# Post-Infectious IBS



## softness (Jan 17, 2009)

Hello,I see there are IBS type-specific forums, but I don't see one for post-infectious IBS, though there is an option to choose IBS-PI when you register to this forum. Can anyone offer advice specific to this type of IBS, or a resource or something?As many of you, I am living with this, and have a doctor who doesn't really give me any other advice than to "wait it out"... Actually, no, he doesn't really give me advice, he just says "Oh it's just irritative bowel syndrome"... and doesn't say anything after that, as if this evident statement alone could stop me from being sick, or at least stop me from requesting him to find what I have.I go from constipated to liquid diarrhoea in a cycle that doesn't seem to stop. This all started when I traveled India and got Giardia Lamblia parasitic infection which nobody could diagnose for nearly 4 months. I was set on Lomotil and kept taking it for months, and when I stopped, I was in deathly pain. Back home they finally found the parasite, treated it, but I didn't feel much better and for a long time I just thought the parasite had resisted the antibiotic. But cultures found no traces of anything, and finally my doctor told me what I mentioned above, with nothing else to help me, no advice, nothing. I just called his office to see if he can transfer my case to a gastro-enterologist.So if anyone knows where I can refer for information specific to post-infectious IBS, I would be very thankful as my doctor has proven to be quite the opposite of helpful.Thanks so much, and good luck with your IBS's!


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## Kathleen M. (Nov 16, 1999)

There really isn't a completely different treatment that works only for Post Infectious IBS that is not used for any other kind of IBS (although it seems most IBS is post infectious).Generally I've seen by the second to third year is when the if it is going to go away it has gone away. Usually you need a minimum of 6 months of symptoms after the infection is cleared to know if it is post-infectious IBS or just normal post infection sensitivity.Usually when people alternate (especially if you go pretty much from constipated stool finally passing to liquid diarrhea) the more important part is preventing the constipation as if you go pretty much every day your body never has to go into "flush mode" to get the stool out and then isn't over-empty which sets you up for the next batch of constipation.If daily fiber isn't enough to keep you going you might look at an osmotic laxative. Either magnesium oxide (in the supplement aisle) or miralax, which is now OTC rather than prescription only at least in the US.If you want something techincal focusing on post infectious IBS there is this article http://www.ncbi.nlm.nih.gov/pubmed/1799133...Pubmed_RVDocSum These are usually fairly readable review articles from this journal and any library should be able to get in on interlibrary loan if you don't have a medical school handy.I would see if you can see a gastroenterologist. There are treatments that work for IBS, but really for a lot of people the mental stress of thinking they are dying and then finding out they have something that is annoying rather than lethal can help with the symptoms. Reassurance is part of the psycho-social treatment for the disease and how the doctor interacts with you and what they say can be a part of the appropriate treatment, believe it or not. I know people that do clinical research and sometimes they have to not let certain doctors interact with clinical trials because they are very good at that part of healing so generate very high cure rates even from the patients on placebos.


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## Puppy3D (Jul 28, 2004)

Hi I have Post-infection IBS too. My IBS started after parasit infection in the hollydays. First I had two days diarrhea and after that, constipation, bloating and pain started. I had to quit school because of this symptoms, that is eight years ago. How do you treat PI-IBS depends on your symptoms. If you have diarrhea you probably try Immodium. If you have gas, than probiotic is worth to try out. Probiotics rebalance gut bacterial flora, which is often damged after infection.


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## tumbelina (Nov 23, 2008)

Stool cultures may miss giardia. It's recommended you take cultures at several different times, including when/if you have diarrhea, to ensure the giardia infection has cleared. Once you have giardiasis, it can take a few rounds of treatment before you manage to get rid of it.You could have IBS-PI, but it might be worth having stool samples taken again a couple times to be sure. I have IBS-PI and have so far found strong probiotics to be the most helpful thing for controlling symptoms.


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## softness (Jan 17, 2009)

Hi guys and thank you so much for your help!!! Everything you have said has been helpful and I will reply to it all right here.* Kathleen :My giardia infection was originally contracted in February 2008, and a truckload of Indian doctors could not find what I had. I had to come back here to get it diagnosed, and finally got treatment in the end of May. Since then I have still had symptoms, so it's been what, 8-9 months I've had these symptoms if you only start counting after the end of the infection.I have thought about treating the constipation when it comes along, but I'm so scared of provoking another bout of diarrhea by using laxatives that I just wait it out. I will try it though, and see if it can reduce the risk of going into flush mode.Thanks also for the articles, I'll see if my university will transfer some issues of the journal for me.I'll definitely see a gastroenterologist. I can't say I have any stress or anything, mostly annoyance. I'm also quite lucky because the severity of my symptoms isn't so high it interferes with my life so much. I only get severely sick about once a month, the rest of the time it's the annoyance of constipation and bloating, followed by periods when my stool has no consistancy and I go several times a day, but it's not like I have daily cramps that make me run to the toilet every 5 minutes. Since January 2008 I have taken anti-depressors which I stopped using in August with amazing results. I have never felt better or less anxious in my life, so I don't think emotional stress is so much a factor right now (though working on my master's and financial problems do make life a bit stressful sometimes).My relationship with my doctor isn't so great though. He's really nice as a person, but he doesn't really answer my questions, and sometimes I feel like I'm wasting his time. I wish some health professional would give me the information I deserve, you know? Anyway, thanks very much for your advice, it's very helpful.* Puppy3D :Wow, that is quite a story. Kind of scary and depressing for me







I'm very lucky, my symptoms aren't so serious that I need to quit studying or anything. For sure I need to work my day around toilet breaks, but sometimes my gut leaves me alone for several hours and mostly I never need to run to the toilet or anything.I have tried probiotics but they cost so much here in Canada! I'll see if I can get them prescribed, maybe that way I can afford them, but I have no idea if probiotic is a type of medicine that can be prescribed and covered by health insurance. I didn't want to try Immodium first because my symptoms vary so much and go in a cycle, and also because I can't see the regular use of Immodium as something good long-term for your gut, what do you think? Maybe I should consider it. Anyway, thanks a lot for your reply.* Tumbelina :I know, Giardia can be tricky to find, but the very first time they did the culture they found it right away, and I had some pretty agressive treatment to it. I took antibiotics (I think Flagyl) twice a day for the first week, and then three times a day for another week. After that I have given in three samples taken at various times, all came back clean. Do you think this is enough? Should I try out again? I tried to take the samples mostly when I had diarrhea, to make sure whatever needed flushing out would get flushed out, and there would be a better chance at finding the parasite if it was still there.Thanks for the hint on probiotic, so far it seems to be the thing that most people are raving about. I will see if I can get it prescribed because BIO-K sure is expensive here in Montreal. Thanks so much for your reply!


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## Kathleen M. (Nov 16, 1999)

I'd stick with the lowest dose of an osmotic that keeps things moving most of the time. Stay away from the stimulatory laxatives that tend to cause a "flush mode" of their own.The osmotics just pull water into the stool so you just want to try to keep it a little bit wetter to see if that keeps things moving rather than waiting out 2-4 days for the body to send a bunch of water through the system to push it out.


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## dmark (Jan 29, 2011)

Puppy3D said:


> Hi I have Post-infection IBS too. My IBS started after parasit infection in the hollydays. First I had two days diarrhea and after that, constipation, bloating and pain started. I had to quit school because of this symptoms, that is eight years ago. How do you treat PI-IBS depends on your symptoms. If you have diarrhea you probably try Immodium. If you have gas, than probiotic is worth to try out. Probiotics rebalance gut bacterial flora, which is often damged after infection.


I have Post Infection IBS too. I was misdiagnosed for 1.5 years and have had good results from Imodium. Long term I am looking at the Cedar Sinai method for remedy. I just ordered the book and plan to find a doctor that can provide some advice. After 1.5 years of frustration the improvements is so welcome. I feel like myself again.


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