Pseudodiarrhea - Also known as Hyperdefication
#341198 - 01/25/09 11:30 AM
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I have been reading these message boards for a long time but this is my first post. I have had IBS for just about exactly 9 years now. Within the past year I came across the term pseudodiarrhea. I have solid bowel movements but 3 or 4 (sometimes more) times in the early morning. I have great pain all day long. I thought that I was constipated until I was prescribed Lotronex earlier in 2008(which did not work!). At that time, the gastro told me about pseudodiarrhea. I have tried most everything including the latest: Xiafaxin, Vivonex, Cymbalta. I continue to take 2 tablespoons of psyllium after each meal and take peppermint oil capsules several times a day. I did a search and could not find any reference to pseudodiarrhea on this website. Does anyone else have this problem? Please respond with any useful information. Thanks.
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ibs-d (pseudo)with pain and bloating
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Welcome to the board,
I have the same symptoms. For some years I thought I was constipated (IBS-C) too until a GI informed me that having many reasonably well formed small bowel movements a day is considered to be diarrhea predominate IBS (IBS-D).
I follow the Heather's Eating For IBS (EFI) diet quite closely but in addition I also have eliminated high fructose foods especially high fructose fruits and juices, honey and high fructose corn syrup. It made a big difference to my bowel movement frequency. Also, I found that pysllium soluble fiber made my symptoms worse. There is a good discussion of various soluble fiber supplements on this web page.
Good luck 
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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Hello Syl
Thank you for your reply. It is good to know there are others who share my problem. Perhaps if I follow your lead I will be more successful at managing my IBS.
 I find the frequency of my BMs to be a nuisance but the severe pain is of course extremely difficult to deal with.
I see from your posts that you are "stable". Does this mean you have your IBS under control? Is your pain controlled?
Which fiber supplement do you use? How often and how much? Which fruits do you eat? When do you eat them?
In general and specifically which foods do you eat? Can you provide an example of a day (or more) worth of food? Which food, when you eat them and how much.
Thanks in advance for any information you can supply.
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ibs-d (pseudo)with pain and bloating
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By stable I mean that I can go about my daily business without IBS being on my mind. It does not mean that I don't have symptoms - it just means that I have them under control enough that I can function fairly normally. One caveat - I don't eat out very often and if I do I am very fussy about what I order
I don't use a fiber supplement. In the past I used a fiber supplement but now I get my soluble fiber from my diet. However, it is probably a good idea to use a fiber supplement. Heather's acacia or Benefiber with wheat dextrin are pretty good fiber supplements for IBS. Be sure to stay away from supplements with inulin or FOS.
The fruits I eat are low in excess fructose. A fruit with excess fructose is one that has more glucose than fructose. The guidelines I use are posted in this message. I also don't eat anything containing high fructose corn syrup, honey or apple/pear juices which are found in many sauces and condiments. They are high in excess fructose.
Generally speaking I follow Heather's Eating for IBS (EFI) guidelines given in her books and on this web site modified for low fructose foods. In particular, I am make sure that every meal contains more soluble fiber foods than insoluble fiber foods. I never eat raw vegetables or foods containing whole grains. I peel and cook all vegetables to reduce the amount of insoluble fiber they contain.
Give Heather's EFI guidelines a try, especially reducing the amount of insoluble fiber and high fructose foods you eat. You should notice positive results within a few days although it usually takes a few weeks or even longer to get stable.
AND ask a lot of questions on the message board. There are a lot of people with plenty of experience managing their IBS who will give you helpful pointers.
Good luck
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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I have pretty much the same problem, if I take my souble fiber caps the bowel movements are ok, but like you the pain everyday gets the best of me sometimes. I went to the GI this morning and he gave me a script for Bentyl, I have never tried this but will give it a shot. Good luck and yes it does help to know there are others dealing with this
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Thank you Syl and steph312 for your replies and thank you Little Minnie and kiwi for your comments in the thread "using acacia fiber". steph312 – I don't know if I ever tried Bentyl, I've lost track. Recently I tried hyocsine (scopolamine) – another anti- spasmodic and as usual it didn't help. Please let us know how well you do on Bentyl.
On another subject, I have trouble maintaining my weight. When I was diagnosed with IBS 9 years ago I weighed over 190 pounds (I was overweight). Nowadays I weigh in the 130s. This is possibly due to several reasons:
1. I have constantly been on one diet or another trying to help my IBS. All of these diets tend to be for weight loss and none helped my IBS.
2. I was diagnosed with malabsorption at one time in a letter from my gastro to Metlife regarding my disability insurance. I am not sure whether this was accurate or just to support my disability claim.
3. I find it very difficult to be enthusiastic about eating anything when I know the pain it will later cause. And so I do not eat large meals. Currently I do eat 3 small meals and 2 snacks in between. For example, yesterday I had Cream of Rice and Rice Milk for breakfast. Home made soup with organic chicken broth, chopped spinach, asparagus, carrots and green beans and tomato puree and again Rice Milk for lunch. A breast of chicken on sourdough for supper and of course Rice Milk. Half way between meals I had a peach (Breakfast - Lunch) and a handful of cashews (Lunch - Supper). After each meal I take 2 tablespoons of psyllium.
I would appreciate responses which detail a day (or more) of meals/snacks and daily (acasia) fiber intake on Heather's diet. I just reordered her book "Eating for IBS" (I had it at one time) and am thinking of buying "IBS Audio Program 100".
Please respond with any help you can give. Thanks again
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ibs-d (pseudo)with pain and bloating
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Thanks capricorn, I did try the Bentyl today and found that it eased the pain a bit but no huge difference  I will keep trying it and if so I will move on to another one. From what I hear I don't think there is one that totally take the pain away or we would all be on it by now. Have you had any luck with other meds?
I also wanted to tell you I have the IBS Audio Program, and it is very good. I listen to it before bed and it helps to relax me, When I was new to all of this I came on here wanting to buy anything in hopes for any kind of help. Good luck and hope you are feeling better.
Stephanie
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I could be wrong, but if you are very D prone, quite a bit underweight and have physical signs like bad ski, hair and nails it shows you aren't absorbing nutrients. Your diet sounds fine to me, except you shouldn't eat cashews alone due to fat content and IF content.
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IBS-A for 20 years with terrible bloating and gas. On the diet since April 2004. Remember this from Heather's information pages:
"You absolutely must eat insoluble fiber foods, and as much as safely possible, but within the IBS dietary guidelines. Treat insoluble fiber foods with suitable caution, and you'll be able to enjoy a wide variety of them, in very healthy quantities, without problem." Please eat IF foods!
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I feel like I poop alot. It's not like I have hard dry stools and can't go to the bathroom. I often walk fast to the bathroom and stools just come out. Almost everytime when the stools come out there is always some still stuck inside I have to manually make it come out. Sometimes tho I get small thin stools that are mushy..thats when I have lots of gas..the only time..other than that is some gas before I gotta go to the bathroom..WHen its smelly gas I know its near diarrhea..and I believe thats when I eat too much bad foods or perhaps hormones.
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As you can tell Iam new to the board and enjoying all this wonderful information. However in regards to pseudodiarrhea I was diagnosed with pseudomembranous colitis last december and was put on antibiotics for about 3 month total I didnt think I would ever get rid of it. 3 months later I had my gallbladder removed. I felt great for about 2 months. One year prior to the colitis my colonoscopy show a trace of colitis near my cecum area which was to small to determine what kind. I returned to my gastro several times after that and began being treated for IBS. Ive had 3 test came back negative for bacterial overgrowth but am still symtomatic not sure what to do except try the IBS approach. Any feed back out their?
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