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How to get tested to find if I have IBS?

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Irritable Bowel Syndrome
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UCer23
Regular Member
Joined : Aug 2017
Posts : 156
Posted 1/21/2019 7:47 PM (GMT -5)
Hello,

I've been on the UC board for several months given my diagnosis of UC back in 2016. I've been flaring since and finally got things reasonably under control with Entyvio. That treatment got me to about 70% effectiveness so we have been looking for the final 30% to get remission. My doctor prescribed Methotrexate 25/mg a week. I had tried similar drugs such as Azathroprine and 6mp and both made me sick including vomiting. So my doctor knew that Methotrexate could be a problem. I also take Canasa suppositories usually every other night.

I am now dealing with what I feel like is a lot of constipation. I am very frequently bloated and have a good deal of abdominal pain. My doctor has floated IBS as a possible problem before but he seems more concerned with the IBD. He did prescribe me an anti-depressant in a very low dosage. In all honesty, I do not want to take an anti-depressant regardless of dosage so I have not tried that yet.

To me, I am still new with this IBS thing, I'm still learning a lot about IBD. My big question is, is there a way to get tested to find if I have IBS? I would like to know if these problems I'm having are more Methotrexate side effects or IBS related. Is that answer to work with my doctor and stop taking the Methotrexate all together and see what happens? I wasnt sure if there was some type of blood test or breath test, or some other type of test that might be able to shed light on IBS?

Thanks!
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straydog
Forum Moderator
Joined : Feb 2003
Posts : 20004
Posted 1/21/2019 8:32 PM (GMT -5)
I happened to see your post & wanted to respond to you. It's pretty common for someone with IBD have IBS. Dealing with the disease alone is bad enough, but add in IBS it's not a picnic. My daughter in law suffered with IBS for years, her issue was constipation & bloating. She was scoped & had all of the typical tests done looking for potential IBD. Thank goodness she tested negative. There is not a specific test for IBS, just the usual testing for IBD.

Her dr suggested she keep a food diary & she was able to pinpoint what foods triggered things. Sounds boring but it works. She found dairy to be a huge trigger. You mentioned your gi offering an antidepressant, yes this is often used to treat it. Not sure what your hang up is, but you may want to reconsider.

Laxatives are too harsh because they deplete water in the colon. If the colon doesn't have water, then constipation becomes a real problem. Talk to your pharmacist about stool softners, but keep in mind they take several days to work. Another thing you can try is eating a handful of prunes at night, or a cup of warmed prune juice. This is a natural approach. Staying hydrated is a must.

I doubt the Methotrexate is your culprit. If anything, folks on it can experience diarrhea. If you can get the constipation under control the bloating will dissipate too.

Take care.
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UCer23
Regular Member
Joined : Aug 2017
Posts : 156
Posted 1/21/2019 9:00 PM (GMT -5)
Hi Susie,

Thank you for the response. That's a bummer about there being no real test done for IBS. It'd be nice to know what is going on. My inflammation from my IBD is finally going down after nearly 2.5 years of this flare. Finally starting to get over that problem and have this problem enter is less than ideal.

Taking a food diary makes sense to me. The reason I've resisted the antidepressants (Nortriptylin) is because I just dont like the idea of continuing to add medications. I feel overloaded as it is taking so much stuff for my IBD plus antidepressants just generally give me the creeps. I know the 10mg is probably a super low dosage so the risks of extreme side effects is low, but I was just hoping there is a more natural way to fix the the symptoms. Might be naive of me to think so.

I've thought about cutting back on the dairy products. Ive already eliminated coffee due to my IBD. I also have a probotic although I havent taken it yet. Probotics are talked about a lot for IBS & IBD so I figured I could talk to my doctor about trying it. I also take daily fiber.

I guess for me, I'm just generally still confused about IBS and what I'm trying to get under control. The symptoms I understand, but I guess I dont get the reason for the symptoms like I do for IBD. For IBD, I have inflammation that causes a number of symptoms that make sense given the problem. Getting rid of the inflammation gets rid of the problem. For IBS, I just dont quite get what the problem is that's causing the constipation and bloating.

Thanks again for your post!
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straydog
Forum Moderator
Joined : Feb 2003
Posts : 20004
Posted 1/22/2019 9:09 AM (GMT -5)
UCer23, I was dx'd with crohns via an emergency resection in 2002. Then in 2005, UC was an added dx. I understand where you are coming from about medications. I had uncontrolled explosive diarrhea for 3 very long years. I literally became house bound except for drs appts. I never had warning when it would hit & many, many times in public I never made it to the restroom. The psychological impact was as bad as the issue at hand. I had mal-absorption problems. I became afraid to eat or drink. That lands a person in bad trouble. I was a mess.

My gi did everything in his power to help me. I was referred to a dr that wrote the first book on diarrhea, lol. He was of no help. Diet is really a key to helping IBS. Believe me, I am not one of these foodies that think diets are the cure for everything. I had to figure out what to eat or not eat, even though I had slim pickings in the food department. To this day I am careful with what I eat. I also found out if I ate something one week, there was no guarantee I could eat the next week without an issue. It truly is an individual thing. You have to be patient & diligent in finding what works for you.

about the antidepressant. There is a connection between the gut & brain. This is why your dr recommended this particular medication. Now a days so many medications are used off label to treat a variety of issues. Try the food diary, if it helps great. If it doesn't perhaps give the medication a serious thought. about the probiotic, there again some folks can take them, others cannot. You will not know until you try.

Take care.
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cyclinglady
Regular Member
Joined : Aug 2015
Posts : 267
Posted Yesterday 11:42 PM (GMT -5)
Consider getting tested for celiac disease. Once you have one autoimmune disorder (AI), you can develop more. Celiac disease can cause constipation and bloating as everything can slow down if their is small intestinal damage.

http://www.cureceliacdisease.org/screening/

Depressed? I have three autoimmune disorders and that is depressing. I have resisted any medication because I have learned that if I am not flaring, I feel good. Celiac disease can be easily flared by gluten. It is the one AI that the trigger is known. I have learned that a gluten exposure will set off not just my celiac disease, but my other AI issues. But, you and your doctor know best.

Can being gluten free help IBD patients? Maybe. There was a tiny study done at Scripps in San Diego with IBD patients. They achieved a 78% remission rate based on biomarkers having patients follow an AI Paleo diet. Of course a larger study is needed, but no one wants to fund a food study?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5647120/
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