IBS: How to Live with It (and C Diff)?

Posted by rr1967 @rr1967, Jul 4, 2023

Hello.
I am a male, lifelong vegetarian, and 55 years old. Last July, I was diagnosed with diverticulitis, for the third time in 19 years. I was put on Augmentin to treat it. Within two days the diarrhea started and I ended up in the ER about 4 days later. The ER doc thought that I may have developed CDIFF because of the Augmentin. I was taken off this med right away and tested for cdiff, then sent home. The following morning, I got the results that I had cdiff and went back to the ER. They then gave me Vancomyacin. It worked and my diarrhea stopped.

However, a week after I finished the vanco treatment, the diarrhea started again and I went to urgent care. Again, tested positive for Cdiff and I went back on Vancomyacin. This worked, but for two more weeks, I had nausea, off and on diarrhea, and severe acid reflux. The reflux was so awful I thought my chest was on fire and I had to take an ambulance to the ER. They gave me esophagus coating medication which took a few days to work. I could not take a real acid reflux medication because that could increase the chances of Cdiff coming back. I also then had an upper GI and all was normal.

I did see several times an outstanding GI specialist who reassured me that I am okay and that it would take months for my gut to heal from the cdiff. I was also diagnosed with chronic IBS-D and this will never go away. There are certain foods I can never eat again and I am trying to go full vegan with the exception of lactose free yogurt and lactose free cheese. He also recommended a probiotic called Florastor that has real clinical research behind it. It is expensive but I started taking it and I really felt better. I did have the occasional bout with diarrhea if I was not careful with my diet.

In March of this year, I had a really bad bout of IBS D and this time they ran a Fecal Calprotectin test to check inflammation in my gut. Test results were normal.

Last Thursday and Friday morning, I had 6 very dark, watery bowel movements between 10pm and 7am. This freaked me out and I ran to urgent care. They ran very detailed stool panel. All results were normal except that they detected cdiff again. I went back in and they told me that I will probably always test positive for Cdiff going forward but as long as I don't have massive, watery diarrhea, the infection is not present...just the germ.

This is what the CDC site also says. People who get a formal diagnosis of Cdiff will always carry the bacteria though have no formal symptoms. Since last Friday, I have have not had any massive watery diarrhea and deal with my "normal" bouts of IBS. No fever, some random pains here and the in my abdomen which I have had for many years.

Finally, I can tell you that I may have anywhere from 2-4 bowel movements a day. At least 2-3 before noon and maybe one in the afternoon. During flare up weeks, I can have up 5-6 movements. My GI doc, who I really like and trust ( very patient, knowledgeable, and a great communicator) states that this is basically my IBS flaring up randomly. During my bout with diverticulitis and Cdiff last summer, I lost over 15 pounds in two months. All blood tests were normal and my doctors told me that I was at my healthy weight and should try to maintain it instead of gaining at all back.

Very frustrating and depressing. I literally avoid going out anywhere in the morning as I need to be near a clean toilet...which is basically my home.

Any thoughts or similar experiences?

Thank you for reading.

Interested in more discussions like this? Go to the Digestive Health Support Group.

@scolio

Hi, RR-- I was wondering how long you've been taking the probiotic and whether you notice any difference so far?
This is very much third-hand information, but a neighbor's friend had some good results by researching and taking some probiotics after a cdiff diagnosis. I don't know exactly what she used or on what kind of schedule but I got the impression that she switched around between different formulas/brands. I think it took quite a while, too.
If you are hoping that cutting back on gluten could be helpful, have you ever looked into other grains such as millet, teff, amaranth grain, quinoa, and kasha/buckwheat? I have used each of these in different ways, including cooking together with oatmeal.
Did you say beans/lentils have been causing you problems lately? How do you do with green vegetables, starchy vegetables, and with fruit?
Another second-hand tip is that supplementing with small amounts of psyllium may sometimes be helpful for ibs-d.

Also here is a thread about pvcs

whttps://connect.mayoclinic.org/discussion/which-form-of-magnesium-for-pvcs-taurate-glycinate/

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Hi Scolio
Thank you for the message and the information.

I have been taking probiotics for years, but then I switched to the Florastor probiotic last summer once I received my Cdiff diagnosis, based on the recommendation by my gastro doc. It does have clinical proven research. I have tried different grains and I have no problem with them. It is only tapioca that causes me issues. I eat a lot of spinach, kale, bananas, and strawberries. I did take psyllium husk for years and then my GI recommended that I try Citrucell fiber instead...I guess it works better in your system.

I now know that I cannot do decaf coffee anymore...the bowels movements are significantly more in a very short time. I made the mistake of having a decaff, dairy free latte on Saturday morning and I have 4 bowel movements in the first three hours. I then had to take a medication called Hycosiamine to stop the movements and I was fine all day yesterday. Even a couple of pieces of chocolate will set off my IBS.

RR

REPLY

That's interesting about the coffee (even decaf) and the chocolate. Those are two things that I avoid myself, not because of digestion (I haven't used them often enough to notice if they affect me that way or not), but because they can increase my anxiety/restlessness and because I get very worried about becoming functionally dependent on any one thing. Plus, I'd rather spend my food dollars on other things.

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@rr1967

Hello Colleen
Thank you for the links and the feedback. I have tried the Fodmap diet. It is difficult for me to do long term being a vegetarian and trying to go vegan. Some of the foods that I love ( broccoli, beans, chickpeas) I am supposed to avoid. I am trying CBT to reduce stress and anxiety and I do see a therapist. I have now completely cut out decaf coffee and have stopped drinking beer or wine ( I only drank a couple of beers or a couple of glasses of wine with my wife once or twice a week anyway).
Thank you!
RR

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Greetings, rr1967:

The FODMAP protocol is NOT meant to be long term. You exercise diligence by avoiding FODMAP foods, wait about 2-ish weeks after achieving anti-FODMAP-ism, then begin adding foods back family by family. If a food type proves to be problematic, then that is what you no longer eat. You may find that no food causes you problems.

The Registered Dietician with certification and/or experience with the diet is your friend and will guide you through the process.

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I didn't read this whole article, but it mentions docosahexaenoic acid (dha) for inflammation. I have found that trying to increase my omega-3 has been helpful for me.
https://www.nature.com/articles/s41598-017-10382-2#:~:text=Supplementation%20with%20DHA%20has%20been%20shown%20to%20help,endotoxins%2C%20particularly%20lipopolysaccharides%20%28LPS%29%20derived%20from%20gut%20dysbiosis

As a vegetarian, you probably don't want to take fish oil or eat sardines, but there are vegetarian DHA supplements available made from a farmed species of algae that is grown in steel tanks just for that purpose. One that I've seen is available as an oil in a 250ml bottle, with both a rosemary flavor and a lemon flavor, to mask the fish-like flavor of the plain oil-- I guess what we think of as the taste of fish comes partly from the algae at the bottom of their food chain.

Taking steps to lower the inflammation in your body certainly won't cure the IBS, but it's not too likely to do a lot of harm, either, and who knows-- it may have some beneficial 'side effects'.

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@rr1967

Hi Scolio
Thank you for the message and the information.

I have been taking probiotics for years, but then I switched to the Florastor probiotic last summer once I received my Cdiff diagnosis, based on the recommendation by my gastro doc. It does have clinical proven research. I have tried different grains and I have no problem with them. It is only tapioca that causes me issues. I eat a lot of spinach, kale, bananas, and strawberries. I did take psyllium husk for years and then my GI recommended that I try Citrucell fiber instead...I guess it works better in your system.

I now know that I cannot do decaf coffee anymore...the bowels movements are significantly more in a very short time. I made the mistake of having a decaff, dairy free latte on Saturday morning and I have 4 bowel movements in the first three hours. I then had to take a medication called Hycosiamine to stop the movements and I was fine all day yesterday. Even a couple of pieces of chocolate will set off my IBS.

RR

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Hello, I hope you are finding some helpful information. I thought of one more thing, which you may already be doing. Years ago I read (ok, maybe skimmed) this book by Glen Merzer, aka 'the mad cowboy', and he included a recipe for a cheese 'replacement', which was mostly just nutritional yeast or brewer's yeast, which can have a cheesy sort of 'umami-type' flavor.

https://www.thriftbooks.com/w/no-more-bull-the-mad-cowboy-targets-americas-worst-enemy-our-diet_glen-merzer_howard-f-lyman/349559/item/1965469/?mkwid=%7cdc&pcrid=77447028765158&pkw=&pmt=be&slid=&product=1965469&plc=&pgrid=1239149900899965&ptaid=pla-4581046492312228&utm_source=bing&utm_medium=cpc&utm_campaign=Shopping+-+High+Vol+Backlist+-+Under+%2410&utm_term=&utm_content=%7cdc%7cpcrid%7c77447028765158%7cpkw%7c%7cpmt%7cbe%7cproduct%7c1965469%7cslid%7c%7cpgrid%7c1239149900899965%7cptaid%7cpla-4581046492312228%7c&msclkid=f63b538b75f71d757fc5373954e4119f#idiq=1965469&edition=3394528
No More Bull!: The Mad Cowboy Targets... book by Glen Merzer (thriftbooks.com)

If you are trying to move toward using less of the hard cheeses, this could be one tool to help you do that. As a benefit, the brewer's yeast also has some b vitamins and protein in it. I've seen suggestions to sprinkle it on top of popcorn, which may not be an option for you given your battles with diverticulitis, but I also enjoy it over polenta, or just about any other savory food for that matter.
Since it is very popular with vegetarians and other health-conscious people, I would guess that it is already in your kitchen, but I thought it may not hurt to mention it anyway.

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Here is a similar discussion
https://connect.mayoclinic.org/discussion/ibs-and-vegetarian-diet/

Also a smoothie recipe that includes some carob.

https://thedesignfiles.net/2015/12/carob-halva-heaven-smoothie-2

The notion that carob may ease or prevent diarrhea seems to date back to the observations of a doctor in Spain half a century ago:

https://www.sciencedirect.com/sdfe/pdf/download/eid/1-s2.0-S0022347649800539/first-page-pdf

"During the Spanish Civil War and at the beginning of the World War II, Ramos of Barcelona, Spain, faced with the increasing difficulty of procuring such dietetic products, sought other material for therapeutic use. He had noticed that during the war in Spain, the children of the poorer classes in Barcelona who ate the fruit of the carob tree had fewer diarrheal disturbances than did those of the wealthier classes. Based on this observation, he employed the dried pulp of the roasted carob mixed with starch for the treatment of diarrhea."

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I started taking more fiber for IBS. Chia seeds and flax grain on a daily basis in a smoothie with one banana, almond milk, plain yogurt, mango pieces and blueberries. Have not had an IBS bout in a long time. Also take a probiotic everyday. Good luck!

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@treesab

I started taking more fiber for IBS. Chia seeds and flax grain on a daily basis in a smoothie with one banana, almond milk, plain yogurt, mango pieces and blueberries. Have not had an IBS bout in a long time. Also take a probiotic everyday. Good luck!

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May I ask what probiotic you are taking? Your smoothie recipe sounds delicious. I'll try it.
Are you diagnosed with IBS-D?
Thank you

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My gastro doctor recommended I take Align. I have now been taking it daily for 3 years. I buy it at Costco when it is on sale.

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@treesab

My gastro doctor recommended I take Align. I have now been taking it daily for 3 years. I buy it at Costco when it is on sale.

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Hello treesab,
Thank you for sharing that. I will try the Align and the smoothie to increase my fiber. But I'm wondering if your diagnosis is IBS-D or IBS-C? My diagnosis is IBS-D so I'm wonderng if the smoothie and the increased fiber could increase the diarrhea.
Thank you,

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