Diet and Health FAQ

Tagged As: Irritable Bowel Syndrome Medication

Question:
My son is 26 years old and has had severe bowel problems for the last three years. �Every time he eats he must first take medication or he gets severe diarrhea.�He has had extensive tests of all kinds which revealed nothing abnormal.�In the absence of anything concrete, his doctors labeled his problem IBS. He was taking a lot of lomotil for a couple of years, but a doctor told him he was becoming (or already was) addicted and recommended switching to a combination of asacol and librax. �This seemed to work for a few months. Then he moved and before finding a new doctor, his prescription ran out. So he used Imodium for a month or so (has to take lots of them with each meal). �This worked ok, but buying Imodium over the counter is too expensive for him. �He found another doctor who gave him a prescription for librax and asacol again. After a few days on this combination, which had worked for him before, he was feeling so lethargic he could barely make it to work (he is not normally like that).�He also began getting pains in his back and spinal area. I told him to stop the drugs immediately.�He did, and felt better immediately. But his current doctor told him it couldn't possibly be the asacol, and he could continue using it. �As soon as he resumed use of the asacol, he got pains in his spinal area again. So he had to stop using it. Now he is back on Imodium, which he cannot afford. He has to take about 6 or 8 of these with each meal. �His doctor says there is no prescription strength Imodium. �If there were, this would help him because he would take fewer pills and they would be covered by his health insurance. �His doctor also did not know of any safe alternatives that he has not already tried. So she recommended he see another specialist. I am the kind of person who uses medicine only if nothing else works, so I am somewhat horrified to see him taking so many pills.�I wonder what the long term effects are of taking all these different medicines. Has anyone else had similar problems with asacol or librax? �What about taking so much Imodium with every meal? �What is that likely to do in the long run? �Is there a safer, better medication to control symptoms while we encourage him to search for a long term cure? �Since, as far as we know, there is nothing organically wrong with him, I am assuming this is a stress reaction which has become chronic. I have had similar problems at times, but controlled it through natural means. �I am very worried about the effects of long term drug use, and would like to know what others have experienced in this regard. I am now trying to do research on the web to try to understand the problem and potential treatments better. �Any information you can point me to would be much appreciated. Are there any doctors who really understand this problem, or is it all hit or miss at this point?

Answer:
There are a few things to try: 1) Is he either lactose intolerant or gluten intolerant? It's possible that he may have a problem with certain foods that can cause Diarrhea. These can include dairy, gluten (wheat, rye, barley, oats), caffeine, fructose, sorbitol, alcohol, among others. 2) Start experimenting with a bulking agent such as Fibercon, Citrucel or Metamucil. (Metamucil is made of psyllium which has negative effects on some people. If it doesn't bother him this would be the cheapest as it's available in generic forms). The packages of these products say they are laxatives. They help with either diarrhea or constipation. If you have diarrhea, take the products with the least amount of water. I prefer Fibercon, or its generic equivalent, because they are pills while the others are powders that must be mixed with water. Bulking agents absorb water which helps normalize the bowel. If you're constipated, you take it with excess water. If you have diarrhea, you take as little water as possible and the bulking agent absorbs the excess water in the bowel. 3) Ask the doctor about taking either Colestid or Questran. While these drugs are not for IBS but taken for cholesterol problems, they help to control bile salts which can cause diarrhea. I take them and have gone from 4-5 diarrhea episodes/week to one every six weeks. They are also very inexpensive. 4) Taking so much Imodium can be overkill. Many people actually get worse diarrhea when the Imodium stops working. If you want to take it on a regular basis, start with 1/2 pill or one pill and give it a few days. 5)It is imperative that he get training in stress reduction. This can be such things as deep breathing, meditation, exercise, hypnosis, biofeedback, etc. 6) There is an ibs support site 7)If you tell me where he lives, I'll try to see if there's an IBS support group in the area. 8) A great place for IBS information on the web is: www.panix.com/~ibs This site will link you to dozens of sites on IBS. Del, a few things occur to me after reading your letter. One is that the Imodium PILLS (liquid is NOT formulated with lactose, go figure) are formulated with LACTOSE, so is asacol!! Try the liquid Imodium for a few days and take lactase tablets a few minutes before and after taking asacol and ANY OTHER dairy product for that matter. Another thing is that L-glutamine, an amino acid, makes the gut a little bit leakier, absorbs liquids better, so you/he might try L-glutamine too. I am also curious as to how much fiber is 'naturally' present in his diet and also how much fat. If he finds it difficult to increase fiber, at least try decreasing the fat a bit.