A few queries

There is quite a long preamble before I get to any of the queries.

I have had some stomach issues since January after coming down with a bug following a period of stress. After eradicating H pylori, which was detected, my stomach continued to hurt. I have not got an official diagnosis but I believe that my symptoms point to IBS. I have been going to my GP since January about these issues but haven't received any really straightforward answers. In fact, I changed GP in March after getting nowhere with my first doctor and seeing a nutritionist, who was not too helpful either.

I started taking antispasmodics such as duspatalin and buscopan and they have worked really well for the pain which has more or less gone away. The exception has been after 9 days of drinking every day, sometimes heavily, at a festival and to celebrate a friend coming to stay. By the end of that, I had cramps, pains and stomach upsets throughout my last night of pushing out the boat.

Prior to this (before taking the antispasmodics), I spent a month teetotal, which must have been the first month completely free of alcohol I have had in the last 10 years. If nothing else, it taught me about how to socialise and stay up dancing until the wee small hours without booze (or anything else).

I realise that to some American readers, that statement might come across as borderline alcoholic but in the UK people drink on most social occasions. It is difficult not to. The biggest issue, besides jealously glaring at many a chilled lager, was probably explaining to people that I wasn't drinking (I pretended to be on antibiotics for most of the month).

With the antispasmodics, alcohol usually causes some diarrhoea the next day plus maybe some extra gurgling sounds but no pain. So I still drink, perhaps less than I would otherwise, because that seems like a price worth paying.

I have noticed that spicy foods often result in acid reflux (which I had never experienced before) and generally a mildly upset system.

I think that there are some other foods that have some influence but I am not disciplined enough to home in what to avoid (however, I have suspicions about the sweet corn I had recently). As far as I can tell, the usual suspects, dairy and gluten, seem fine. Also, I spent most of March feeling like my own dietary Mussolini, following a truly totalitarian regime provided me by the nutritionist I mentioned above. That put me off playing around with my diet too much.

If I keep a sense of perspective, I can breathe a deep sigh of relief that I do not have to abstain from alcohol, coffee or fish suppers. I just have to know that there are new limits.

All in all, the typical effects of IBS (bowel and stomach related) are not too onerous to deal with. They are a bit of pain but they are manageable. The bigger problem, the one that gets in the way of me feeling on top of things, is tiredness. I feel far more tired than I should be and this is something that has waxed and waned over the last seven months. I have had periods during which it hasn't affected me that much but it often comes and screws with all my plans for how I want to live my life. I can feel it around my eyes frequently around the middle of the day so it is not caused by sleep disruptions, which I get more occasionally.

The first query I have is whether I can put this tiredness down to anxiety. I have had several tests to rule out other physical causes (vitamin B12, blood sugar levels, etc...) and everything has come back well within the normal range. For a while I was quite resistant to the idea that I am suffering from anxiety. It is true that I have been quite upset but it always seemed to me that this was a response to the IBS and the tiredness, not the other way around. But I understand that it is all part of a complex whole in which the one both affects and is affected by the other.

I think that I was also resistant because of stigma around it being a mental health issue, which I didn't want to own up to. In a similar way, I think I didn't want to put my problems down to IBS for a long time. In part, because I was never given this diagnosis at my clinic but also because I thought that the H pylori infection made for a story I was happier with: You have a nasty bacteria, you use some medicine to clear it out and you get better. Bish, bash, bosh.

So I am ready to see my tiredness as something related to anxiety. As such, I may raise this as a separate thread in one of the anxiety forums. Still, I know lots of people with IBS report tiredness and don't look to anxiety (lots of responses in ibsgroup.org/forums/topic/94837-fatigueweakness/ - none of them talk about anxiety) so I still want to know if IBS can cause tiredness in a more direct, physical way. I think I will find it easier to deal with with tiredness as a symptom of anxiety if I can be sure that I have done everything I can to attend to potential physical causes first.

Some people talk about the contractions of the intestines causing tiredness due to all that extra work being done to push food through. That doesn't seem too plausible to me since I can run half a marathon easily enough and feel a lot more awake through the physical exertion. Also, it is not the kind of tiredness you get from exercise (if only it were!). Some people talk about the fact that the altered gut behaviour stops all the nutrients from foods being absorbed. While it makes sense to think that food that moves through one's system and comes out as diarrhoea does not get absorbed as well, my tiredness isn't all that related to the occasional diarrhoea I have. Besides, the clinic has assured me that if I weren't getting enough nutrients from food then blood tests would have revealed something important that I was lacking.

The other query I have is about a film (white and foam-like) appearing in the surface of the water after passing urine or a BM. This happens perhaps during a third of trips to the bathroom. I have read that this is typical of IBS. Is it the case, as suggested in this thread (healingwell.com/community/default.aspx?f=26&m=791838), that the film is mucus that is secreted by the colon when it contracts and that with IBS as a condition this happens more often and with greater vigor, which causes the excess mucus? If so, I guess your body just keeps making more mucus and there are no harmful consequences. I had been worried that (as suggested elsewhere) it is undigested fat. I thought this would explain my tiredness (since, despite the bad press it gets, fat is pretty essential). I just need to put my mind at rest so that when I use the bathroom and see a film on the surface I can see it as something normal and benign.

That was quite lengthy! :shrug: