptiline. It does help to also keep busy and try not to think of it then suddenly after a few days i will remember the pain and think hey, ive not had this for a few days. Anxiety can cause so many problems, i know this from experience. Your always needing to go and soft stools could be a side effect of your medication. Did it start after you started the sertraline? It could also be your hemmies. I have suffered with these for the past 9 years (internal) and i do find that if i go more or pass lots of wind, this also causes the pain. It could also be a muscle problem, some sort of pelvic floor thing, which i am starting to think my problem is. Speak to your GP again and let us know how you get on. Take care.


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## LuSmith (Dec 15, 2011)

Lemon247 said:


> I have the feeling as either needing to go or needing to pass wind. Sometimes as if something is stuck there, a sore feeling or ache inside. Sometimes it moves into the cheeks on either side, Very difficult to describe. I have also had the rectal spasms which wake me from my sleep, very painful but lucky that they are very few and far between. I have been suffering like this for over 3 years and tried everything. It always gets worse when i start thinking and worrying about it, which i guess is why i am on the amitryptiline. It does help to also keep busy and try not to think of it then suddenly after a few days i will remember the pain and think hey, ive not had this for a few days. Anxiety can cause so many problems, i know this from experience. Your always needing to go and soft stools could be a side effect of your medication. Did it start after you started the sertraline? It could also be your hemmies. I have suffered with these for the past 9 years (internal) and i do find that if i go more or pass lots of wind, this also causes the pain. It could also be a muscle problem, some sort of pelvic floor thing, which i am starting to think my problem is. Speak to your GP again and let us know how you get on. Take care.


Ah okay so it can be quite a normal thing? I think thinking about it constantly doesn't do me any favours but I know what you mean! I don't get woken from my sleep by it, only by my bladder really, but it definitely feels worse if I'm not distracting myself keeping busy. Usually feels better if I'm walking out and about unless I really have to go. My Sertraline I've been on for about four-four and a half months and the really bad diarrhea started at the beginning of my third trimester when I was pregnant seven months ago. It then turned into the soft sticky narrowish stools I'm getting now since baby was born and has been with me around 5 months so definitely not a medication thing, but I did end up having four lots of antibiotics in 5 months so maybe I need some good bacteria put back in my system which is why I'm considering probiotics.I'm thinking mine could be a pelvic floor issue too, muscle issue?? who knows. Having a baby and pushing for two hours can't have done me any favours! oh and my hemmorhoids are real small now, so not sure if they're the problem or not.


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## Lemon247 (Mar 4, 2012)

pip x said:


> I can't go on tricyclic antidepressants as much as I know it helps some IBS sufferers and may help me. I am on Sertraline and there's an interaction between the two so it's best if I just stick with what I've been given. Let me know if the amitryptiline works for you?? I don't know enough about the low-FODMAP diet - is there somewhere I can read up about it?


From reseraching it, it looks like sertraline = Zoloft = Selective Serotonin Reuptake Inhibitor, which as described here as the "other" class of antidepressants prescribed for IBS pain. And while it seems the tricyclic ones are given to people with IBS D, the SSRIs tend to be given to people with IBS C. But I'm guessing you can only be given one class of pill at a time. The basic idea behind the low-FODMAP (Fermentable Oligo-, Di- and Mono-saccharides, And Polyols) diet is that a group of foods (quite a lot, sadly) have these specific kind of carbohydrates which brings about pain/bloating/etc in certain folks with IBS. The best low-FODMAP diet reference I've found is IBSfree.net but it looks as if someone on this forum also put together a good chart here: http://www.ibsgroup.org/forums/topic/138274-printable-fodmap-diet-chart-for-your-convenience/ The hard part is that all this research is relatively new and sometimes foods that were seen as "safe" i.e. low-FODMAP turn out to later not be, so be careful when googling around to different sites when trying to look up a specific food.


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## LuSmith (Dec 15, 2011)

Lemon247 said:


> So far (about 1 week into low-FODMAP + 30 mg amitryptiline) things are certainly better. Maybe some minor C a couple days ago (not sure if that was due to the meds or IBS) but overall less fullness/tightness/tenesmus and less bloating (though this last piece is still present). Going to try strict diet for another week and then do the "challenge" phase where I start introducing some of the high-FODMAP foods back in and see if I get worse.But there is another class of pill for these pains, because LuSmith is on it...see below...possibly the docs have had more luck with the tricyclic ones?From reseraching it, it looks like sertraline = Zoloft = Selective Serotonin Reuptake Inhibitor, which as described here as the "other" class of antidepressants prescribed for IBS pain. And while it seems the tricyclic ones are given to people with IBS D, the SSRIs tend to be given to people with IBS C. But I'm guessing you can only be given one class of pill at a time. The basic idea behind the low-FODMAP (Fermentable Oligo-, Di- and Mono-saccharides, And Polyols) diet is that a group of foods (quite a lot, sadly) have these specific kind of carbohydrates which brings about pain/bloating/etc in certain folks with IBS. The best low-FODMAP diet reference I've found is IBSfree.net but it looks as if someone on this forum also put together a good chart here: http://www.ibsgroup.org/forums/topic/138274-printable-fodmap-diet-chart-for-your-convenience/ The hard part is that all this research is relatively new and sometimes foods that were seen as "safe" i.e. low-FODMAP turn out to later not be, so be careful when googling around to different sites when trying to look up a specific food.


I didn't know that Sertraline/Zoloft was used in IBS patients. It hasn't really helped me much but I have to say when I was pregnant my diarrhea was horrific and it's never been that bad since (except the one day). I guess in a sense the Mebeverine has helped slightly, but I still wish to have something to rid these feelings of urgency or fullness. I'm gonna take a look into the FODMAP diet thing, thanks for the link


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## pip x (May 10, 2011)

Lemon247 said:


> So far (about 1 week into low-FODMAP + 30 mg amitryptiline) things are certainly better. Maybe some minor C a couple days ago (not sure if that was due to the meds or IBS) but overall less fullness/tightness/tenesmus and less bloating (though this last piece is still present). Going to try strict diet for another week and then do the "challenge" phase where I start introducing some of the high-FODMAP foods back in and see if I get worse.But there is another class of pill for these pains, because LuSmith is on it...see below...possibly the docs have had more luck with the tricyclic ones?From reseraching it, it looks like sertraline = Zoloft = Selective Serotonin Reuptake Inhibitor, which as described here as the "other" class of antidepressants prescribed for IBS pain. And while it seems the tricyclic ones are given to people with IBS D, the SSRIs tend to be given to people with IBS C. But I'm guessing you can only be given one class of pill at a time. The basic idea behind the low-FODMAP (Fermentable Oligo-, Di- and Mono-saccharides, And Polyols) diet is that a group of foods (quite a lot, sadly) have these specific kind of carbohydrates which brings about pain/bloating/etc in certain folks with IBS. The best low-FODMAP diet reference I've found is IBSfree.net but it looks as if someone on this forum also put together a good chart here: http://www.ibsgroup.org/forums/topic/138274-printable-fodmap-diet-chart-for-your-convenience/ The hard part is that all this research is relatively new and sometimes foods that were seen as "safe" i.e. low-FODMAP turn out to later not be, so be careful when googling around to different sites when trying to look up a specific food.


Hi Lemon247 I will mention the zoloft to my GP next time i see her. I think the reason i was given the amitryptiline in the first place was because my IBS was mainly the c type for many years with the occasional diaorreah (probably once a fortnight) and very bad stomach pains all the time. I had a colonoscopy done about 20 years ago and i had many tears found so obviously suffered badly with constipation. About 7 years ago i found i was getting diaorreah every week, so bad that i could not go out as it had no warning, my GP then prescribed the amitryptiline to stop it and the pains. Every time since i have tried to come off the amitryptiline, the diaorreah always came back. So guessed my IBS has changed over the years. I will definately also look at the FODMAP diet too. I know a few things that set mine off, onions and sausages.LuSmith - I remember when i was pregnant with one of mine, i suffered terribly with diaorreah all the way through. It was put down to the iron medicine or oranges whether juice or fruit. My GP sent away samples but came back normal. I would definately look into the muscles being the problem with the pain though. Do you feel as though you are tensing up the muscles down there all the time? i know i did when the pain was very bad. Also when i have the spasms during the night i seem to tense them up as the pain is so bad. I think this causes the aching, fullness and sore pain the next day, sometimes the pain is so bad that i am scared to open my bowels as i am so sure that there will be blood. Never is though. The pain can also spread to the front and when its bad i have to keep passing water, even during the night im up about 5 times, no stinging or burning though and sure its no infection, which is why i think its a pelvic floor problem. I looked up levator ani syndrome and it all seems to fit. Walking about also seems to help. How are you doing with the lactulose? its early days yet though. I am still trying to keep busy and occupy my mind with other things as i think along with the amitryptiline this is helping. I have been to work all day today and not had a single pain for 4 days, although i havent 'been' for 3.5 days this is probably why. As i mentioned before my pains seem really bad when i am taking stuff to make me go and my mind is focused on the pains all the time. I was always checking my poo for any abnormalities, size/shape/blood/amount/colour/mucus. I was totally obsessed and paranoid. Always thinking that any difference was a sign of something serious. Now, I guess i am just one of these people who dont/need to go every day and try to relax, although it is very hard. I am sure my GP thinks ''here she is again'' every time she sees me walk through the door. But i am quite sure that she would have sent me for thorough tests by now if she thought there was anything wrong. She sends me off for other things that i think are trivial. Let me know how you are both getting on. pip x


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## LuSmith (Dec 15, 2011)

pip x said:


> Hi Lemon247 I will mention the zoloft to my GP next time i see her. I think the reason i was given the amitryptiline in the first place was because my IBS was mainly the c type for many years with the occasional diaorreah (probably once a fortnight) and very bad stomach pains all the time. I had a colonoscopy done about 20 years ago and i had many tears found so obviously suffered badly with constipation. About 7 years ago i found i was getting diaorreah every week, so bad that i could not go out as it had no warning, my GP then prescribed the amitryptiline to stop it and the pains. Every time since i have tried to come off the amitryptiline, the diaorreah always came back. So guessed my IBS has changed over the years. I will definately also look at the FODMAP diet too. I know a few things that set mine off, onions and sausages.LuSmith - I remember when i was pregnant with one of mine, i suffered terribly with diaorreah all the way through. It was put down to the iron medicine or oranges whether juice or fruit. My GP sent away samples but came back normal. I would definately look into the muscles being the problem with the pain though. Do you feel as though you are tensing up the muscles down there all the time? i know i did when the pain was very bad. Also when i have the spasms during the night i seem to tense them up as the pain is so bad. I think this causes the aching, fullness and sore pain the next day, sometimes the pain is so bad that i am scared to open my bowels as i am so sure that there will be blood. Never is though. The pain can also spread to the front and when its bad i have to keep passing water, even during the night im up about 5 times, no stinging or burning though and sure its no infection, which is why i think its a pelvic floor problem. I looked up levator ani syndrome and it all seems to fit. Walking about also seems to help. How are you doing with the lactulose? its early days yet though. I am still trying to keep busy and occupy my mind with other things as i think along with the amitryptiline this is helping. I have been to work all day today and not had a single pain for 4 days, although i havent 'been' for 3.5 days this is probably why. As i mentioned before my pains seem really bad when i am taking stuff to make me go and my mind is focused on the pains all the time. I was always checking my poo for any abnormalities, size/shape/blood/amount/colour/mucus. I was totally obsessed and paranoid. Always thinking that any difference was a sign of something serious. Now, I guess i am just one of these people who dont/need to go every day and try to relax, although it is very hard. I am sure my GP thinks ''here she is again'' every time she sees me walk through the door. But i am quite sure that she would have sent me for thorough tests by now if she thought there was anything wrong. She sends me off for other things that i think are trivial. Let me know how you are both getting on. pip x


Hey! Thanks for putting my mind at ease a little. I do get a little consumed with doubts and worries, like you. I'm lately studying my stools too for any abnormalities, which I suppose ups my stress a little. I couldn't go today surprisingly, and just tried to distract myself, and finally went in the evening. I felt constipated at first, and had a firmer stool for the first time in forever (at least it looked it), and then when I went after it went back to its usual softer narrower self. Sigh. I now have those feelings again, and the tailbone aching etc, but I guess it would happen just after I've gone. I think the Mebeverine has helped a little, but I've gotta be careful with fibre I think as it seems to irritate my gut. I thought I might have levator ani syndrome too at one point, I don't know for sure as I always end up self diagnosing myself as the dr doesn't diagnose me properly most of the time. Funnily enough I have problems with my bladder too but have for many years (I think I suffer from IC) but it could be I've just worsened my muscles after having the baby. But who knows. Dr told me to do pelvic floor exercises but I don't really know enough about them. I think a physiotherapist is probably a good bet.Haven't tried the lactulose yet - haven't actually been to pick it up. I had my repeat blood test today as my white blood cell count came back a bit low last week and my red blood cell count is borderline :\ I'm hopefully getting a stool sample in this week.haha and if you think you're bad, I think even the receptionists are having bets on when I'm next gonna be in! I've been there so much the last few months, seriously! I'm sure you're fine yourself though, I think alot of people with this condition constantly get paranoid, but I know that IBS is actually quite a common thing and with all my hormones messed up it's more likely to be that than something serious, right?


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## pip x (May 10, 2011)

LuSmith said:


> Hey! Thanks for putting my mind at ease a little. I do get a little consumed with doubts and worries, like you. I'm lately studying my stools too for any abnormalities, which I suppose ups my stress a little. I couldn't go today surprisingly, and just tried to distract myself, and finally went in the evening. I felt constipated at first, and had a firmer stool for the first time in forever (at least it looked it), and then when I went after it went back to its usual softer narrower self. Sigh. I now have those feelings again, and the tailbone aching etc, but I guess it would happen just after I've gone. I think the Mebeverine has helped a little, but I've gotta be careful with fibre I think as it seems to irritate my gut. I thought I might have levator ani syndrome too at one point, I don't know for sure as I always end up self diagnosing myself as the dr doesn't diagnose me properly most of the time. Funnily enough I have problems with my bladder too but have for many years (I think I suffer from IC) but it could be I've just worsened my muscles after having the baby. But who knows. Dr told me to do pelvic floor exercises but I don't really know enough about them. I think a physiotherapist is probably a good bet.Haven't tried the lactulose yet - haven't actually been to pick it up. I had my repeat blood test today as my white blood cell count came back a bit low last week and my red blood cell count is borderline :\ I'm hopefully getting a stool sample in this week.haha and if you think you're bad, I think even the receptionists are having bets on when I'm next gonna be in! I've been there so much the last few months, seriously! I'm sure you're fine yourself though, I think alot of people with this condition constantly get paranoid, but I know that IBS is actually quite a common thing and with all my hormones messed up it's more likely to be that than something serious, right?


Hi LuSmith I gave up worrying about the receptionists years ago. Funny now its the cab/bus driver i worry about, as always seem to need either to take me to Docs. Think i have been premenopausal now for a while so i'm sure hormones do play a part, especially with the bladder problems etc. I only need to cough/sneeze/laugh or run and i leak. Honestly, this getting older thing sucks. I dont know anything about blood tests so i dont know what the white/red blood count thing means. I know i have them quite regularly but are always normal. I've had stool tests for blood and infections and all normal. I had the faecal test which you take samples over 3 days 2 years ago and all normal. I was so sure there was blood, but i guess you just see what you want to when you are looking so much and so paranoid. I read a while back that most people who see the specialists for bowel problems are diagnosed with ibs after tests. Its such a common thing and most peoples symptoms differ so much. People just dont talk about 'bowel' things. Me, I tell anyone that will listen-lol. Im glad that you finally got a firmer stool, shows somethings working, whether its the mebeverine or not worrying for a little while. I dont think i can take the fibre either, too much.Keep in touch and let me know how you get on with things. x


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## LuSmith (Dec 15, 2011)

pip x said:


> Hi LuSmith I gave up worrying about the receptionists years ago. Funny now its the cab/bus driver i worry about, as always seem to need either to take me to Docs. Think i have been premenopausal now for a while so i'm sure hormones do play a part, especially with the bladder problems etc. I only need to cough/sneeze/laugh or run and i leak. Honestly, this getting older thing sucks. I dont know anything about blood tests so i dont know what the white/red blood count thing means. I know i have them quite regularly but are always normal. I've had stool tests for blood and infections and all normal. I had the faecal test which you take samples over 3 days 2 years ago and all normal. I was so sure there was blood, but i guess you just see what you want to when you are looking so much and so paranoid. I read a while back that most people who see the specialists for bowel problems are diagnosed with ibs after tests. Its such a common thing and most peoples symptoms differ so much. People just dont talk about 'bowel' things. Me, I tell anyone that will listen-lol. Im glad that you finally got a firmer stool, shows somethings working, whether its the mebeverine or not worrying for a little while. I dont think i can take the fibre either, too much.Keep in touch and let me know how you get on with things. x


I haven't had the faecal test done to be honest, it would be something I'd wanna do to ease my mind but the dr hasn't offered me anything like this. All I can do is hope that a stool sample will be good enough to diagnose anything! I'm taking one in tomorrow if I can make a BM in the morning, I usually can but since taking the Mebeverine it's been a bit all over the place. I guess if it's something most people are diagnosed with then perhaps I shouldn't worry too much but my mind gets carried away with all the aches and pains and tenderness I feel, and I start worrying about worse things. lol I'll also talk to practically anyone who'll listen. I'm not really that old either which is why it worries me as I shouldn't be feeling this way at my age. I've already got hormonal problems with my uterus, I wish I didn't have the other! and my family history makes me panic but I don't know which age they were diagnosed with bowel cancer, for my mum's mum I know it was around 60, and my grandad perhaps the same but not sure - I think this means I'll probably go for a colonoscopy around 50 like the rest of my family.Sometimes I feel like I'm constipated, other times I feel off, I just feel weird sometimes! I have weird feelings in my pelvis and tailbone/rectum and it confuses the hell out of me because I know there's nothing amiss in my uterus etc. Just have to see this through and hope my stool sample is normal! I think I want a referral to a GI or something if I can get one here... but the NHS you know


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## pip x (May 10, 2011)

LuSmith said:


> I haven't had the faecal test done to be honest, it would be something I'd wanna do to ease my mind but the dr hasn't offered me anything like this. All I can do is hope that a stool sample will be good enough to diagnose anything! I'm taking one in tomorrow if I can make a BM in the morning, I usually can but since taking the Mebeverine it's been a bit all over the place. I guess if it's something most people are diagnosed with then perhaps I shouldn't worry too much but my mind gets carried away with all the aches and pains and tenderness I feel, and I start worrying about worse things. lol I'll also talk to practically anyone who'll listen. I'm not really that old either which is why it worries me as I shouldn't be feeling this way at my age. I've already got hormonal problems with my uterus, I wish I didn't have the other! and my family history makes me panic but I don't know which age they were diagnosed with bowel cancer, for my mum's mum I know it was around 60, and my grandad perhaps the same but not sure - I think this means I'll probably go for a colonoscopy around 50 like the rest of my family.Sometimes I feel like I'm constipated, other times I feel off, I just feel weird sometimes! I have weird feelings in my pelvis and tailbone/rectum and it confuses the hell out of me because I know there's nothing amiss in my uterus etc. Just have to see this through and hope my stool sample is normal! I think I want a referral to a GI or something if I can get one here... but the NHS you know


Hi LuSmith I suffered pains all the time in my lower abdomen from about the age of 20,(after my first child) i couldnt even call it griping pains. They were so severe that i was convinced at times that i was in labour. My Husband used to call the dr out to me and they could never find anything wrong. I was always advised to eat more fibre. Then i started to suffer from diorreah which always woke me in the night, but it was the pains that were my main issue. I also thought i saw blood on my stools at times. My GP at the time said as long as it was on them and not in, it was not usually a serious problem. There was never any blood there when they checked. In the end, i think i pestered them so much they sent me for tests just to shut me up.I had my colonoscopy when i was 26.I had 2 young children( under 5) at the time, i should have been enjoying them not worrying so much about my stomach. The colonoscopy was fine. All they found were plenty of old tears. My mum always told me i suffered badly since being born from terrible constipation and at one time they rushed me to hospital as i was grey and delerious through it. It was about 9 years ago (and 2 more children later) that the rectal pain started that i was sent for a barium eneama and sigmoidoscopy. As mentioned earlier, a duty GP felt a lump in my bowel just by pressing my stomach (he even mentioned the precise spot of where it was by its medical name) He wanted me referred straight away for the usual tests again. Hubby was having none of it and took me straight to hospital, where the lump was in fact a mass of poo. The Dr in the hospital told me as soon as he felt it. Constipation. Still had the tests though. Again nothing only internal hemmorhoids. After having both tests i was better. The pain didnt go completely but was nothing to what it had been. So that proves to me that worry makes things so much worse. I had a breast cancer scare 3 years ago. I was a mess for about 3 weeks waiting for appnt and results. All during that time i had no rectal pain at all. A year later i had a lump in my cheek, again 6 weeks of torture waiting for results, with no rectal pain. Yet before and after both episodes the pain was bad. When it starts again i think i will get my poor hubby to stamp on my toe Lol. I know exactly what you mean about not feeling right and not understanding how you can be in so much pain but nothing is wrong. Im sure that when they check your stool sample if there is any blood they will find it even if you cant see it they will. The tests they do can find even the most minute trace. Ive done these myself, one i bought from chemist and the other the dr did. Nothing, so i dont know what i see. Think it must be the light in my bathroom or my paranoia. Just relized Ive spent the past 28 years worrying about my bowels. How rediculous is that, but i guess i will spend the next 25 years doing the same. What joy. Let me know how you get on. x


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## Pete_SI (Dec 23, 2011)

Wow I think you guys are describing my symptoms. This is the first time I've read anything like this on the internet and I've been doing a lot of research.I use to have diarrhea on and off in the morning for the past 3 years. But since a year a go I feel like I always have the urge to go to the bathroom even though I really don't. I can barely leave the house. What I do to help is I only eat 1 meal a day (supper) so I can still sort of go on with my day. But I'm pretty sure that has left mal nutrition. I'm better if I'm alone in the car driving or anywhere with a bathroom. I've had colonoscopy, MRI and endoscopy and they found nothing. I'm hoping it's a mixed signal from the brain to my bowel and that a low dose of anti depressant would help me.I've always had bout of diarrhea but for the last 2 months since I've been taking Metamucil I seems to have stopped my diarrhea but not my urgency problem. I've actually seem to be a little bit more constipated now. I'm a regular in the morning and if I can't go it makes it worst.I have a little bit of bloating issues, worst when I over eat which is hard not to do since I only eat once a day. I have also some stomach growling.I've never had any types of relief at all. I was hoping this was maybe cause by a parasite infection but it doesn’t seem to be the case since I've been taking a parasite cleanse with no relief.


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## Lemon247 (Mar 4, 2012)

OP here with an update:Have been feeling much better over the past week on the low-FODMAP diet + the tricyclic antidepressants, until today. So it's one of three things:- I did finally "cheat" and have a sandwich last night for dinner with wheat (but no onions or other high-FODMAP foods). However, I was totally fine afterwards and this morning. In fact, I was good after my lunch (all "approved" foods) as well, and then...- I had a snack of 5 little gluten-free cookie/cracker things, which are dairy-free and vegan and the whole nine yards. The only unfriendly ingredient is "rice syrup". But 20-30 minutes after eating them, I was in definite pain and having all the same feelings as before over again.- The third possibility is that's it's all random or something and I've just been lucky recently. I doubt this one, personally.I'm guessing it's the 2nd option (and hoping it is too, because I don't want to give up wheat...it would be easier to give up the syrups that are in some foods, at least at higher levels). And before when I would have issues it was right after eating something, not 24 hrs later (like it would have to be if it was the wheat). But either way, it seems as if I probably have some kind of fructose malabsorption issue, which may be all tied into the SIBO/IBS thing. Finally got the date for my hydrogen breath test (the Monday after next) where they will test for SIBO (not the exact same test as they do for FM), so I'll report back when I finally get the results. I may end up spending a lot of time in the Diet forums...


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## LuSmith (Dec 15, 2011)

Lemon247 said:


> OP here with an update:Have been feeling much better over the past week on the low-FODMAP diet + the tricyclic antidepressants, until today. So it's one of three things:- I did finally "cheat" and have a sandwich last night for dinner with wheat (but no onions or other high-FODMAP foods). However, I was totally fine afterwards and this morning. In fact, I was good after my lunch (all "approved" foods) as well, and then...- I had a snack of 5 little gluten-free cookie/cracker things, which are dairy-free and vegan and the whole nine yards. The only unfriendly ingredient is "rice syrup". But 20-30 minutes after eating them, I was in definite pain and having all the same feelings as before over again.- The third possibility is that's it's all random or something and I've just been lucky recently. I doubt this one, personally.I'm guessing it's the 2nd option (and hoping it is too, because I don't want to give up wheat...it would be easier to give up the syrups that are in some foods, at least at higher levels). And before when I would have issues it was right after eating something, not 24 hrs later (like it would have to be if it was the wheat). But either way, it seems as if I probably have some kind of fructose malabsorption issue, which may be all tied into the SIBO/IBS thing. Finally got the date for my hydrogen breath test (the Monday after next) where they will test for SIBO (not the exact same test as they do for FM), so I'll report back when I finally get the results. I may end up spending a lot of time in the Diet forums...


Well if it is a diet thing, even though it can be frustrating at least you will be able to eliminate other worries and get a load off of your mind with a bit of work! I wish it were that easy for me, I seem to feel the same every day despite what I do or don't eat, even when I don't eat!I feel completely and utterly clogged up, especially towards the lower back.. its horrible







I've tried everything to go but nothing is working! I'm only able to go small loose amounts and its not relieving the feeling!


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## pip x (May 10, 2011)

Lemon247 said:


> OP here with an update:Have been feeling much better over the past week on the low-FODMAP diet + the tricyclic antidepressants, until today. So it's one of three things:- I did finally "cheat" and have a sandwich last night for dinner with wheat (but no onions or other high-FODMAP foods). However, I was totally fine afterwards and this morning. In fact, I was good after my lunch (all "approved" foods) as well, and then...- I had a snack of 5 little gluten-free cookie/cracker things, which are dairy-free and vegan and the whole nine yards. The only unfriendly ingredient is "rice syrup". But 20-30 minutes after eating them, I was in definite pain and having all the same feelings as before over again.- The third possibility is that's it's all random or something and I've just been lucky recently. I doubt this one, personally.I'm guessing it's the 2nd option (and hoping it is too, because I don't want to give up wheat...it would be easier to give up the syrups that are in some foods, at least at higher levels). And before when I would have issues it was right after eating something, not 24 hrs later (like it would have to be if it was the wheat). But either way, it seems as if I probably have some kind of fructose malabsorption issue, which may be all tied into the SIBO/IBS thing. Finally got the date for my hydrogen breath test (the Monday after next) where they will test for SIBO (not the exact same test as they do for FM), so I'll report back when I finally get the results. I may end up spending a lot of time in the Diet forums...


Hi Glad you seemed to find some relief with the FODMAP even if only for a while. That is going to be my next option. Its interesting about the fructose. I once saw a Duty GP who was Dutch about 6 years ago when my IBS was quite bad. He advised no fruit or fruit juices at all as they were found to be bad for IBS sufferers. I have still eaten fruit since then though. Good luck and let us know how you get on. x


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## Mary2001 (Aug 25, 2006)

Lemon 247
I have come across your posts as above but cannot find your follow up (maybe it's posted somewhere else) but I would love to know if you have had any success since. I have the exact same symptoms as you describe. Please post how you are now and what helped. Thanks x


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## Michael Cushing (Dec 29, 2015)

I have Pressure/Urgency/Tenesmus right now pretty much all the time. However, I also have massive prolapsing internal hemorrhoids that I need to have treated soon.


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## Mary2001 (Aug 25, 2006)

Michael just typed this into Google: diet for hemmerhoids sufferers. There is a few websites you might find helpful for which foods to eat until you go for your tests. I am going to look into changing my diet to see if it will help. It says spinach is very good for the bowels/digestion. I never ever eat that, so maybe it would be a start to have a dietary change. Good luck at your tests and please post how you got on.


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## Michael Cushing (Dec 29, 2015)

I also have problems with my digestion. I don't do well eating Spinach or Lettuce or any of that. I just wind up pooping out leaves and loose stools. It sucks having both IBS and HUGE Hemorrhoids. But 13 more days till I see the Colorectal Surgeon. That's not that long off.


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## Lemon247 (Mar 4, 2012)

Mary2001 said:


> Lemon 247
> I have come across your posts as above but cannot find your follow up (maybe it's posted somewhere else) but I would love to know if you have had any success since. I have the exact same symptoms as you describe. Please post how you are now and what helped. Thanks x


Things are overall improved, certainly not back to where they were pre-IBS but better than 2012. SIBO tests came back negative so I just ended up using a similar regimen as before:


trying to stick to low-FODMAP foods (I cheat here, more often than I used to, you really get used to going in public bathrooms)
tricyclic antidepressant (amitriptyline), which supposedly has a side effect of helping with these things

And that's about it. You sort of figure out over time what foods will give you problems, etc and adjust accordingly. Wheat usually sends me in one direction, while coffee sends me in the other (i.e. the bathroom)-- and you end up just planning your meals around it. Most of the time it's not a big deal except when friends want to go for "dinner and a movie"


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## Mary2001 (Aug 25, 2006)

Lemon 247 thank you for posting again. Have you had any tests for your pelvic floor or prolapse issues or is it definitely IBS and hemmerhoids is causing the feeling of incomplete evacuation (always feeling you need to go to bathroom versus trapped gas feeling)? I have never been too sure if it was a pelvic floor problem also. Did the amitriptyline help you with that feeling of needing to go when you really don't? I must have a look at the fodmap diet. I cannot pinpoint what foods is the cause of my symptoms or if it's hemmerhoids / weak pelvic floor, so very frustrating day in day as I can go ok to the bathroom first thing in the morning but then after that I keep thinking about needing the bathroom so many times and when I go there I sit straining thinking I haven't emptied properly, but the feeling comes back again and again and again. I'm beginning to think the more attention it gets the worse it gets, but pinpointing what's the cause would be such a help. I am beginning to think it's some "mind " thing that makes me think I need to go thinking there is more that didn't come out or else it's hemmerhoids. If I knew it was a "mind" thing then I would start ignoring it but I never know do I need to go or not (even though I've already been. It sounds crazy whatever causes it. I eat a lot of bread. What does wheat do to you. Maybe some foods really does play some part in causing that feeling of needing to go and go. Sorry I'm ranting a bit here! So frustrating. Again thanks for posting. x


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## Lemon247 (Mar 4, 2012)

Mary2001 said:


> Lemon 247 thank you for posting again. Have you had any tests for your pelvic floor or prolapse issues or is it definitely IBS and hemmerhoids is causing the feeling of incomplete evacuation (always feeling you need to go to bathroom versus trapped gas feeling)? I have never been too sure if it was a pelvic floor problem also. Did the amitriptyline help you with that feeling of needing to go when you really don't? I must have a look at the fodmap diet. I cannot pinpoint what foods is the cause of my symptoms or if it's hemmerhoids / weak pelvic floor, so very frustrating day in day as I can go ok to the bathroom first thing in the morning but then after that I keep thinking about needing the bathroom so many times and when I go there I sit straining thinking I haven't emptied properly, but the feeling comes back again and again and again. I'm beginning to think the more attention it gets the worse it gets, but pinpointing what's the cause would be such a help. I am beginning to think it's some "mind " thing that makes me think I need to go thinking there is more that didn't come out or else it's hemmerhoids. If I knew it was a "mind" thing then I would start ignoring it but I never know do I need to go or not (even though I've already been. It sounds crazy whatever causes it. I eat a lot of bread. What does wheat do to you. Maybe some foods really does play some part in causing that feeling of needing to go and go. Sorry I'm ranting a bit here! So frustrating. Again thanks for posting. x


I did actually get my pelvic area muscles looked at a few years back. I don't remember the exact tests but they had electrodes or something taped to me and I had to "flex" and so forth. Kind of awkward. I was supposed to do exercises or something. Back then I thought maybe it was a neurological thing...where it was the "feeling" of having to go even though there was nothing there. I'm not saying that there is no neurological component to it-- I have some other problems in that arena-- but after living with this and seeing the changes pre- and post-diet, I would attribute at least 80% or more of it to IBS. Sometimes I think people that get IBS-C or IBS-D are "lucky" just because they know what to expect, whereas with whatever the heck I have I get IBS-ugh-now-it-feels-like-I-have-to-go-but-I-already-did-twice-today-and-I-know-I-can't.







(That's what the "bad" foods do to me in general-- though some of them er...dry me up inside, some not so much...kind of difficult to explain w/o getting overly graphic







) FWIW I've never had any external hemorrhoids though straining all the time will probably lead to it, so bullet dodged I guess.

Anyway, check out the FODMAPS diet, or at least try to avoid the "big three" (wheat, onions, and garlic) for a while-- maybe a couple weeks or so-- and see how that works. Gluten-free bread sucks for the most part, though you kind of get used to it...and you appreciate good real bread when you cheat! I tend to eat more rice these days. If I adhered religiously to the diet I might not have good days and bad days like I still do, but I'm in a better place than I was before.


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## kenvh (May 16, 2015)

Hi lemon

I too have PI-IBS and I also had a raised calprotectin inflammation marker in the beginning.

I also have tenesmus a lot! I know the feeling.

fodmap isnt a real diet for tenesmus. SCD minus fodmaps is better.

I did the fodmap diet for 6 months, it did improve a very little.

but it stoped working bcoz there has been done more and more damage.. until u cant process any type of carb anymore.

I could eat patatoo and rice.. after a 10 months, I even couldnt eat those anymore.. the frequency and tenesmus went up.

In my believe: our source of problem can be VINCULIN.

specially when u are PI IBS/tenesmus.

see this video from pimentel for PI-IBS cause:






My believe is this mistaken auto immune response damages our GI tract nerves and enzymes and motility.

the fake nerve feeling is triggered by this, also motility out of wack: this gives the gurgling sound.

the break down of enzymes will finally end up no carbs at all.

Try to eat 4 days only meat and cooked veggs (no fodmaps) and u will see that tenesmus is better!

just dont eat carbs for 4 days, no rice, no patatoo. only fish meat and fodmap free cooked veggs. u will see its better.

Im just curious if the anti bodies we created against vinculin will down regulate in time or not?

U can try the reishi mushroom and boil tea from it.. it regulates immune mistakes.

I cant drink it bcoz i have an inflammed bladder also. otherwise i would drink it all day, i believe this can stop the immune response.

when anti bodies stop: inflammation and tenesmus stop too. then enzymes restore and motility too.


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## Mary2001 (Aug 25, 2006)

Lemon 247 thank you for your post and I'm glad you feel better with the fodmap diet. I get this feeling though every so often that something in my pelvis is falling from time to time that is causing the feeling of needing to go and go versus can't go, same as you describe. I get a feeling of bulging sometimes like I need to really go and can't. Do you experience the bulging in the back passage?


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## Patrick ibs c (Mar 5, 2016)

i feel bulging often


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## Mytlass91 (Jul 24, 2016)

I finaly found the thread that describe me exactly the same situation as you guys , at fist I think I was constipated cause I had this tenesmus all the time, and when I go to bathroom I either just pass wind a lot of or poop a small stool(cause there is nothing inside me) So doctors says IBS-C cause I had abdominal pain too the one that spread all aroud to your back , however , when I start to make low fodmap diet it kind of reduce my pain , I cant keep 100% low fodmap diet , cause in my country there isnt alot of food that is low fodmap but still I manage my pain, sometimes it comes right after I eat something but ... I took mebeverine and its goes better , however this feeling tenesmus  that I always need to poop or pass a gas , is killing me , Im using some fiber supplements for making my IBS-C better(if I ever have it) the only think that point my IBS is the abdominal pain and that some times my stool are thin, however I also have a hemerhoids I suspect internal cause they comes out only when strain. So right now im stukc with this tenesmus , I basicly go to toilet two times a day , evacuating not small but I dont think its also complete cause I definetly use to evacuate more before, so its really hard for me with this tenesmus my unviersity start in 2 months and I dont know what to do im basicly stick with this feeling and im not able to do anything I found one strange thing, that when I get dead drunk like I drink 300-400 ml of whisky this feeling start to fade away , but being drunk 24/7 is not an option . Nothing else change in my life beside this feeling , I feel energized I do fitness , eating normaly everything is good beside this tenesmus, and oh yes I have Helicobacter pylori and I used to treat this with antibiotics for 10 days and my whole IBS start in a month after the treating , so I make again test for HP and its positive so I still have this bactery in my stomach , my doctors says that HP have nothing to do with my problems but I dont know , if I should go for a longer antibiotics cycle and try to kill the HP and see if my symptoms improve , but yes definetly I can say this is related to the brain the more I think the worse it goes , I really dont know from where to strat killing HP or remove my hemerhoids or just go ask a neurology doctor for some amitriptyline? I see the thread is old I will be happy to hear what happend with your tenesmus did u find any salution?


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## laylow (Jun 2, 2016)

I am responding to this thread in hopes of reviving it and possibly hearing any updates from anyone who has posted in it. I feel like the symptoms of posters are fairly close to mine.

Here is a brief summary of my symptoms: Almost every day: Trapped gas (giving tenesmus feeling), lots of flatulence, stomach and intestinal gurgling. Point tenderness in stomach or duodenum area (constant), with occasional nausea and stomach pains. Occasional diarrhea and basically always lose stools with mucus.

I have tested positive for Fructose Malabsorption. My doctor has yet to diagnose me with anything.

I've been on Low Fodmap for over 2 months. Symptoms have improved, but tenesmus and gurgling still very frequent. Point tenderness and lose mucus stools basically everyday. Over the past 6 days, I have done 2 things:

1. Very strict Fodmap diet: Basically Fodmap/SCD combined, but even more strict. So what I have eaten:

Meats: Mostly chicken, some turkey, and occasionally beef

Fruits: Strawberries, Grapes, Blueberries

Vegetables: Green Beans, Carrots, sweet potatoes, and red potatoes

Drinks: Diluted Apple Cider Vinegar (first thing in morning), and water

2. Supplemented with L-Glutamine: I feel this has been a lifesaver so far. It has reduced my point tenderness stomach pain (possibly gastritis?) immensely, after dealing with it for about 8-9 months. I have worked up to 2 tsp, twice a day, right after a meal.

The biggest changes I have made in the past 6 days have been cutting oats, peanuts, and sugar. Basically no processed foods at this time. I am going to attempt to stay with this strict diet for another week and if I remain almost symptom free, I will consider adding things back in slowly to see what happens.

After these changes, my condition has improved quite a bit, but not perfect. The first 3 days I was virtually symptom free. Now I am noticing that the tenesmus has been greatly reduced, but still rears up once in awhile. The gurgling, however, seems to have increased! Also, gas has increased in the past few days but not too bad. My bowl movements have been reduced to once every 2 days instead of once a day, or usually more than once. I will keep experimenting and post updates.


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