# any advice



## Melfank (Jun 19, 2003)

My Ibs just started no long ago. It was a few days after I found out I was pg. My dr thinks it was triggered by all the hormones. I get awful pain. When it first started I was in the emergency room 3 times before I knew what it was. The only thing that helped the pain was percoset. Well Changing my diet has relieved a lot of pain but I am still in pain every day. One of my problems is gas. I get awful gas that gets trapped and it will be in there for hours just building up. For some reason I seem to be able to pass it after 10pm but no before. So until then I am miserable. So the things that have worked most for me with the pain is cutting out fat. I am just starting to learn about this problem and just learned that carbs make the gas worse! That makes sense to me now that I look back. My problem is this. If I cut out fat and carbs there is not much left for me to eat. I am staying away from a lot of meats because of the fat. Now I need to stay away from carbs also. What should I eat. I am pg and am losing weight which my ob is not crazy about. I know that there is stuff I can eat. But am so new at this I have NO idea what is good and what I should stay away fromMy dr suggested looking for triggers. But for the most part my pain is all day every day so I can't really figure out what causes it.Any idea or help... any good websites out there for this kind of thing??Thank you sooo much!!!!melissa


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## Melfank (Jun 19, 2003)

A follow up question!! Sorry. What are the best meds for gas?? Also what about fiber. My stools like everyone else's are weird. My dr suggested taking fiber. But that seems like it would cause more gas. Is there any herbal stuff that will help??Thanks again melissa


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## california (Aug 22, 2002)

Melissa, come on over to Eating for IBS . There are several pregnant IBSers on the board, so you can get lots of hints. There are lots of recipes also and the author of the book, Eating For IBS, comes in and gives invaluable advice. I also have a hard time with carbs, so no fat and no carbs is the same way I try to eat........note I said TRY! You are right, it's hard to find adequate foods, I can't imagine being pregnant and trying to follow these dietary limitations.


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## Mike NoLomotil (Jun 6, 2000)

MELFANK _______________________"My Ibs just started no long ago. It was a few days after I found out I was pg. My dr thinks it was triggered by all the hormones." _______________________yes. Anything which increases the production or release of certina prostaglandins will produce abdomianl pain and even cramping, bloated sensations, diarrhea.For example, we know Prostaglandins Released In Non-IgE Food Reactions may be released by Mast Cells, T Lymphocytes, Monocytes, or other immunocytes. Due to the female predomominance of IBS symptoms among ï¿½healthcare seekersï¿½, and the frequent comorbidity of ï¿½diarrheic IBSï¿½, Functional Abdominal Pain and Dysmenorrhea,as well as the symptoms you describe appearing in some unforatunate pregnant women, the following information about PGE2 and PGF is often noted:Effects on Gastrointestinal Tract: ï¿½	PGE2 and PGF2a contract longitudinal muscle. ï¿½	PGE's and PGF's stimulate water movement into the intestinal lumen (diarrhea).Effects on Uterus:ï¿½	PGE1, PGE2, PGF2a and TXA2 contract human uterus while PGI2 relaxes. ï¿½	Dysmenorrhea is caused by excessive endometrial synthesis of PGE2 and PGF2a.ï¿½	In the pregnant human uterus, PGE2 and PGF2a produce an increase in uterine tone and rhythmic uterine contractions which can be severe and require treatmentIn fact Cervidil, a form of PGE2, can be used in an IV drip to induce labor, so powerful is the effect on the smooth muscle.While what happens to the immune system in pregnancy is very complicated, to prevent your body from misidentifying the fetus and appurtencnes thereunto as foreign and possibly rejecting it or attacking it, PGE2 is one of the hormaones that in its own specific way dampens or modulates a certain part of the immune respones. So there is the effect however on smooth muscle...which is supposed to be balanced by other changes which occur.Sometimes this does not happen quite right ....sometimes the cellular immune changes can cause a perosn to lose oral tolerance to some foods, which then result sin the appearence of what doctors will call "IBS"...and after pregnancy it will subside. __________________________"My dr suggested looking for triggers. But for the most part my pain is all day every day so I can't really figure out what causes it" __________________________Doc is barking up the right tree, but unless you have very specific instructions how to keep dietary intake logs and symptom onset logs, and how to evluate them, it is very difficult manty times toi evaluate which foods you have lost tolerance to and which are aggravating an already diffcult problem. This is becasue the response to the food challenge can be delayed up to 72 hours from ingestion, or it is even more often dose-dependent. So you either have to eat alopt of it at once, or a little at each meal over time until a sufficient reaction builds to elicit symptoms. Then there is little chance of matching it up with your log unless it is done very specifically.Have you sought out an experienced RD who understands these issues so that you can get help? This is one suggestion.Also the instructions in this book on how to keep a log can help you do a better job than guessing at how to do it:IBS: A DOCTORS PLAN FOR CHRONIC DIGESTIVE TROUBLESBy Gerard Guillory, M.D.; Vanessa Ameen, M.D.; Paul Donovan, M.D.; Jack Martin, Ph.D. http://www.amazon.com/exec/obidos/ASIN/088...3369143-6824157 While efforts to avoid known stimulants (like caffeine and histamine containing foods) can help avoid throwing kerosene on a burning flame so to speak, it probably will not produce as much relief as if you can isolate which foods or additives are rpovoking even more PGE2 release through loss of oral tolerance.You may also wish to ask your doctor about medications which are known to inhibit the effects of prostaglandins. I hesitate to discuss it as this can be a delicate matter in pregnancy...medictaions often used for this purpsoe may not be efficiaisou in pregnancy...but it is worth asking since the doctor may know of some new protocol or medication for this purspose which is safe that the rest of us do not know about.MNL


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## Mike NoLomotil (Jun 6, 2000)

"Is there any herbal stuff that will help??"Exercise caution as some laxatives, natural or not, work via prostaglandins. Senna, for example, has been shown to increase PGE2 production and thus exert its effects.Indeed gas can be worsened by fiber supplements this is why I recommend not taking these big lumops of fiber like metamucil inw ater...eat some fruit (pectin fruits like apple pear etc) 4 per day in splitdoses (maybe 1/2 with breakfast 1/2 for midmorning snack 1/2 after lunch 1/2 in afternoon 1/2 with dinner 1/2 in evening...etsbalish a steady intake of pectin fiber (soluble fiber) from natural sources like this and you may find it works OK in a few days.On the other hand these fruits may be something you have lost tolerance to, which you should know shortlyu, and have to resort to fiber supplementation...in which case just be sure to split the doses out over the day not just one big glop all at once!MNL


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