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?
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!
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.
My oldest daughter has Chron’s disease. Any of these intestinal issues are so difficult.
Best wishes to you.
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.
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.
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).
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.
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.
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.
When you can get her in to see a doctor sharing the food diary will help.
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.
A huge help!
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.
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?
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.