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Thanks for taking the time to post all this! It sounds like you're doing all the right things. I've never tried the Citrucel caplets, but the ingredient list reads safer than the mixes, so that's probably not it. I'm going to do my best to point out a few foods you listed that sort of jumped out at me:
Do you usually eat an apple without problems? Is it a whole apple? I know just half an apple, even if peeled, gives me a stomach ache, gas and bloating.
What about the soy cheese? Soy cheese still contain a couple of ingredients that a few IBSers, like myself, are sensitive to: casein (a milk protein) and carrageenan (an additive). I noticed a significant descrease in gas, bloating, and urgency when I cut out soy products that are dairy food alternatives and contain casein and carrageenan. Not everyone is sensitive to these additives, however, it might be worth a try to avoid them if you're still struggling to get stable.
Do you know what was in the baked beans? Sometimes the canned ones can be high in HFCS or restaurant ones can be made with ham. Just whole beans can be problematic because of the IF skins. You could try mashing them to mechanically breakdown the IF and make it easier to digest. Aren't beans sulfur-containing foods? Couldn't this lead to the odor and gas you experienced?
What about the sourdough bread? By keeping a food journal, I've noticed that eating sourdough bread in the past has triggered an attack--I've also experienced smellier stools with it too. I'm not sure why, but I found when I switched to regular French bread and limited the amount of yeasty bread I ate a day, certain symptoms improved, such as frequency and odor. It could be an intolerance or sensitivity to yeast.
Do you take a probiotic or eat soy yogurt? I find eating soy yogurt helps reduce odor.
With Immodium I would take 1 caplet in the morning or the evening, depending when I felt most crampy or rumbly, before I had an actual attack. Now that I'm stable, I take 1/2 to 1 in the morning before an important event or traveling. If I take two Immodium, it's usually after an attack, and I do notice that it makes me more crampy, gassy, and then a bit constipated for a few days. With 1/2 to 1, I get the desired effect but without the constipation--I'll have a regular BM the following day, although I will be a bit more gassy.
I hope this helps. How are you feeling this afternoon?
Edited by Maria!Maria! (07/05/05 03:01 PM)
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Well baked beans are majorly gassy for me - I can't eat them at all now. Pickles, shredded carrot, appleas and soy cheese are also all triggers for me.
And it doesn't sound like you're eating very often at all! For safety, you should be eating something SF every 2-3 hours.
The trick with Immodium as a preventative is to take a low enough dose. If even 1/2 a tablet once a day makes you C, then you can get the drug (loperamide) on rx in liquid form to allow you to take teeny amounts. I have to say, I do recommend it.
If you're on Prevacid, you shouldn't really be drinking peppermint tea! 
Have you tried narcotics like codeine for the pain?
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Quote:
I take the citrucel caplets, 4 in the am, and 4 pm
If I'm reading Heather's SFS FAQ page right, you're getting only 4 grams of soluble fiber a day. I would definitely try increasing that - go up slowly. As I said, I take 20 grams of SF from acacia a day. That's high for a D, but I think 4 grams is too low.
You don't seem to be getting a whole lot of IF, but you may be getting more than you can handle or possibly you just can't handle certain kinds of IF. For example, I noticed there are a lot of sour dough items in your diet. The sour dough bread and rolls I see all have whole wheat in them - from what I can tell, it is used in the starter somehow. Perhaps you cannot handle that - my gut objects to any whole wheat at all. At a minimum, I would try Maria's suggestion and switch to just plain French bread for a while. I also agree with her that soy cheeses can be problematic. Since you're not stable at this point, I suggest you avoid any dairy like the plague.
I really would try the Break The Cycle diet for a few days and see if that helps. If it does, then re-introduce IF very, very slowly and carefully. I'd go with cooked IF first - it seems like raw is harder to handle. And be sure to keep all dairy out at least until you're stable with a reasonable amount of IF. I still won't touch dairy. Also, my experience has been that I cannot handle fat well in the morning, which is my worst time. If your worst time is at night, then I'd be particularly careful about eating fat late in the day.
As I understand it, both the diarrhea and the cramps result from your colon going into spasms, so I don't think the diarrhea is actually relieving the cramps, although I know it feels like it. If I'm wrong about this, I hope someone will correct me.
What the Immodium should do is ease the spasms, which should help the cramps while it prevents the diarrhea. (BTW, your pattern is totally familiar to me: cramp, bathroom, bathroom, bathroom diarrhea, bathroom worse diarrhea, bathroom mostly liquid diarrhea, done. Cramps stop, diarrhea stops, but really, really tired. I don't get a sulfur smell, but I used to get ammonia smell when it was really, really bad.)
The meds I can't help a lot on. I take Immodium when I go out near home and Donnatol when I travel longer distances. They both help, but the meds I tried before I got on Heather's diet and acacia did nothing, so for me the meds are the icing on the cake - Heather's diet and acacia do 90% of the work and the meds just mop up the last little instability.
The one thing that does stand out is that you're drinking peppermint tea before bed and you're taking Prevacid. Maybe one of the GERD people can help out here, but I thought Prevacid was for reflux and peppermint tea is not good for reflux, especially right before bed.
As for the prozac, if you flared up right after you got off it, there might be a connection. I just don't know enough about it. Maybe someone else can chime in here.
The two big things I would suggest you try first are increasing your SFS (slowly!) and going back to just soluble fiber foods for a few days, then adding in other foods (very slowly!). It took me 6 months to go from all soluble fiber foods to baked beans and even longer to get to pickles.  I know you've been doing this for a while, but something seems to have de-stabilized you badly (or perhaps you were never completely stable) and I think the best thing is to kind of start over.
I also like the idea of taking Immodium as Maria suggests, but I never did that (wish I had) so I can't speak from personal experience there.
I hope some of this helps.
--------------------
[Research tells us fourteen out of any ten individuals likes chocolate. - Sandra Boynton]
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Maria!Maria!
Thanks for the tips, If I put apple, I meant applesauce, the natural unsweetened kind, if I do eat an apple, is it skinned and I cut it in small pieces, if it's apple, I try to eat it after the SF, since I did read that apples without the skins are safe. I don't have baked beans often, but I always get Bush's vegetarian style, and try to get all my SF in before I eat them and don't eat them in huge amounts, just enough to get my ISF. I have only ate the sourdough bread, since it does seem to be a favorite of the board and considered safe. I have never tried any other safe "white" bread, french, country, we have a delicious bakery close to wear I work, they have all kinds of homemade, maybe I should try me a loaf of french. I just assumed the sour dough was the safest. I will get the imodium and experiment, I will try taking one when I start cramping up. The most frustrating thing is the timing, as I said, seems to be usually at night, after I've gone to sleep, the cramping wakes me up and keeps me up.
Does anyone know any findings on BCP's (birth control pills) and IBS or Prozac and IBS, wondering if I should try starting them up again, just to see.............
Today, I have had my Citrucel, water, Half a bagel for breakfast, the other half and some pretzels and a graham cracker for lunch, dinner I'm going to try some baked white meat chicken and plain rice and some applesauce, to get my fiber in...............I have to work tomorrow, so I hate to eat anything that I think might trigger an episode. I think I will start an eating journal, I keep a D journal, pretty sad huh, now I think I'll keep the food journal
Thanks again!!!
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IBS-D, extreme pain and cramping - GERD - lactose/dairy intolerant, OCD, Fibromyalgia
DX: w/ Multiple Sclerosis 3/10
I can do all things through Christ who strenghtens me. Phil 4:13
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Linz,
I drink the peppermint tea for my tummy cramps and gas, does it and Prevacid have a contraindication with one another. Prevacid is the only med that helps my awful GERD. I guess since I saw the carrots on the SF list I assumed they were safe, that's why I added them to my sub and I LOVE seedless cukes...............Can you eat regular cheese or low fat or fat free cheese?? I dont' eat often, cause I'm usually not hungry  Like If I eat oatmeal for breakfast, I'm usually not hungry by lunch time and a lot of the time make myself eat something.............I need a gut replacement, forget the boob implants and botox, I just want a normal tummy....................:) I'm going to get some Imodium and keep it here and start trying it.
Thanks
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IBS-D, extreme pain and cramping - GERD - lactose/dairy intolerant, OCD, Fibromyalgia
DX: w/ Multiple Sclerosis 3/10
I can do all things through Christ who strenghtens me. Phil 4:13
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Sand,
I do get more fiber than just the "Citrucel", the pretzels I eat have fiber, applesauce and the sourdough stuff I eat has fiber. I do eat bananas, nutrigrain bars, most anything I try to eat, like no yolks and pasta plain, have some fiber, I try not to rely on just the citrucel for my SF fiber. I would say probably in a day I get about 10gm of SF fiber. I may have asked this before, but where is the break the cycle diet on the board?? Thanks so much to everyone, lots of tummy hugs
Cheryl
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IBS-D, extreme pain and cramping - GERD - lactose/dairy intolerant, OCD, Fibromyalgia
DX: w/ Multiple Sclerosis 3/10
I can do all things through Christ who strenghtens me. Phil 4:13
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Quote: (BTW, your pattern is totally familiar to me: cramp, bathroom, bathroom, bathroom diarrhea, bathroom worse diarrhea, bathroom mostly liquid diarrhea, done. Cramps stop, diarrhea stops, but really, really tired. I don't get a sulfur smell, but I used to get ammonia smell when it was really, really bad.)
OMG, I can't believe there is someone out there that KNOWS what I'm talking about.......Thanks Sand
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IBS-D, extreme pain and cramping - GERD - lactose/dairy intolerant, OCD, Fibromyalgia
DX: w/ Multiple Sclerosis 3/10
I can do all things through Christ who strenghtens me. Phil 4:13
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Your D journal isn't sad! Lol! I mark the # and quality of BMs I have on my calendar as well as in my food journal! The food journal has been a great help; I've been able to pinpoint some things I never would have thought of such as the soy substitutions for dairy that contain casein and the sourdough bread (although I admit when it comes to bread I can overdo it, which would probably make anyone sick).
There might be some studies posted in the IBS Research Library about the birth control pill and IBS. I know for some people the Pill has made their IBS worse. However, in my experience, the Pill has actually helped; I've been on it for about eight years now. I did go off it for about a year and during that time my IBS worsened--especially the week before and during my period. I did have to experiment with a few different pills before finding one that reduced my cramps and duration of my period. Because my periods are shorter and the cramps minimal, I find I rarely ever have a D attack during that time. I still get period farts, if you know what I mean! Lol! 
If your attacks happen at night, why not try taking 1 Immodium before you go to bed or following dinner? At least this way you can get some rest and break that cycle! Speaking of breaking the cycle, here's a link to Heather's recommendations I think you asked for earlier: FAQs (including BTC overview) and What to Eat When You Can't Eat Anything (I hope this is the right info you wanted).
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I get the same attacks that you and Sand describe. The horrible, horrible cramps that take your breath away. Bathroom, bathrooom, bathroom, some D, explosive D, liquid D, done and completely drained (literally) and ready for bed.
I am not sure about your bakery but mine here glazes their sourdough bread in egg which could be a problem. I would try white bakery bread. I cannot stand "wonder" bread or any with preservatives so I always buy bakery bread, french or white sandwhich bread is safe.
I have GERD and cannot have peppermint caps, teas or anything because it irritates it. Have you tried fennel? it soothes and calms my tummy.
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Microscopic Colitis, IBS-A, GERD, Hiatal Hernia
Bethany, Ontario, Canada
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Peppermint tea is a MAJOR GERDs trigger, so you should not be drinkinng that. Try very strong chamomile and fennel instead.
Cooked carrots are fine. Raw, the relatively small amount of IF can be a problem for some. The cucmber SHOULD be fine, but the skin has plenty of IF in it. Baked beans are soooo bad. Soy cheese usually has casein in it.
Try snacking instead of doing meals. I'd be so ill if I was eating that infrequently...and so little! Tiny amounts of food are fine...just frequently.
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