IBS diagnosis, how does that work with the DS?

 I've had so much trouble with my stomach lately, and that's just the latest in the litany of health problems I've had to deal with the past two years.  :(

But enough of my grumbling. 

Anyway, I just had a colonoscopy and was told that I have "Constipation Dependent Irritable Bowel Syndrome." Meaning, I guess, that I have SEVERE dismotility resulting in constipation, which in turn is resulting in Irritable Bowel Syndrome. Or, maybe it means, "we-don't-know-what-the-hell-is-wrong-with-you-so-we're-calling-it-IBS." 

Hmmm, ok, whatev. 

I've been instructed to take Miralax everyday until I die. Not a problem. Miralax is easy on the gut. Much better than having to drink Milk of Magnesia. Blech! 

But the thing is, while this IBS diagnosis explains the nausea, stomach pain, etc., it doesn't explain the chronic fatigue, my Mystery Tachycardia, and the constant ringing in my ears that rings in time with my heartbeat (Pulsatile Tinnitus). So far, every doctor I've seen regarding my health complaints–and there have been a lot of doctors getting rich off me lately–have blamed my issues on my gastric bypass and dumping. 

So alright then, this just adds weight to my decision to get a revision to a DS, right? But then, I have issues with my bowels. Issues that are hard to live with. Getting a revision means messing with my bowels and I'm not sure how IBS would affect things. 

Anyone have any thoughts on this?

Lynda

Hey there!  Though I do not have an IBS diagnosis, I have some of the symptoms.  I was tested for Celaic and Chrons too, but do not have those either.  That being said, this was something I wanted to look into before deciding on a DS.

Basically, from what I've read, it could either improve your situation, or it will remain the same as it is now (possibly even getting a bit worse).  And there's no solid way of knowing before you have surgery, which category you'll be in.

Since you have an RNY, you are probably already taking the supplements that are known for causing a "normal" person stop up.  A lot of members on the board take some sort of stool softener, and also there are several advocates for probiotics.

I just ordered Digestive Advantage Intense Bowel Support based on another thread I saw on here.  I don't have any idea if it'll work, but the reviews on Amazon were positive.

I'm sorry I can't give you a definitive answer to your question, but it seems like there is no solid answer from what I've seen.  Perhaps someone with actual experience in this will comment soon!

I'm very curious as to how you got an IBS diagnosis from a colonoscopy.  It is my understanding that this is something you cannot "see."  Unless they were ruling out other conditions and didn't find anything, so they called it IBS.

If you have severe dysmotility and it is a physical, anatomical problem that can be seen and measured, that is colonic inertia, not IBS.  And the "cure" for colonic inertia is a subtotal colectomy (no colostomy bag...rectum left in place).  If the colonic inertia is in fact the diagnosis, I think the DS could put you in more pain.  Lots more stool, no movement = pain.  And if you were to get a subtotal colectomy at a later date, serious risk of dehydration and the DS would probably need to be altered at the same time to create more surface area to absorb water in the small intestine.

Does the miralax help?  There are other medications out there that are supposed to help with IBS-C.  I have funky bowel problems that are probably IBS too, and I'm happy to discuss all the tests and BS I've had over the last 3 years with you if you could just PM me and ask so that I remember.

Amitiza is supposed to help with IBS-C.  Pretty much the only med out there.  If it is life changingly helpful to you, I'd be concerned about malabsorption after the DS, and it's kind of a oily emulsion pill.

anyways, I am rushing to get other things done right now, so I can't write a long message, but I have done so for other people in the past via PM, so feel free to either reply here and I'll reply on the message board, or PM me.

Kayla, Orangecrushed, Justin, and Ghkal, I am so, so sorry it took me so long to reply. I just haven't felt well at all and didn't have the energy to get on the computer. 

Orangecrushed: I hadn't considered the fact that iron is constipating. Though I don't see how that could be my problem; I've been taking iron for years and this constipation problem is rather recent. Thanks for the heads up on what supplements can do, however.

I was told by the doctor to take a probiotic. But I have no idea which ones are good. Let me know how the probiotic you just ordered works, if you don't mind. I'd like to know. 

Justin: Like you, my problem seems to be slow transition of my bowels. Sorry to be graphic, but in the past, if I was constipated, I'd feel some rectal pressure and my stools were hard as rocks and hard to pass. Now, it's like I feel all the pressure in my ascending (right side) and transverse colon, while the left colon feels empty. No pressure, no stool. It's like all my bowel contents are just sitting there, not moving. After several days of this, it starts to feel like a bowel obstruction. Very painful. 

I'm glad things are better for you. I don't mind taking Miralax, by Milk of Magnesia is so disgusting. How do you tolerate it???

Ghkan: Ulcerative Colitis is a nightmare, I've heard. How was your DS modified? And are things better for you now?  

Kayla: I've saved you for last since I've read some of your posts and I think you and I have had to contend with the same things (rectocele, etc.). 

My "diagnosis," I think, is exactly what you said: the doctor ruled out other problems, couldn't find anything wrong, so settled on an IBS diagnosis. I'm just not buying into it. 

As for as colonic inertia, I did some reading up on that and, dear God, I hope that isn't it. I have NO desire to have my colon removed. That would absolutely destroy my chances of getting a DS. 

 
I'm not sure how colonic inertia is even diagnosed. My GI doctor said something about swallowing a pill that has a computer chip in it, or something like that, that would show how long it takes for the contents of my bowels to move. I haven't had my follow up visit with my actual GI doctor yet (a different doc did the colonoscopy), so I won't really know anything more till then. 

Actually, at this time, I'm pursuing my hypothyroidism. The last two tests I had done (six months ago) showed a low free T4 level, but nothing was done about it. And a lot of my symptoms can be attributed to low thyroid: fatigue, feeling cold, foggy thinking, constipation etc. The problem is my symptoms could mean so many different things! It's going to be a battle to find out what's wrong. I just had my blood drawn today. Won't know more until next week. Just gotta hurry up and wait!


A little FYI here: I just learned Armour Thyroid changed its formula in 2009, adding more cellulose to the mix. It seems most people have to chew or crush the pills in order to separate the medication from the cellulose and get better absorption. Now, I've been on Armour since 2004, and I remember that around 2009 I began having some trouble with it. Little things. Small recurrences of hypothyroid symptoms. Nothing that jumped out and screamed at me, but enough changes took place that I'm beginning to wonder if it's Armour that's part of the problem. 

I hope, I hope, I hope the bowel problems I've been having lately and the ongoing fatigue (since 2009) is because of my thyroid and the fact that Armour is harder to absorb now. Hypothyroidism can be easily fixed. Colonic inertia? That's a whole 'nother animal!

Like I said, I'll know more after my follow up visits with my PCP and my GI doctors. And like I said, I appreciate the help and I'm sorry it took me so long to reply. 
 
~Lynda

PS: It's possible that my adrenal function is sluggish from being on steroids for two stinkin' years. Would adrenal insufficiency cause problems with my bowels? 

I was diagnosed with colonic inertia originally from a colonscopy.  GI said my colon was long, floppy, and wide and the muscles didn't respond the way a normal colon does.  So, it must have some physical symptoms that you thankfully aren't exhibiting.

I have now decided, however, that despite my physically weird colon, that I do not have colonic inertia, and I cried when I first read about it.  I was only 22 fer cryin' out loud!  Anyways, I ran away from the diagnosis for a year, kinda accepted it in the back of my mind, but didn't want to have my colon removed so I avoided the GI for a year until it started getting on my last nerve and I went back.

I would have SWORN up and down on my LIFE that my stool was getting caught in my transverse colon...but the whole time, it seems I did have stool in the left side that I just couldn't feel.  I think sometimes if we're used to having stool there for so long we become insensitive to it...so hey!  you never know.  An xray might be able to visualize it.

Anyhow, it's come to light that despite the big floppy colon I do not have colonic inertia (yayyyy)...but that means it's either my rectocele (probably not...tests show I have the capability to empty it), IBS, or something else.  Stinks having these problems.  I feel you.

I think my issue might be hormonal.  Low estrogen and stuff certainly doesn't help the situation.  Neither does hypothyroidism.  I haven't had any surgeries for it yet.

There are somethings that I have found helpful.  80% of patients that try biofeedback for IBS see significant improvements.  It kinda teaches you to strengthen your pelvic and ab muscles to support yourself better.  I had a good pelvic physical therapist and she helped strengthen lots of muscles...abs, hips, glutes, etc.  Scheduling difficulties are keeping me from her right now, but I'd go back if I had time.

It definitely won't make anything WORSE.  :)

Oh, and milk of magnesia: the cherry flavor tastes better than the others, IMO.  But yes, I don't find stool softeners that helpful because usually my stool is already soft...just won't come out.   I rarely rarely rarely have hard stools.  

I do think suppositories are helpful.  They are kind of interesting...they helped me realize that I had stool in my descending colon when I didn't know that I did.

Good luck with the issues.

Kayla, are you a medical professional?  I am constantly amazed at the amount of stuff you know! (Really, I'm not being facetious).

Lynda, This is anecdotal but I had both IBS and GERD before the DS operation.  Now I don't have either.  I do have to take Milk of Magnesia and Mirilax more often than I'd like but it is because of slow transition through my bowels, not because of pain/discomfort/etc.

Good luck!
Justin

Thanks Justin!

I am not a medical professional.

I am studying to be a dietitian, but am not one yet.  I'm a university student and I love to research.  I also have some funky medical problems that I've researched in order to better help me understand my own weird-ness, so when people have questions about those same medical problems...I share what I know!

So, if you hear anyone ask about severe constipation and goofed up hormones, you can bet I'll respond.  haha.

 I have suffered/been diagnosed with UC for 14 years.  It started out with one flare up a year in which I lost 40+ lbs, then spring and fall with no weight loss for several years, and shortly before surgery I believe I was having 3 flare ups a year.  My doctor spoke with my "butt" doctor and together they decided it would be best to modify my DS so if I had UC problems later in life there was still "room" to work with.  I had my surgery 18+ months ago, I had one flare up that lasted 2-3 days, it was directly related to stress.  (Husband lost job 2 wks before Christmas)  I have not a flare up since.  

I hope this gives you some idea of what I dealt with and how things are now, I know its not the same as you but it still deals with the bowels.