# What to try next?!



## MIRMAK (Sep 27, 2009)

Hi everyone,I'm new to this forum, I just recently found it. I'm sorry that you probably read a lot of such similar topics, but I think that time is came to ask for some help for me.I think I have IBS-D (but doctors didn't say it officialy) for already more than 1 year, it is started in July of 2008. I tried to remember exact day, but I could, I tried to think what caused that, but also I could, I didn't do anything unusual in July, no changes to life style or etc.My main problems is: mucus excretions (usually it happens, before I feel that I need to go to toilet, but usually I can even hold my feeling and won't go to toilet and wait more than one hour, but mucus excretions are there), diarrhea (usually 7-8 times a day, in best days 4-5), pain in right side of the stomach, gas (but it is not irritate me so much compare to everything else). A little bit more about mucus: it is transparent (white) color, I think without any smell, but there a lot of it and during all day. And because of this, I can't wear anything except jeans, if I will wear trousers from more thin fabric then there will be "water" spots on my back







Also I fill irritation and can't some times sit still for half an hour even, because of mucus my back often become irritated. Sometimes I also see mucus in my stool.And I'm still straggling with that. I already visited a couple of doctors, made as they said all possible investigation: colonoscopy, echo, x-ray, endoscopy, blood tests, faeces tests. And it seems that everything is okay. So they couldn't find any cause of my problems. What they found, that I have really fast digesting (or maybe I could digest a lot), because all food, which I eat, coming out in around 8 hours.I tried to eat different food: tried to eat mostly rice, tried to eat almost only fruits, tried to not eat fruits or vegetables, it seems that food doesn't influence on my symptoms at all, maybe only amount of food, if I eat less, then it is nothing to come out or it is coming out in small peaces, then I fill better, but mucus is still there. Also I tried to eat the same food for couple of days, and one day I felt really bad and another it was pretty good (just need to go to toilet 5 times and less mucus.)About medicine:loperamide - didn't really help, I was needed to go to toilet the same amount of times, but to spent on toilet more time, because it felt like constipation.metamucil - two times, maybe it helped a little, but all problems are there. It makes easier to come out and bigger in amount of faeces.decitel - was not prescribed by doctor, I decided to try it myself, tried for a month without success.magnesium oxide - nothing happen.immodium - also without any success.nifuroxazide - the same result.Maybe I forgot something, if I will remember, I will add.Currently my doctor prescribed Questran, I was taking it from Tuesday (so for 5 days, but I stopped today), because I felt my self even worse than before, I was needed to go to toilet even more often, my pain increased, usually I just fill a pain all day long, but it was increasing and felt like I need urgent go to toilet. I will try to contact my doctor on Tuesday, but will see if it possible. What do you think, should I continue with Questran and it is normal feeling which I have, or if it didn't work for me, then I should seek for something else.Now I'm thinking what to try next, because doctor couldn't think of anything, and she said that maybe we can try loperamide again, but I know that it won't help. Any suggestions, what should I try to take next?I was thinking about lotronex (but I'm a man and also I live in the Netherlands, so most probably, I couldn't find it), cilansetron, renzapride, zofran, kytril, but I don't know if it will be possible to find (can my doctor prescribe them or not?!) in the Netherlands.It is really hard to me, currently I'm 25 years old and it is really hard to me live like that. I reject my family (I have small son) to go anywhere on weekends, I reject my friends to go anywhere outside. Usually I spent all my days at home. It is good that my work only in 40 minutes from home, so I still can go to toilet when I wake up and then when I get to the office. Every trip on plane or train or else make me scare. Very often I think that it is better to die, than live like that, but I force myself not to think like that because of my son.Will be thank you for any answer/help!!!


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## AliceD (Sep 19, 2009)

I don't have any answers, just sympathy for how bad you are feeling. There are a lot of things that can cause mucous in the stool and IBS-D is just one of them. Your doctor should rule out ulcerative colitis, bowel obstruction, bacterial infections such as salmonella or yersinia, anal fissure, bacterial overgrowth. etc. (The Questran is curious, usually they give that to someone who has had their gallbaldder out.) Don't give up. Remember you are worthy of finding an answer and keep asking questions until someone gives you the help you need. You will always have a sympathetic ear here, and maybe someone else will read your story and be able to share what has worked for them. Good luck!


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## Kathleen M. (Nov 16, 1999)

Questran was initially approved to reduce cholesterol. It does bind bile. It is constipating for a huge percentage of people who take it no matter what their stool consistency it.It doesn't get into the body so is pretty safe (but it does seem to upset the stomach of some people) and it usually can't lower your cholesterol too much or have the side effect of some of the other cholesterol meds.Now they use it for people who can't control the release of bile and/or can't recycle the bile. However there seems to be some people that are unbalanced without surgery to remove the gall bladder or the tail end of the small intestine. And even if your bile is perfectly balanced it will still be constipating for something like 1/3 to 1/2 of the people who take it. Questran is on many lists of drugs for IBS-D and does not require gall bladder removal. Although it is often prescribed for those who have had that surgery as well as a few others.I mean the only reason you take Imodium for diarrhea is it is a constipating side effect without the main effect of the other narcotics.Loperamide is Imodium so usually if one won't work the other won't either.Not sure why you too magnesium oxide, usually it causes diarrhea, not prevents it.Calcium Carbonate is usually the mineral supplement people around here use to bind things up and firm up the stools (it is known for it's constipating side effect).I don't see a tricyclic antidepressant on your list of things you've tried or things you are thinking about. Sometimes that will work, especially to reduce pain in people with IBS-D. So that may be something to look into.


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## MIRMAK (Sep 27, 2009)

First of all, thanks for everyone!!! It is nice to know that somebody hear you and even able to write!


AliceD said:


> (but it does seem to upset the stomach of some people)


It seems that it is my case. Because I felt even worse than without it. I was needed to go to toilet much more and also I felt really bad pain and urgent feeling with that pain. And also I didn't feel empty after any visiting of the toilet. So as I said I stopped for now, will try to contact my doctor tomorrow, if it will be possible.


> Now they use it for people who can't control the release of bile and/or can't recycle the bile. However there seems to be some people that are unbalanced without surgery to remove the gall bladder or the tail end of the small intestine. And even if your bile is perfectly balanced it will still be constipating for something like 1/3 to 1/2 of the people who take it.


Is there any test to check control of releasing or recycling of the bile?It didn't get any constipating effect after taking Questran.


> Not sure why you too magnesium oxide, usually it causes diarrhea, not prevents it.


I also got physiotherapy and doctor said that maybe I have a lot of hard stool in my bowel, which can't get out and only small pieces (water) are coming, so my main doctor just perscribed magnesium without any checking.


> Calcium Carbonate is usually the mineral supplement people around here use to bind things up and firm up the stools (it is known for it's constipating side effect).I don't see a tricyclic antidepressant on your list of things you've tried or things you are thinking about.


Thank you for suggestion. I will put these two also in my list and will ask my doctor.


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## mrae (Apr 28, 2009)

HAVE YOU TRIED LOMOTIL YET? IF NOT I WOULD GIVE THAT A TRY IT HAS BEEN THE ONLY THING THAT GETS ME OUT OF THE HOUSE AND I STILL AM ABLE TO HAVE BOWEL MOVEMENTS THE NEXT MORNING BUT ONCE I TAKE 2 LOMOTILS IN THE MORNING I AM GOOD ALL DAY WITHOUT WORRY.


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## TVgirl (Sep 16, 2009)

you said you tried dicetel without a prescription. I am curious are you in Canada? from what I understool it isn't in the USA. I am also curious about how much dicetel you were taking. I am in Canada and have prescription for dicetel. I found my tummy to be a little more relaxed and my bowel movements seemed a bit more regular. however I was on nexium and stuff so I decided to go off everything and retry. so I will be going on dicetel again soon. I am just curious because if you weren't taking a high enough dose three times a day that may be why it didn't help you. Other than that I would keep up with the metamucil because you did notice some help. How much of that were you taking and how often? I think the calcium might be a good idea to try. buy the calcium that isn't mixed with magnesium. should just be calcium and vitamin D.I think Buscopan is another medication that is a relaxant that might help. worth asking about.Somebody else had luck with glycopyrolate which is an anticholinergic which dries you up. ask doctor as I don't think this is a typical drug used for IBS.Have you been tested for food allergies? celiac disease, fructose or lactose intolerance. Have you tried cutting out dairy. Have you been tested for H-pylori ? some people with this don't just have stomach issues but can have the diarrhea as wellAbdominal ultrasound can check for gallbladder disorders.any chance you could have a hernia that is affecting your bowels....like inguinal hernia which is more common in guys?Just throwing some suggestions out there.I really liked this website. This doctor talked alot about psyllium which is in metamucilhttp://www.kidstummies.com/pdfdocuments/Ir...e%20Handout.pdfgood lukc


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## MIRMAK (Sep 27, 2009)

mrae said:


> http://www.kidstummies.com/pdfdocuments/Ir...e%20Handout.pdfgood lukc


THANK YOU! I will read it!


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## On Edge (Aug 25, 2009)

The thing I can suggest is psyllium. It really helps to create a formed stool and fewer stools a day. You need to take it twice a day, morning and night, and be persisitent, just a few days is not long enough. As for the mucous release, do you have leaking liquid mucous constantly? I had that problem before for over a year but it disappeared slowly over time. At that time I found that folding a piece of tissue or toilet paper and sticking it partly into my butt absorbed most of it.


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## MIRMAK (Sep 27, 2009)

On Edge said:


> As for the mucous release, do you have leaking liquid mucous constantly? I had that problem before for over a year but it disappeared slowly over time. At that time I found that folding a piece of tissue or toilet paper and sticking it partly into my butt absorbed most of it.


Yes, it is constantly, every days, when I wake up after couple of minutes (1 minute) it starts, usually it is gone for some time after visit to toilet. And some times (not every day) it can be a lot. Do you fill comfortable with tissue or toilet paper? Does it irritate you butt?


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## MIRMAK (Sep 27, 2009)

Tried to reach my doctor for already three weeks and finally got in touch. Described my problems with Questran and she said that there is no other solution for my problem except Loperamide. I tried to argue with her that I already tried it and didn't help and asked if there any 5-HT3 antagonist or maybe any antidepressant on a market which she can prescribe for me, but she said that there is nothing and asked me to play around with loperamide: try for 1 week 1 tablet every morning, next week 2 tablets. Should I try it?Also, I'm thinking it is the best time to try calcium, which I will try to order in USA.I still have appointment on 3rd of November, so I don't know what to do, try Loperamide or go to my GP and ask for another specialist.


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## Kathleen M. (Nov 16, 1999)

Generally with Imodium (Loperamide) a lot of IBS-D types can find a dose that works. Usually a twice a day dosing gives the best results. So I'd try 1 tablet twice a day and then work up in dose to see if you can find one that works.Calcium is another thing worth trying. You may be able to find a calcium carbonate formulation where you are, it is pretty common. Just look for one that is almost all calcium and very low in magnesium.It may be worth seeing if you can find a gastroenterologist that believes in other treatments for IBS-D.


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## MIRMAK (Sep 27, 2009)

Went to GP today with almost no success, she was just saying, that if specialist didn't find anything and said that loperamide is last posobility, than she is also thinking, that I should accept my current situation and live with that. I hate it! It is easy to say like that without such problem, she thinks that it is easy and acceptible to go to toilet 6-8 times a day (some times 3-4 times just in the morning) and wear only jeans and have all this pain.But still she prescribed me duspatalin and I started it today. Will see in couple of days how it goes. Also she said that probably it won't be worst it to contact psychotherapist. She said that she will give me some list of questions which I will need to answer and then she will decide base on them, if I need to go there.Are duspatalin and decitel the same? If decitel didn't help, should I still try duspatalin?Also I ordered caltrate 600+D and it should be here in the begging of next week. So I'm going to give a try for calcium as well.


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## Kathleen M. (Nov 16, 1999)

They are both considered an antispasmodic type of drug, but they have different mechanisms of actionMebeverine hydrochloride is duspatalin"Direct smooth muscle relaxants"pinaverium bromide is dicetel"first available drug with a specific effect on calcium channels"So it probably is worth trying it. Sometimes even if they are the same exacts class of drugs one will work for some individuals and not others and you can't be sure it can't work until you try.I think both of these are generally a 20-30 minute before a meal type of drug for best effect.


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## MIRMAK (Sep 27, 2009)

Can duspatalin cause constipation?Because I'm taking only duspatalin now and I still need to go to toilet the same amount of times and mucus is there, but sometimes, I feel that I want to go to toilet and I feel "something" inside of me, but I can't get it out.


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## MIRMAK (Sep 27, 2009)

I just (1 hour ago) received caltrate 600+D, so I'm going to start this evening from 1/2 tablet and will update everyone on my progress in couple of days and probably in Linda's thread.And I stopped a while ago metamucil and today (yesterday evening) I stopped taking duspatalin as well, because it didn't work well... even at all... for me.


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## BQ (May 22, 2000)

Glad it finally arrived. Now it may take a bit time-wise to feel the effects so give it a chance ok? I sure hope it helps you.All the bestBQ


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## MIRMAK (Sep 27, 2009)

BQ said:


> Glad it finally arrived. Now it may take a bit time-wise to feel the effects so give it a chance ok?


Thanks!I took half a tablet yesterday with some fruits before I went to bed and this morning I still had pain (cramps) in my stomach, discharge as usual, but it was a little bit easier to pass and I had one part of my stool really formed and I think normal size and color, but after it still some small parts are came out. I also took another half of tablet this morning with yoghurt, but still I have the same feeling as every day: a lot of cramps and excretion, I went to toilet already half a hour ago and had not formed stool (usual







) and still have the pain and excretio'n. But I'm not going to give up, I will take another half of tablet with lunch and at least I'm going to see if there will be difference in week and especially when I switch to full tablet in 3 days.


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## MIRMAK (Sep 27, 2009)

Does somebody now how fast calcium should work? Because if I read from calcium thread that usually it helps on next day after taking it, but for me it seems that almost no changes I am already taking 3 tablets (starting from Saturday) almost for a week.


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## mrae (Apr 28, 2009)

I tried the calcium to and it never did anything for me at all. From What I understand you should have already been seeing some type of change.


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## MIRMAK (Sep 27, 2009)

It seems to me that calcium doesn't work for me. It seems that I have less mucus excrection, but it probably because calcium just bind some water and I feel a little bit constipated, but again after defecation I don't feel myself empty and still need to go to toilet 5 times, but it is better than was before, maybe around 25% better.And I already ordered Digestive Advantage IBS (because it is pretty easy to order through internet and not such expensive as Align), so in one week it should arrive to me. Does somebody know, if it possible to take calcium and Digestive Advantage in the same time?Also I will have another appoinment with my gastroenterologist on 3rd of November.I'm going to ask her also about zofran, kytril, amitriptyline and tricyclic antidepressant, also what good probiotics are available in the Netherlands. Also will ask her about ibs blood test, vitamin D test and HIDA scan.I don't think that HIDA scan will show anything bad, because I already tried Questran and I felt even worse with it, so I think that my gall bladder works normally.Vitamin D test - I want to know my level of vitamin D, because I'm thinking that probably it can be a problem with my stomach, that I don't have enough of vitamin D and maybe because of 1200 UI (which I'm currently taking with caltrate) helped a little bit, but I heard that somebody also takes around 5000-10000 UI, so much more than me. I was thinking about vitamin D, because I moved from Ukraine to the Nethelands almost two years ago, and there is not a lot of sun and a lot of rains, compare to Ukraine (it is not so hot, but still hot summers and an enough of sun).What else I should ask my doctor?


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## MIRMAK (Sep 27, 2009)

I'm stilll here...







Just some update:I was on 3rd of November in hospital with gastroenterologist and I finally asked her to give me something else (and not loperamide and fiber), so she prescribed amitriptyline and also I did some more blood tests (I will have one more apoinment on 1st of December and will know results) for vitamin D and basic tests for allergy (and some more).So I took calcium for two weeks and it make me a little constipated, but problem with mucuos and D were still there, so I didn't fully stop, but currently I'm taking calcium only in the nght (one full tablet).Also starting from 4rd of December I'm taking amitriptyline and for now it the best medicine which I tried for my problems and in good days I go to toilet 2-3 time now and mucuos excrection usually only before defecation, but I still have bad mornings and there are still a lot of bad days (and my BM is still loose, not normal even in good days) and also uncomfortable, itching feeling in my back, so it definitely is not a cure, but seems that it slows down my digestion. And there are a lot of side effects from it (but still better than I was before): like dry mouth, dizzy and sleepy feelings (I'm almost falling asleep at work), also urinating (it seems to me that now it become harder to pee and also after peeing I don't feel that it is empty and I can go more and more and have some uncomfortable and aching feelings in my penis). My dose now is 3 (25 mg) tablets a day with meals (so 75mg in total).And also recently I received digestive advantage probiotics and already for three days I'm taking one tablet in the morning, will stick to it for 2-3 weeks and see what it will change.And already on a forum read about other probiotics (medicine) which I will add to list to try: IntestAid IB, Florastor, ProvexCV - so these on my list now.


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