# What to try next for IBS-D?



## Dave1111 (May 21, 2009)

I have IBS with the following symptoms:
- D
- Excessive gas (sometimes)
- Loose stools (i.e. if takes me forever to wipe to make it clean)
- At the times that I don't have D I feel as though I am all bunged up

- I don't spontaneously get pain however if I press down hard on my intestines they feel sore.

All the colonoscopies have come back normal (with some gastrointestinal inflammation noted)
I have tried the following:
- Fecal microbiota transplantation (did not work)
- Peppermint capsules (did not work)
- Calcium (did not work)
- Soluble fiber (mixed results, overall did not help)
- Rifaximin (gave me the weird sensation of both having D and feeling constipated)
- Salofalk (did not work)
- Sulfasalazine (did not work)
- Loperamide (seems to work somewhat in stopping the D but only at high doses and is inconsistent)
- Nortriptyline (seems to help but at high doses makes me feel bunged up)
- Iberogast (gave me gas)
- Chinese medicine (did not work)
- Chiropractory (did not work)
- Psychological therapy (helped me in other areas but did not affect the IBS symptoms)
- Diet changes (FODMAPS, low food intolerance diets etc) - did not make difference

I was wondering if there was anything else that could/should be tried, either traditional or complimentary treatments? Any additional investigations? I was wondering if there could be a bacterial component that does not respond to FMT?


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## bushja1 (Apr 23, 2003)

I have many of your symptoms and have tried many of the things you mention. Have you tried Lomotil instead of Loperamide? I have much better luck with it and less of the side effects of Immodium. The latter always made my gut feel tight and painful. It is prescription but worth asking your doctor. I had one gastro who wouldn't prescribe it because of perceived risk of dependancy, but I have never had a problem and I've using it off and on for over 20 years. Unfortunately, it just treats the symptoms. I have started seeing a Cognitive Behavior Therapist to try to address the psychological aspects of this disease. Too soon to know how that is going.


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## BQ (May 22, 2000)

Dave you might need to try a couple things simultaneously to make an impact. Most people find that a number of treatments working in concert helps them best. And in my case... my D didn't stop with imodium and calcium together.. but it did make it less urgent and more predictable. And that *did* make it easier to live with.


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## kthejung (Mar 30, 2013)

I've had IBS-D for 16 years and have tried many different meds and FMT also. I had high hopes for FMT and was devastated when it too ultimately failed. Next thing I will try is Enteragam. It is made from cow antibodies or something like that and I might as well give that shot.


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## squat2poop (Feb 2, 2014)

How you tried yogurt for a week? I used to totally avoid dairy, and just about everything else. But I had to force down the yogurt and now I love it and only eat it a few times a week. It was like a miracle for me. Try it!


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## goodmorning111 (Feb 20, 2014)

I found that imodium (loperamide) works for about 1 hour, then dies. Not good when you're grocery shopping, or not near toilets. that blackberry remedy diarsoothe does stop diarrhea, it's true. you do have to make it sweet though, its not juicy juice sweet.


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## happymommmy (Jan 28, 2014)

yes, the diarsoothe for ibs-d. you don't have to take that much, either.


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## Dave1111 (May 21, 2009)

Enteragam - I had a look at this however I could not see how this would work (i.e. it seemed to be more about treating lack of nutrition associate with IBS).

Thanks for all the above suggestions - I will try Lomotil. Any further suggestions? I was wondering whether I should see another medical specialist aside from a gastro since I have seemed to have exhausted all of the mainstream options. I was thinking of seeing a endocrinologist to see if there could be a hormonal imbalance - has anyone ever done this?


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## FoodandFitness (Mar 17, 2014)

Dave,

Have you considered getting a MRT (mediator release test) to test for food intolerance with a RD specialized in LEAP diets? Often times IBS triggers are not "one size fits all" and you can narrow down your specific reactions based on a test like this. Here's a link to more details. A colleague of mine specializes in this kind of therapy and there's a lot of good scientific research and results to demonstrate the effectiveness of such combined therapies http://www.susanlinke.com/portfolio/leap/gallery/labs/ Here's the link.

I think something like this would be a more calculated approach than just a shot in the dark and trying to combine your mentioned therapies.


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## Sarah Dunsbee (Mar 22, 2014)

have you tried actual food intolerance testing...


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## chlorophyll (Jul 31, 2013)

Try chlorophyll. You've tried everything else, so why not and it's cheap (and works super-well for some of us with IBS-D).

edit: I'd also say to try those cereals advertising themselves as having added fiber. Sometimes I snack on them dry (I don't drink milk) and they seem to make a noticeable difference. Chlorophyll tends to swing me from being terribly IBS-D into the other direction and really puts a halt to things, and sometimes a bit too much. I don't remember ever having such perfectly formed and also regular (daily) bathroom trips as when I was taking chlorophyll and also snacking on some "added fiber" cereal. My IBS-D was subdued, but I was also still going regularly. It was glorious.

I've been lazy lately and not taking any chlorophyll because I've been feeling pretty ok for awhile, but by chance this week I've been snacking on some more "added fiber" cereal and toilet-life is better than it usually would be under the current circumstances. Something to consider.


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## PD85 (Aug 19, 2010)

How about completely changing your diet or examining every food in your diet very closely?


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## happymommmy (Jan 28, 2014)

Ditto- imodium is so temporary, and when it did work, it was good for an hour- ugh. using diarsoothe now. it's very refreshing, actually gives a boost, and alleviates cramps, diarrhea. it helps me with nausea, as well.


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## goodmorning111 (Feb 20, 2014)

Have you found your trigger foods so as to avoid them? also, digestive aids and amazon sells Diarsoothe,


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## ericlahey (Jun 12, 2013)

Try out SMECTA http://home.intekom.com/pharm/pharmpln/smecta.html

I take it once a day, an hour after my dinner. Its a natural silicate based clay which removes toxins from your gut and reduces inflammation. The 2 things that make IBS-D a snowball effect once you're in flare up.

Also...


Reduce intake of food, stick to 3 meals a day (My diet is 2 bananas in morning, soup or light meal for lunch and something healthy for dinner.. I have the odd small snack here and there.. but try to limit it)
Stay away from those bad foods like Tomatoes, onions, peppers, brown / refined breads, beans, short grain rice, fizzy sugary drinks, chocolate, etc..
Drink more herbal teas (lemon, chamomile) but stay away from green teas / black teas and especially coffee
Have an immodium every 4-5 days or when your body is going into a real shock to get you back into a rhythm.
Chew all your food well and have yogurts (natural and sweetened purely with lactose) after meals.
I know it's probably just me, but stress can cause things to worsen, I have nicotine patches that I use every day, as they kind of make you feel a lot more balanced (not that I smoke or anything).

You should soon feel better and lead a more normal life.. That worked for me anyway after trying everything these past 15 years. Also if you can, get a stool for your toilet, so you can have a squatting position (makes going easier and more natural) and ensure you have wet toilet wipes.

Good luck!


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## IBS2 (Feb 7, 1999)

Dave,

I would recommend you look into Lotronex, which besides using other anti diarrhea meds like immodium is the only thing that has given me a degree of consistant control. I would also add probiotics to your daily regimen. I use Align, but don't expect results any time soon. It will takes weeks if not longer to see any improvement with the probiotics,


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## bushja1 (Apr 23, 2003)

I was under the assumption that Lotronex was only for women. If I remember, my doctor let me try it when first on the market and I thought I was going to die. I've tried so many meds over the years that I forget which ones I've tried, but I'm pretty sure it was Lotronex and it was not good for males


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## IBS2 (Feb 7, 1999)

I don't think it was the fact that Lotronex was "not good" for men, rather the clinical testing was limited to women. I assume this was done because by percentage women are more effected by IBS. I can tell you Lotronex is effective, but must be used with care. I had to go to a gastroenterologist to get a prescription and needed to sign a release. Also it was not covered by my insurance company, so I now use it sparingly.


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## gettingbetternow (Mar 23, 2014)

that diarsoothe stuff is still working for diarrhea- needed it for an extremely stressful meeting. You wonder if something will work after using it several times, yeah, it does.


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## BQ (May 22, 2000)

So glad to hear it is working so well for you!


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## jstezelecki (Sep 23, 2013)

Lomotil ( IC Diphen/Atropine) works well for most people. Though it's a narcotic It's only addictive if it's used in very large dosages that are not prescribed for IBD D.


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## acureisoutthere (Jun 28, 2014)

Hi,

I'm curious about the protocol that you followed for the FMT. Please Google : Probioitic Therapy Home Infusion Protocol.

Is it possible that if you followed this protocol, you might have success ?

Some other thoughts to consider and research : (1) Soil Based Organism probiotics

(2) consuming small amounts of good clean dirt, that stuff that babies can't wait to put in their mouths, and doesn't kill them. Dirt has many more strains of bacteria than even the best probioitc. More research.

(3) taking Colostrum supplements to heal the muscosa, along with multistrain probiotics.

It seems that each person's problems and successes are a little different. I would guess this is due to the many, many different kinds of bacteria in our gut flora, and that one person has an overabundance of a few bacteria causing their problems, while another person has an abundance a few different bacteria causing their problems.

I'd really like to hear more about your experience with FMT.


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