IBS?

[lass]

Hi, I'm not sure if you can help me or if you are only able to comment on neurological problems, but I'll ask the question in the hope that you can help! (I apologise, this is a long post).


I'm a 36 year old woman and since February 2006 I have become aware of a very irregular bowel habit. (This was the cause of my anxiety). I have had this investigated, in the form of blood tests and sigmoidoscopy, and everything came back normal. A year on, I still have what I would consider an abnormal bowel habit and some other symptoms that worry me. I have arranged to see a consultant (mid April) in the hopes that this will reassure me that something more serious has not been missed, and also to hopefully get some help on how to live with my symptoms.


These are:


Mainly constipation
Often mucus
Occasional diarrohea
Occasional blood on wiping (bright red, small amounts)
Occasional rectal pain/discomfort
Abnormal stools (small, round "pellets", or long and thin, or the look of mushy undigested food!)
Occasional bloating and wind
Occasional urgency and not much control
Occasional niggly abdominal pains which come and go very quickly, but no cramping


I worry because I have a family history of bowel disease (my father has ulcerative colitis and bowel polyps, and his father and sister also had chronic digestive problems, although I'm not sure exactly what).

I also worry because, although some of my symptoms match what I have read about IBS, other symptoms don't (such as not experiencing the terrible pain others suffer, and also the blood in stools concerns me a lot). And I thought IBS came and went, whereas my symptoms stay with me in one form or another. I used to think the anxiety was to blame, but I do have periods where my anxiety is very much under control, and the bowel symptoms continue.


I have been taking fibogel (twice daily) and initially this helped the constipation a lot, but I've found lately that it doesn't seem so effective.

I eat a very healthy diet and exceed my recommended 5 a day fruit and veg. I drink lots of water plus herbal teas and roobush tea, and I avoid caffeine. I don't drink alcohol regularly and I don't smoke. I exercise regularly and am active in my day to day life. I limit wheat in my diet as I find this makes my bloating/wind worse. Basically I feel I am doing everything I can think of, yet am still having problems!


I think I have probably read too many books on the subject of IBS and other bowel disorders, and I am now concerned that maybe I should have had other tests that I have not had; such as for stool analysis, parasites, faecal occult bloods, ovarian cancer. One book particularly worried me saying MS should be ruled out first! I'm not sure what is available on NHS. When I had my sigmoidoscopy I was told that if I wanted a full colonscopy that I would have to pay for this privately (I guess it was not seen as essential with my symptoms), and I've always wondered since whether I should have had this done, although it is very expensive.


I was really hoping you might be able to advise me on what, if any, further tests you think I might need so that I can discuss them with my consultant.


My GP seemed very unconcerned about the bleeding when I mentioned it (many months ago), however I have not been given any explanation for it and I have had several episodes since I last saw her. She also suggested my rectal pain was due to a "mobile tailbone"; however I have noticed that it seems to be associated when my stools are very small and I think are maybe not being passed and perhaps causing irritation. Is this possible?


I'm sorry this is so long, I hope it makes sense, I'm just trying to sort out all the worries spinning round in my head so that I can go along and see my consultant with a list of what I want to discuss in the limited time available.


I really hope you can help.

Many thanks.

[RLR]

Okay, let's take a breath and relax. I understand your concerns and here's some information that may help. It's important to realize when reviewing information about illness and disease that a "range" of symptoms are possible that occur over a broad segment of the population afflicted.

As for observing streaks of bright red blood on tissue, this is most commonly due to very small vessels that rupture due to straining during bowel movements, most typically by those suffering with constipation. The sort of blood we see with regard to oncogenic processes is rarely bright red and if so, it is observed by the patient in very copious amounts to the extent that anemia is present in most cases.

Pain with IBS is more common in the lower left quadrant, but does occur elsewhere for some patients. It is oftentimes confused with pain from gas that becomes trapped in the lumen of the intestines, which can cause discomfort in many areas and is rather transient and difficult to pin down.

If you have a family history for colitis, etc,. then it's simply a matter of being screened by a gastroenterologist if symptoms appear. Also, IBS is a diagnosis of exclusion, meaning that after ruling out other disorders, IBS is the likely cause. While your symptoms appear to be IBS, consultation with the appropriate specialist will help get you on track. Treatment is available for IBS, with drugs such as Zelnorm that can help with a great deal of success.

[lass]

RLR,

I just want to say a big thank you to you for taking the time out to answer my post. You have reassured me enormously. I wish I'd had some reassurance earlier about the bleeding, because I have spent many hours worrying myself silly over this.

Thank you again.