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My mother, 89 years old, has suffered from Irritable Bowel Syndrome for as long as I can remember. She also has Generalized Anxiety Disorder. She would give you a longer version, but basically, there are foods that she cannot eat without stomach distress. Periodically she gets to where she cannot eat anything, literally, without hurting. Latest bout is lasting longer than normal. Constipation is an ongoing problem. We have tried every type of fiber and laxative out there, but even when that is under control she still hurts, has gas and bloating. Every type of food, singly or in combination, including FODMAP. Worse when her anxiety is high (which she denies). She has also tried a number of prescription medications, including Carafate and Protonix, which she is using right now. Acid reflux is an occasional problem. She is on low dose amitriptyline and Lexapro.
Her doctor recently retired, and she refuses to go to a doctor right now anyway because of Covid. Over the years, I have bought quite a few OTC products for her to try. She uses lactose-free milk. Has anyone tried any OTC products that have helped similar problems? Brand names to trust or avoid?

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You are now describing both upper and lower distress. Is this new? Has she been tested for SIBO (small intestinal bacterial overgrowth). There is a simple breath test for SIBO that can be an indicator. For myself I had it for many years thinking I had IBS-D.
You say you tried fibers. Have you tried specifically CITRUCEL. Metamucil is the big boy that gets recommended often and to my mind and in my nurse experience it often caused more problems because of the manner in which it ferments in the body causing gas and pain involved with gas. For me it is citrucel every night, and has changed my life; recommended with the information in ER by a great doc familiar with the fact Citrucel ferments differently in body and for many of us causes no pain.
I would say if you are now dealing with upper and lower pain, and a worsening in pain, that it is worth exploring with a new doctor as things get missed with those of us with IBS--it becomes the "go to answer" and other things can be happening. Happened to me with a severe bout of diverticulitis.
Good luck. I can identify!
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Learn2Cope Oct 2020
Yes, Citrucel is what I have recommended to her and is what she is using now. Also a little black strap molasses in warm water.
None of her pain is new. Having stomach issues and bowel issues together is quite common. The only thing new is that she had an injury that necessitated her taking pain medication that worsened the constipation for a while. Also limited ability to move around as usual, and also increased her anxiety.
She is a chronic complainer, so it is hard to sort out what is old, new, minor, or significant. I do know if it gets life-threatening she will go to the doctor. Until that time, I am the one that is dealing with it.
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Grrrrrr! You’re dealing with an awful situation.

My oldest daughter has Chron’s disease. Any of these intestinal issues are so difficult.

Best wishes to you.
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AlvaDeer Oct 2020
Anyone who has Chron's gets the hero badge from me. It is such a tough thing to deal with. My best out to your daughter. Like me she almost certain knows where the toilets are FIRST anywhere she goes. Hugs.
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The only insights I have into something remotely close are my sister's challenges with ulcerative colitis, which our paternal grandmother also had.    The mediocre health care plan doctor she had been seeing through work provided heatlh care had repeatedly diagnosed her condition as "flu", and she suffered miserably for months until one of her nurse co-workers arranged to have her nephew (radiologist), intervene,  and he D'X'ed UC.    She took a med for it but I can't remember what it was.    No more problems since then.

As to laxatives, we've always believed in natural resources, but you've indicated that she's already tried FODMAP regimens.

I don't know if this helps or not.   

What you might try to do is work on lessening her anxiety, which admittedly is hard at this particular time b/c of the pandemic as well as political strife.    Maybe you could have quiet sessions to inject calm, something like listening to her favorite music, thumbing through soothing magazines with photos of baby animals, country scenes (Country and Country Extra magazines are like this).

I think that sometimes facing medical issues directly can be reinforced by interaction methods.  When my mother was aging and facing health challenges, I brought her either carnations or roses every time I visited.    She was so happy, that I knew it was a worthwhile gesture, and a helpful one.
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Learn2Cope Oct 2020
My mother is legally blind, which increases her anxiety and stress. She cannot do any of the things that she used to do - she has always been a very "doing" kind of person. Has never had patience to read or focus for very long at a time. I've tried music - works some times, but she's really picky. Either she's "tired of the same songs", songs by singers that are dead "make her sad because they're dead now". Did I mention she's negative (even when not depressed, so worse when she's anxious or depressed). Says she can't follow plot lines in tv shows any more because she can't see the characters. Listens to news all the time because she can understand it. (And yes, I've told her it's not a good idea with all negative things right now.) She's terrified of getting Covid, worries about all the family members - this is normal for her. When I was growing up, I thought she was a worrier, until I read about Generalized Anxiety Disorder. I realized right away it was her problem.
Only one doctor said, yes, she has an anxiety disorder. And still she thinks her anxiety comes from her stomach problems and not the other way around.
She thinks worrying is normal, and worries about the fact that other people don't worry about things - especially family members. I have tried for years to use Cognitive Behaviour Therapy tools with her. Before she lost her eyesight, after she lost her eyesight. Now if I try, it is "You've told me all that before. It doesn't work."
I do record short articles from podcasts for her to listen to. She doesn't have or want the Internet.
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Lexapro and amitriptyline both have constipation as a side effect.
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Learn2Cope Oct 2020
The last time she tried going off Lexapro she started having panic attacks, led to a downhill spiral that was the worst shape I've ever seen her in. I would like to see her try to taper off the amitriptyline. I had brought this up with her family physician and he gave her some samples of Linzess. She tried a couple of times and didn't like what they did, so would not try again. The amitriptyline was prescribed by a gastroenterologist. The pills are too small to split, and I am afraid to try anything without doctor's assistance because if she stops taking them I'm afraid her panic attacks will get worse. She has had some lately, along with depression.
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Learn2cope, Your mom is in tough spot. I hope that her doctor can find another solution for her gastric problems.
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Learn2Cope Oct 2020
Thanks.
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Learn to cope, a stool softener often helps, colace perhaps once daily. Again, an over the counter thing. Not laxative but keeps stools softer.
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Learn2Cope Oct 2020
Yes, she's been taking that, too.
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Bentyl has helped me a great deal with any pain. The magic little blue capsule seems to stop spasming, at least for me, in about 20 minutes.
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Too many years ago, my doctor explained that the CARAFATE, with it's coating action, surrounds the other meds, rendering them inactive.
Do not know how the needed Lexapro could be working on the anxiety if your Mom is still taking Carafate. imo.

The Lactaid free milk has an added enzyme, called Lactaid. Can you try non-dairy products instead? Try Rice Milk or Almond Milk instead, imo.

Protonix has side effects listed:
Gas
Dizziness
Headache
Vomiting
Diarrhea
Stomach Cramps
Joint Pain

A review of her medications might help. One can consult a doctor over the phone now, or through online Zoom or Skype (the doctor can see you).
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Learn2Cope Oct 2020
Thanks. We were given to understand that we should just not take other medications within a two-hour window of the Carafate. I'll look into that, and double-check when she is taking things. She doesn't like the rice or almond milk, and the Lactaid has been okay for her until this last bout. She was off the Protonix until recently also. Though it definitely hasn't caused diarrhea, ha!
Her primary physician retired, and new doctor seems to require an in-patient visit for first appointment. Her insurance doesn't cover virtual visits. Paying for a virtual visit would be okay, but some of the routine doctor-on-demand services seem more appropriate for more cut-and-dried issues than what we are dealing with. I myself am having problems with less-involved issues that doctors are refusing to deal with virtually, grrrr.
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Seems you are doing all the right things with OTC meds. I know it is problematic, but it appears she needs to see her primary care doctor and get a consult for a gastroenterologist. She may need prescription medications to help at this point.
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I’ve had IBS symptoms for years, according to my daughter. I told her I didn’t want a diagnosis of yet another problem, and she said I was probably doing most of what mattered anyway.

I use Donnatab, which is OTC here, then nibble a little bit of bread, and find a higher pillow to keep me a bit more upright in bed (it is usually worst at night). Sometimes I walk around for a while. I also did a lot of checking to find out what was irritating my bowel, and it was chili. It is in so many things (sometimes hidden as ‘spices’) that it is worth checking very carefully. It wasn’t the only cause, but certainly the most reliable. Garlic is apparently the next on the list of likely suspects. If she likes food like this, it’s worth keeping a food diary.

It sounds as though your mother’s problem is worse than mine, but I hope these suggestions may help.
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Have you tried a spore probiotic? Just Thrive has one that works wonders.
Then there is licorice root that’s great for settling an upset stomach.
Or essential oils rubbed on the stomach, like Digest ease , Peppermint or
Ginger.
Ginger tea is also good, made with organic ginger root.
Digestive enzymes before meals are another great help.
For the acid reflux, a nice cup of warm lemon water made with one whole squeezed organic lemon in purified water first thing after getting up really works.
I love raw organic garlic and eat about 5 cloves daily and the reflux and heartburn were terrible until I started with the lemon water each morning. Been doing this for over 7 years now no reflux or heartburn. And now I can indulge in my favorites habanero pepper which I put on everything!
Drugs are never the answer, look to more natural remedies and be amazed.
Yet, this is my opinion and things I use and have had great success. Give them a try they can’t hurt.
Diet is also important, try going low carb and get the sugars and refined flours out of there and add more fiber rich foods.
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Is she ingesting other dairy foods? Since you have her on Lactaid milk I’m assuming that lactose intolerance may be one of her issues. Also there may be another food source that is causing her symptoms. I would suggest a food diary be kept for at least a week, Look for any repeats within a week that may be contributing to her symptoms. Typical offenders are eggs, nuts, certain fruits (especially citrus), seafood, gluten/wheat and soy. Food sensitivities can cause major digestive reactions without causing anaphylactic shock, eating more than one of these offender foods at a time can really cause havoc. Even if she’s eaten these foods all her life doesn’t mean she still can.
When you can get her in to see a doctor sharing the food diary will help.
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sorry for her distress.....have you tried yogurt?  there is Activia which can be drank 2 times a day (about 3 oz) flavored which has good pro-biotics to help with some stomach distress.  she should definitely stay away from anything with seeds and bloating type foods.  you can google for foods that "reduce bloating" (which I have done for hubby since he has some), mostly they are foods with plenty of water in them or other good stuff, I could list some = ginger is good for stomach ailments (ginger ale), cantaloupe, watermelon, cucumbers (without the seeds), pumpkin, coconut water, sweet potatoes (you can google for more).  She should see a gastroenterologist (she can wear a mask) because she definitely doesn't want to get a bowel obstruction (especially since you mentioned she has had a constipation issue).  Wishing HER luck as well as you.
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I probably have suffered from irritable bowel most of my adult life. I am 64 and just connected with an excellent gastrointestinal doctor. I always blamed my symptoms on stress. I take Heather's Tummy Fiber each morning and weaned myself off all acid reducers by using peppermint oil. Since IBS is an inflammatory disease I have begin a strict anti inflammation diet. Amazed by the results......no pain, diarrhea or bloating. I have had no flare ups in several months!!!!! So exciting. In the past I did use ginger pills and mint or chamomile tea for relief. Breakfast every single day is plain greek yogurt with fresh blueberries.
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I'm a 69 year old female, and have identical problems, for over several years. Last week I had and EGD scope, diagnosed with gastritis and inflammation around the esophagus ring. The GI doctor said to continue with normal diet for now until the results come back from the polyps biopsies. Meantime, back on Protonix 40 mg/once a day, which I've been on for years, off and on. When I googled gastritis, the special diet of no caffeine and acidic fruits and juices, and dairy, should be avoided. I'm now using Lactaid milk, too. What I'm concerned about not is that Protonix causes UTI's, which I seem to get frequently. Can't win!!! Not supposed to eat sugar, too, but I have to cheat once in awhile. Anyway, pain continues frequently. Also, don't use any Ibuprofen, NSAIDS, or aspirin, or products with those in it. Causes ulcers. Tylenol helps some, but not as great as I wish. Let me know if you find a "cure"......this is ridiculous to suffer so long with various doctors give different advice. Seems they keep passing the buck for someone else to make a decision. Good Luck.
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InFamilyService Oct 2020
Sugar is definitely an irritant to your GI track. Consider trying the Anti Inflammatory Diet.
I use Heather's Tummy Care fiber and peppermint oil but I have no esophageal issues. Mine is more colon related. I also take apple cider gummies and a probiotic.
Only Tylenol for pain relief.
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My significance other (SO) suffered from GI problems for years. Went to over twenty doctors to try to alleviate her distress. GI specialists, integrative medicine, acupuncture. On and on. Finally went on anti depressants and anti anxiety meds including ativan. I always suspected some brain involvment since doctors couldn't find anything else. Also because Parkinson's runs in her family. Eventually, she declined cognitively. She was diagnosed with dementia two years ago and has declined further since then. I originally thought the physical GI issues had led to the mental problems. Now I believe the neurotransmitter problems (the mental)were involved in the GI issues. There is definitely a mind body connection. Worth considering.
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On top of everything else that people are recommending is she chewing her food adequately and/or is there a problem with her teeth? Infection in the mouth can wreak havoc with the rest of your system and if food isn't broken down enough, blockage can occur. Last, on a similar note, could she have adhesions from old surgery that is causing a blockage? Strange things can happen. My dad had issues with low motility due to medications that led to entrapment of a portion of his small bowel in his thoracic cavity (next to his heart). Your mom should be assessed.
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InFamilyService Oct 2020
Very good points lynina2.
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https://www.heatherstummycare.com/
A huge help!
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scrapbooky Oct 2020
I agree with Heather’s Tummy Care. Wonderful website with lots of info. I especially like the forums. My son has been taking her Acacia for years.
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IB Guard - natural peppermint oil in a capsule, and Iberogast - natural ingredients. These two items have been lifesavers for me. IB Guard you can get at any CVS or Walgreens, but Iberogast is only available via Amazon.
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I feel for your Mum and you. Digestive issues are such a challenge to deal with and I can understand why your Mum has become a Negative Nelly. I have IBS-D, so no help with the constipation issues.

I did want to chime in about FODMAP. I was introduced to it 4 years ago and since the first reintroduction of foods, I have found more and more that I just cannot eat. In the last year I have had to give up cauliflower, cooked or fermented cabbage, raw spinach, beets (tops and root). I was 100% gluten free for 4 years, now I can manage small portions a couple times a week.

Lactaid does not help me, as I cannot digest the protein in milk as well as the lactose. Yoghurt is a terrible trigger for me. I can eat small amounts of goat or ewe cheeses.

Every day I eat a high fibre breakfast of granola (usually homemade, store bought is full of sugar), 1/2 a banana and 1/2 cup of berries with Almond Milk. Even us with IBS-D need lots of fibre, but we need soluble fibre to absorb the excess liquids.

When I have a flare up, I find that a bowl of cooked white rice (not instant rice) with butter and soy sauce for a couple meals helps to settle things down.
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InFamilyService Oct 2020
I have to share my favorite flare up food is ramen noodles(chicken flavor) with a beaten egg added. I have IBS-D too.
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Imho, she should see a new gastroenterologist STAT. Quite honestly, I would not wait. Even though I was never dx'd with IBS-C nor gastritis, I recently went to the ER for severe dehydration from eating far too much raw vegetables and using faux sugar products. For your mother in the meantime until she can be seen by a specialist, does she take a daily probiotic? Prayers sent.
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With over 20 yrs of IBS, and having consulted woth several Gastroentorologists, I may have found one who can help.

First go to: Irritable bowel syndrome - Diagnosis and treatment - Mayo Clinic which will give you a full and concise explanationof IBS.

You will note that the many of the medications suggested to help were not known to me before, even with consultations of "experts".

IBGARD is an over the counter pill that contains peppermint oil. That treatment may help you, so far it has helped me. Should that not work I may need one the prescription meds. But start as I suggest and find a Gastroentorologist that specialiizes in IBS.

I pray this helps you?
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Oh man, poor woman.

I always recommend probiotics through food, drink and supplements. Our guts are wrecked from our western diets and meds. You can buy kombucha at any grocery store or you can learn how to make it at home on Utube. Research the items available to find what would be the best option for your mom. We eat a fermented food every day to keep our friendly bacteria populated and we notice the difference.

Studies show that approximately 80% of Americans are magnesium deficient and that is a vital nutrient that affects our bones, heart and especially our nerves, just to name a few. When taken at night with zinc it helps our bodies to naturally create melatonin, which means we sleep better. But the best thing about it is that it will flush through your bowels, keeping you from being constipated. (When a loved one was on high doses of narcotics for a broken back he was taking all the prescribed remedies for constipation and not having any results, I recommended adding magnesium to his nightly routine and his issues were solved. He stopped taking anything but the mag and zinc and was not constipated again while taking those strong meds. He also slept better and that helped him heal.)
(EDIT: start with 400mg and go up until she has a BM. It can take a couple days when we are deficient, as our bodies are using every bit of it. Be sure that she takes it with at least 6oz of water to avoid any tummy upset.)

You can also buy magnesium in a liquid form, typically with calcium, which means you can't take the zinc within 2 hours to avoid minimizing the affect. But magnesium gluconate (splg?) Is a small gel pill and is easier for some to take.

I also recommend a good bone broth to help build up her gut health, kettle and fire has a wide array of tasty products. It isn't cheap but you don't need more than 4 to 6 oz daily, I would sip it 2 or 3 times daily at first to get things back in balance faster.

I have read the responses for natural products and they are really good advice for keeping it natural, which is my 1st choice always. I hope that you find the best solution for your mom and something that helps calm her nerves.
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