Treating IBS-C

My GI Dr suggested I take Lexapro (a drug for anxiety because the brain and the gut interact with each other. It has helped my IBS-C because I am able to relax more now when I go to the bathroom and has allowed me to have less anxiety. I’m also following a low FODMAP diet which helps.

adrienne9484,

Rectal and anal pain, for me, would be due to hard stool stuck in a pocket of my rectum.

I have IBS-C, a redundant colon (too long) and a rectocele (a pocket of loose muscle in the rectum). My gastro docs didn't even consider a rectocele, surprisingly. I also have no firewall between my brain's emotions and my gut. My IBS-C is triggered by stress/anxiety and the wrong foods. Guessing what might help what you have, based on what helps me:

Hard stool: If I eat the wrong foods, my stool is hard. I also pass mucus. Stool also can gets stuck in my rectocele when I have IBS-C spasms.

Solutions: Once you have hard stool, there are a lot of OTC products out there to soften stool. My OTC is Colace or Colace 2-in-1 (with a stimulant too), and that is after I have tried massage/stretching, sitting a certain way to compress my rectocele so the rectum responds more normally to stool, drinking hot liquids/eating hot cereal, etc.

To prevent hard stool, I do a couple of things. First, as a night snack, I cook rhubarb and some of the other soft fruits I can eat in the microwave with water, for a compote. I add a makeshift crumble crust and cook a bit more. I then top it with a cut-up, fresh kiwi. Rhubarb and kiwi are mild stimulant laxatives. I definitely need them. At bedtime, I take a magnesium supplement and one Colace -- both are stool softeners. I need them too.

Second, I take 1/8 teaspoon of Frontier brand slippery elm inner bark powder with almost every meal. It supports the mucosa, so provides the slip to move even hard stool along.

To prevent IBS-C spasms/misfiring: The anxiety/stress front: Hopefully this is not an issue for you. CBT hypnosis worked for me. I was very motivated. I paid for seven sessions with a therapist. I can relax at will now (almost always).

The food front: Find out what you can eat. The Monash University FODMAP app was my starting point, but I already knew I had trouble with grains such as rice/oats/wheat, as well as lactose. Through trial and error, I learned that I usually cannot eat the quantity of low FODMAP food Monash listed. I also learned I can only eat about "15 things" and that many spices were triggers too (bland is so much better).

Through trial and error, this is what I can eat for a wonderfully calm belly and near-regular elimination ( you should be able to eat a greater variety than I am able to, or it might be a different variety. I also have mild lupus, BTW, so that may be part of the reason I need such a limited diet):

I eat reasonable quantities of green plantain flour, Lactaid milk, egg white powder, fresh egg whites, fresh parsnips, homemade bone broth.

I eat small quanitities of Lactaid cottage cheese, pea protein isolate, extra-firm tofu, shrimp, ground venison, fish, spinach/collards, green onions (green part only), radish, fresh green plantain, potato, dragon fruit, papaya, rhubarb.

I eat very small quantities of fresh ginger, pure stevia drops, maple syrup, brewers yeast, potato flour, olive oil, coconut oil, walnut oil, dried seaweed square, walnuts, pumpkin seeds, sunflower seeds, brazil nuts, Fody-brand condiments, turmeric, oregano, salt and pepper.

I cook all my foods except the raw kiwi at night. I drink warm/hot water and other liquids. Cold water can be a liquids can be a trigger.

I take Intoleran brand digestive enzymes and a fat/protein digestive enzyme, with each of my six small meals a day. I also make sure I sip plan water during the day.

My IBS-C/food intolerance seems to be getting worse with time/age. It could be due to my redundant colon lengthing or if my intolerance is lupus-related. I would be surprised if yours wasn't an easier fix.

I have not tried Linzess or other IBC meds. I don't think my system would like them. Some of the other stool softeners like Miralax make me nauseous and do not help my elimination.

All my best!

Hi,
Any anxiety or depression drugs I have been prescribed only made me worse, infact irrational and aggressive. For some unknown reason they work in reverse for me.
I found accepting my diseases and the limitations they place on me brings relative calm.
You are correct what we eat is what the brain lives on, so it is important to look after oneself, as best you can.
Cheers

Happy New Year to @aegis1952 and all my other Mayo Clinic Connect friends! Thank you for your generosity with your time and your desire to help others.

I suffer from IBS-C, chronic gastritis, redundant sigmoid, pelvic floor issues, hiatal hernia, etc.

Anyway just wanted to share that I did a few things recently that seem to be helping significantly: 2 mg Motegrity once daily, 3 Senna (8.6) twice daily, 2 Colace twice a day, Visbiome probiotic one tablet twice a day, lower fiber diet, plus drinking a half cup of Kefir twice daily, and three teaspoons of Greek, plain, unsweetened yogurt with blueberries. Only been on Motegrity about a month. After a rocky start, it seems to be working. Stomach and bowels are much better. Hope it lasts! Best Wishes!

Hi Mark: If I took 6 Senna and 4 Colace every day, I might be able to cure my constipation for good ! But that seems extremely harsh on the digestive system. Of course since I am 83, maybe I shouldn't worry about that. I haven't the slightest care about living 20 more years or even 10 more. Right now I just started a new med, Amitiza, which I doubled and still does nothing. Maybe I will invest in Senna and Colace and try your way. I have the same problems as you.

@phxbarb
Completely understand. I have communicated with folks who say Senna gives them all kinds of horrible problems that I, and others, have never experienced. What works for one may be intolerable to another. In theory, the Motegrity should have been sufficient on its own. But it wasn't--not at all. As I enter the second month of Motegrity, I may try to step back the Senna a bit. I did that before and got badly blocked. I have been taking the Senna for probably close to three years now. I seem to be doing okay as far as side effects. I take 3 Senna and 2 Colace at 7:00 am, and then again at 6:00 pm. I take the Motegrity at 9:00 am with breakfast. The Visbiome and the Kefir have both helped the gas and subsequent bloating from IBS-C. I did not mean to prescribe my regimen to others. Just meant to share what is working for me. Movement, for me,(walking/trampoline) is vital, as are small portions and a largely plant-based diet. Best Wishes!

I’m a 68-year-old male and I’ve had IBSC for years although I didn’t know it till two or three years ago. Now, all my meds have stopped working. I’ve used magnesium citrate, I use Linzess, which worked fairly well till recently and plethora of over-the-counter and prescription medications. I’m at my wits end and I’m having a hard time going home with this illness. I’ve tried all the home remedies like dude prunes, which were thoroughly disgusting but did absolutely nothing and I just don’t know what to do anymore. I’m thankful I have my wife and grandkids. I wouldn’t consider going on with this discomfort and pain. Please, someone tell me there’s something else I can do thank you.

Try miralax and magnesium citrate powder mixed in large glass of water about three hours before bed followed by drinking two more large glasses of water before bed. Yes you may have to pee during the night but it may help. Continue your Linzess. Get up at same time every am and take with a lot of warm water and then move around for a Half hour then eat. No white bread or soft wheat bread only sprouted grain like the Ezekiel bread kept in the freezer. No cheese. I do lactose free milk and I make my own yogurt with lactose free kefir and I mix defrosted frozen cherries in it. Good fiber. I do fiber gummies too. I eat my dinner at lunch and then in the evening eat light like a bowl of steal cut oats and an apple or salad. . Something healthy. There are others meds besides Linzess. Talk to your GI DR. You can also try the relatively new thing for constipation called the Vibrant Capsule but it has a tiny battery bins it so once you start you CAN NOT get an MRI. It is working for me. It stimulates the normal movement of your intestines. I do the miralax and Mag mixture at 6:30 and the Vibrant cap at 7:30. I go to bed at 9 and wake of without fail at 5 am and take my Linzess with very warm water. I use to have to drink like 7 cups of water with it now I only have to drink two 20 ounce glasses of warm water with it. It’s a royal pain in the ass to do all this BUT it works. I have no to minimal movement and adhesions in my colon. I do exercise, and am active, eat healthy and drink a lot of fluids. This regime isn’t for everyone. My GI appointment is coming up soon and I may talk to my GI Dr about switching my Linzess but I finally am getting my Linzess for free from Abvie. I’m on Medicare. Regarding switching RX CIC meds, Montegrity comes in generic but has a lot of side effects that Linzess doesn’t have like psychotic issues, like suicidal thoughts ,you should not take if you have any Hx of depression and mental illness. There are other meds but all super expensive unless you have a premium RX insurance plan. Also consider side effects. My hope and contentment in life isn’t based on my physical well being or circumstances but my hope is in God. Ask him to guide you and give you wisdom I dealing with this. Look up, not down. No man is a mountain so do go it alone. I pray you find what works for you. Always let your Gastroenterologist know what you are doing and what your needs are. We don’t all fit into the same mold. 😊

@emoecurly - welcome to Mayo Clinic Connect. I wanted to let you know I've moved your post here to this existing discussion so that you could meet others talking about IBS-C:

- Treating IBS-C https://connect.mayoclinic.org/discussion/treating-ibs-c/

Glad to see you got some input from @bb03. Hoping others in this discussion such as @mark1952 @phxbarb @researchmaven and others also will chime in with what has helped them with IBS-C.

Do you see a gastroenterologist you trust, emoecurly? What does he or she suggest you do at this point for treatment?

@lisalucier ive seen a few. I live in an isolated area and although we do have several G.I. doctors here, my primary care recommends I avoid them. However, I did go see one and had a procedure and I never met the doctor. He sent in his assistant to do the preop and postop in the only time you see the doctor is a 15 seconds before they put you to sleep.they’re not available to answer questions. I did have a G.I. surgeon here who are really liked, but they moved recently. Is there any new meds that you have heard of that might help my situation. Are there any home remedies? Thanks for the thought and I’m trying to gather my strength, but I am so down right now.