# Undiagnosed and scared



## VictorCharlie (May 17, 2013)

So, to begin with, I'm a 32-year-old male who has suffered intermittently from stomach problems - usually related to anxiety and stress - for most of my adult life. My counsellor says I carry my anxiety in my stomach. About three years ago, I began to experience some quite disruptive symptoms (leakage, morning diarrhoea etc). My doctor was very sympathetic but said it just sounded like IBS coupled with poor diet.

Since then, the symptoms have been pretty manageable and unobtrusive. For the past 6 months to a year, I've subsisted on an appalling fatty and sugary diet, due to my determination to maintain my weight and also quite severe depression which made cooking another unneeded chore. (Ironically, last summer, I had suicidal feelings for the first time in my life, and the health anxiety and associated symptoms melted away).

About six weeks ago, I was prescriped a new anti-depressant (Effexor) at a higher-than-usual entry level dose. A few days later, I had a fairly severe attack of diarrhoea, panic attacks and reflux. This has happened before with high doses of anti-depressants from scratch, so I wasn't unduly concerned.

Since then, however, it's returned intermittently and with varying severity. My doctor diagnosed a stomach bug circulating in the community at first. I went back yesterday after a relapse, and (another) locum prescribed an anti-biotic (Flagyl), because she reckons it's bacterial. I know this isn't ideal with diarrhoea, but I feel I have no choice but to try it. If that doesn't resolve it within a week, she says she'll arrange a "camera test" (colonoscopy, I presume).

At the moment my symptoms are sudden urges (usually when out in the city centre), followed by a large mass of fairly pale stool and then 5+ movements of mushy, pale, grainy-looking stool over the subsequent 24 hours. I've also lost some weight, which is naturally stressing me out, though I haven't been eating my usual amount. No blood or abdominal pain.

I've never been so miserable or scared in my life and I'm really at my wit's end with this.


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## BQ (May 22, 2000)

Well let's wait and see how the Flagyl works. And sometimes Flagyl can take more than 1 week to have an impact... so I would finish the course (usually 2 weeks) first before making any decisions.

Keep us posted!


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## Louise Rizzo (Apr 16, 2013)

Hi,

I suffer with IBS-D and anxiety (mostly health anxiety) so I can really sympathise with you. When my symptoms first started (back in January) I lost a fair bit of weight, which made me panic as I'm really petite anyway so I certainly didnt want to loose weight.

I think my IBS is certainly mostly caused by anxiety, I notice when I get anxious or upset I start getting cramps and diarohhoea. It's good you're seeing a counsellor. I recently finished having cognitive behaviour therapy, which has helped me quite a bit! I'm learning how to cope with my IBS flare ups ( before I used to get really upset anytime I felt Ill) as well as learning how to cope with my anxiety, when I'm relaxed I notice my IBS calms down a lot.

Don't worry, it does get better. I think you should keep at the counselling, maybe ask for information on health anxiety as well as exercises to practice coping with anxiety. I think once you acknowledge what's causing your anxiety your IBS will calm down. Also, with regards to medication, I'm taking mebeverine an anti spasmodic tablet which slows down my bowel movements which really helps with the D!

If you need any more info on health anxiety, let me know. I got quite a lot of stuff from my therapist


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## VictorCharlie (May 17, 2013)

Thanks for the replies, guys. I got through a major meeting yesterday by dosing up on Imodium, and committed to five weeks of work in the office (I haven't been working recently). Naturally, that's a daunting prospect in the circumstances. I hope the Imodium gets me through it and things don't go further downhill.

I'm really convinced something is seriously amiss here. The severity and persistence of the symptoms is such that I can't believe it's simply due to IBS (which I haven't been formally diagnosed with, having only had blood tests - all normal except slightly elevated cholesterol - during my last major episode three years ago).

Louise, that info would be helpful. Willing to listen to anything at this stage.  Thanks. BQ, I've only been given a week's prescription of Flagyl (21 @ 3 p/d), but I'll finish the course.


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## Louise Rizzo (Apr 16, 2013)

That's really good. Just make sure you don't back out, don't let IBS get the better of you. Otherwise it just turns into a vicious circle, honestly I have found that its best to try and continue with things that you normally do and enjoy.

The symptoms could be so severe because you're worrying about it all, I find this is the case with me. Perhaps Imodium isn't strong enough, maybe go back to your doctor and get something prescribed. I started off with Imodium and it did nothing for me, but mebervine does.

Unfortunately, doctors can't actually properly diagnose you with IBS as it won't show in blood tests, stool samples etc, they can only diagnose by your symptoms.

I will send you the info in a private message


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## BQ (May 22, 2000)

If the problems persist perhaps look into some Cognitive Behavior Therapy. See out CBT/Hypnotherapy Forum for more info.

Also here is a good article:

http://ibs.about.com/od/treatmentofibs/p/cbtrx.htm

Please do not underestimate the severity of IBS symptoms. Many of us have severe symptoms and .. it is *just* IBS. I would try to relax as best you can as anxiety will only aggravate your symptoms as you have seen.


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## VictorCharlie (May 17, 2013)

Thanks BQ, appreciate that! Apologies, I didn't mean to underestimate the severity of IBS. I've read heartbreaking stories here and elsewhere, and I know it's a life-changing and extremely debilitating condition for many people. It's just that my own symptoms have never been as severe or prolonged before, which leads me to suspect it might be something more sinister (though I know the worst candidates are relatively rare in my age-group).


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## Dianaearnshaw (Feb 22, 2013)

Hi I'm a nurse and nutritionist.

I think that you should have all that the tests your doctor offers just to rule out any other problems but my impression is IBS.

Doctors tend to treat symptoms but as you confessed, your diet has not been great and as a nutritionist - I believe that this is perpetuating the problem although it may not be, on it's own, the cause.


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## Leila1934 (May 15, 2010)

IBS-D, just like old age, is not for wimps! I have lived with it for about 15+ years and have spent time trying to figure it out. It is an elusive condition - sort of like trying to hold on to an eel or greased pig. Here are a few of my experiences with the 'devil'.

My IBS-D began after changing antidepressants from desipramine (generic) to Zoloft because a new doctor said the initial med was out dated. However, it turns out the initial med was suppressing the symptoms. I endured all the tests, and at the end, the doctor announced that it was IBS.

I told him that after serious bouts, I felt awful and asked what foods might be beneficial to put into my system. I thought that was a reasonable question, but his reply was, "Just regular food". I realized I was going to have to do some research on my own, if I wanted helpful answers.

Before I tell you some of the things that helped, I want you to know that my IBS-D has not been cured, only somewhat improved more of the time.

1. Convinced that food played a huge role, I read Heather Van Vorus' book: Eating For IBS. Trigger foods are listed, the difference between soluble and insoluble fiber explained, along with many recipes helpful to the IBS sufferer. I gave up carbonated drinks, rich/fatty foods, lessened amount of sugar in recipes, milk, beef, whole wheat bread, etc.

2. I found that eating smaller portions at one time reduced the bathroom dash. Now I eat 1/2 and take the rest home.

3. I learned to listen to my gut and take the messages seriously e.g. if I'm in a store and the gut is indicating it may need a bathroom, I DO IT NOW. Before IBS, delays would be o.k., but that option no longer exists. The first thing I do is locate the bathroom, so I'll be ready. I always joke that I know where every bathroom in San Diego is located.

4. I went to Croatia for 3 months to teach English. The thought of being in the air for so many hours was scary; however, I refuse to let IBS turn life into a cage. During the 20+ hour trip, I drank only water and made it both ways without problems. (I would not go to a third world country where food is different and bathrooms uncertain.) While in Croatia, I had no problems with IBS, and so I analyzed the differences in food. Every day there is a farmers market with any kind of fruit or vegetable you can find in Southern California. Anyone who has a piece of land plants vegetables. (A good question would be, are insecticides used?) Bread is made fresh everyday and has no preservatives. Drinks are cool but not filled with ice cubes. There were no opportunities for fast food in Trogir. The pace of life is much slower, and everyone takes time for coffee or tea on the Riva.)

There is more but must stop for now.


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## VictorCharlie (May 17, 2013)

An update on this; I got through the weekend on Imodium (two tablets bung me up fairly comprehensively), felt okay Monday, and then had my first day (minus Imodium to see how it went) at the office today. It was going okay until lunchtime when I had a bottle of water and some (very little) shortbread, and immediately became gassy.

The urgency struck during a meeting, but I held out until 5.30, at which point I went to the bathroom. I was freaked out to see some dry reddish matter embedded in the loose stool. Is this how blood in the stool would present? I'm gonna go and see my doctor tomorrow anyway because of the recurrence. It looked more like food matter to me, but I don't remember eating anything which might have caused it, other than tomato-based bolognese sauce I eat most days. Anxious beyond belief now.


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## BQ (May 22, 2000)

> Is this how blood in the stool would present?


No. Blood in the stool would make the stool very dark (black) tarry with a stickie consistency. The matter you saw in the stool was more than likely something you ate. Very likely the red sauce you ate. Use the imodium! It seemed to work for you. If 1 tablet is too much... break it in half.

No reason for anxiety.... all of this is very typical for IBS hon.


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## VictorCharlie (May 17, 2013)

Just a further update on my progress. I didn't return to my doctor as the symptoms largely cleared up. I was still having periods of discomfort, gas, morning urgency etc, but only really one episode of loose stool, and that passed quickly (no pun intended). The weight loss I was concerned about has been reversed (I've gained at least three or four pounds since, though I'm probably still underweight), and I've become a little lax with my diet.

Unfortunately, the diarrhoea has struck again today (two loose-ish movements, small amount of mucous) for the first time since the end of May. I'm having a very busy and stressful time at work, and I've got best man duties to perform at a wedding on Saturday. I'm wondering if it's worthwhile going back to my doc without further symptoms. Given that she's already essentially diagnosed me with IBS, I'm not sure I'll get anywhere presenting with intermittent diarrhoea flare-ups coinciding with stress.


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## VictorCharlie (May 17, 2013)

Latest update: Saw my regular doc for the first time during the current episode today. I went back because the gassy bloating was making my worklife a misery and also worrying me (as a fairly sudden escalation).

Strangely, as the doctor who initially "diagnosed" my IBS, she didn't mention IBS at all. Her theory is that the stomach bug that caused the original bout of diarrhoea has also left behind a lingering malabsorption or "temporary" intolerance problem. She prescribed colpermin capsules and Fybogel (ispaghula) and said to come back in two weeks if there's no improvment.

Same story today. As soon as I put anything into my body (a cup of tea at 4 p.m.) the bloating and urgency hit, and I had to go immediately when I got home at 6. Stool was again firm. Very puzzled by the whole business.


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## KevinMT (May 20, 2013)

Everything you describe is very much related to stress/anxiety/health anxiety ... I have gone through and continue to deal with similar issues...as far as the weight goes, I started drinking an Ensure (or a generic equivalent) each day--in the USA they come in 8 oz bottles (vanilla, chocolate or strawberry)..they taste good and you can get 250 or 350 calories in one serving. You may want to give it a try--it has helped me maintain weight and they seem to have a calming effect on my stomach more so than most foods. Kevin


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