Worsening IBS....definition of D
#358579 - 05/12/10 02:00 PM
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Been dealing with IBS for 3 years.....probably triggered by 20 yrs of panic disorder.....Since i developed painful anal fissures 6 wks ago....my IBS is off the charts....and usually im neither C or D....just painful gas....nausea and upset.....but now im vacillating between C and D.....one question is....i eat a mix of soluble and insoluble fiber(if i just eat white bread, etc....i get constipated...if just whole grains....go to bathroom too often)......today ive gone to bthroom 3 x and feel the urgency to go again.....and everytime i go...my fissure goes into spasm and pain which lasts for hours....So...my stool is not watery...its well formed, etc.....but going 3x per day even if well formed.....is that considered D? I feel stuck between a rock and a hardplate....panic///ibs////anal fissure....not sure what else to do...
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i guess no one on this board has experienced this?
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It is difficult to give advice without knowing exactly what you are eating. It would be helpful if you gave the meals and snacks you have eaten in the past 2-3 days.
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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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thanks...ive posted in the past...thought you remembered me 
This has been going on for a 5 weeks and getting worse.....mostly i stick to the diet below and am fine but lately not fine...ever since fissure.......
Bfast......oatmeal with almonds banana and walnuts
snck on pretzels
lunch.....white/brown rice with almonds, apple(1/2) and walnuts
dinner...pasta with chicken or fish.....this has been going on for a few weeks....
I have varied above diet over last few weeks...with artichokes/chicken with cheese/rice balls/etc etc......but even these might be trigger foods...seems the same....
i think its related to my anal fissure......and the cream im taking nifedipine......it lowers bp and applied to rectum is prob influencing bowel habits????? plus im in pain from the bowel movements ......its a crazy cycle.....
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Hi - I remember you - I just don't recall what you are eat
Is your primary objective is to promote healing of the fissures? If yes then you might consider reducing the amount of insoluble fiber in your diet for a while. For example, remove nuts, brown rice, unpeeled apples, etc and increase the amount of soluble fiber from peeled well cooked even pureed veggies and fruits. Does this make sense?
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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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thanks....not sure if it makes sense...all my doctors are telling me to avoid constipation since it prob caused the fissure and hemmoroid to begin with.....if i dont eat any soluble fiber i become very constipated.....so not sure what to do......do you think the cream is causing it....the cream helped healing it but i had to reduce it since it made me light headed, etc.....so im screwed either way.....like panic and ibs wasnt enough.....fissure is like having knife blades in your anus...sorry...very painful.....
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Are you C (3 or fewer BMs per week) or D ( 3 or more BM per day)?
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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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im usually neither....but now im 3 bowel movements per day for a few days and then 0 bowel movement for 1 day and then back to 2 to 3 bowel movements.....you have to remember...each bowel movement causes the intense pain/splitting for hours after.....i tried colace every night which also helped soften but it was causing me even more ibs problems....
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It seems like you are more D than C. And it sound like your bowel is having lots of spasms.
Insoluble fiber, particularly from whole grains is a strong GI stimulant and since they indigestible they may irritate fissures as they pass. Perhaps you should worry about getting insoluble fiber from nuts, brown rice or whole grains for the moment. You can get all the soluble and insoluble fiber you need from well cooked peel veggies and fruits. Later when thing settle down you can go back to experimenting the nuts and brown rice in your diet.
Have you been tested for Crohn's disease or ulcerative colitis?
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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 will give it a try...will start out slowly reducing...perhaps the nuts are also irritating ........white rice is ok then?
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Much of the insoluble fiber in nuts and whole grains is not only not digestable but it is not fermentable by bacteria in the colon. The results is the tough bits passed unchanged irritating the fissures.
White rice is great!
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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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thanks syl....i will have to change my eating habits at work next week...will give it a try......but need a colonoscopy.....between the fissure that bleeds.....and for the last 3 months ive had dark brown urine....esp after running....something seems off to me.....
thanks for helping so many on these boards..
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Closest I can say is I have horrible "hems"  , with bleeding sometimes. Someone posted to use vaseline prior to BM - sorry to be so technical, but best advice I ever received.
Like you, I may be "D" for a week, then vascilate back to "C" and not go for 2 days. If I don't use the vaseline, I have horrible pain and bleeding. May have a fissure - must make myself have an endoscopy and colonoscopy this summer.
Lots of bread makes me "C" and also causes candidias (yeast) for me, but makes my tummy OK until the "C" gets bad. Also if I eat lots of fiber - horrible pain, gas, bloating - feel like the Goodyear Blimp!  It's so hard to find the right combination - especially when you are trying to stay "regular". Used to eat brown rice, green beans and roasted chicken and it would work - now it just causes pain. Go figure!
As for the dark brown urine - if you haven't seen a dr., you need to asap - could be blood in your urine - nothing to mess around with....See your GP or a urologist about this.
Blessings! - Dorothy
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"I Will Survive! :-)... I shall live and not die and declare the works of The Lord..."
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Thanks....
I cut out all nuts now for 4 days...and eating skinned 1/2 apple..no improvement....still having oatmeal in AM with a bit of peanut butter and 1/2 banana.....and then lunch is a mix of white and brown rice(didnt completely cut out the brown yet)....with kale or spinach cooked......im wondering if the fissure is causing the diarhea(not watery...just ahve to go a few times per day) or if the nifedipine cream is causing it? Not sure anymore
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I just had to have my say in this, as your situation sounds so familiar! I have IBD, and last fall was horrid with active UC and a fissure (or two) - but I've lived through it, so keep your spirits up - no matter how hard it may seem right now!
D is NOT caused by the fissure, rather the fissure is caused by the frequent visits to the toilet or C (try not to push too hard). I got light headed from the cream at first too, but in the matter of a few weeks my body got used to it (don't apply it on an empty stomach!). What I found very relieving for the pain (and bowel spams) was taking hot/warm baths at least up to my waist, and I've heard going to the toilet is less painful when doing it inside a cube of warm water (as discusting as it may seem!). I assume your doctor has already told you to use a hand shower to wash up afterwards, or at least use alchohol free baby wipes instead of regular toilet paper.
Taking loads of liquids also helps the evacuation through the fissure, and please follow the dietary suggestions Syl has given you! It's not easy to change our habits, but living with the kind of pain fissure causes is no life at all!!
It took two months for the fissure I had to fully go away - I'm ever so relieved it did, and I hope it never comes back! Hopefully you'll be able to say the same soon!!
Regards
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I would try cutting the oatmeal and brown rice out completely. I am not Celiac but oatmeal and brown rice don't agree with me at all.
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IBS-D for 12 years
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