Am I IBS-D? Unsure how to categorize
#363457 - 02/13/11 08:58 PM
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Hi everyone,
This forum is awesome and I have learned so much more from all of you than from the 2 doctors I've been to! My question is that I am not sure how to proceed with diet, supplements, etc. because I'm unsure if I'm IBS-D. I do not have emergency bowel movements or have to plan my errands, etc. around bathrooms. I have one normal BM every morning and then I have small ones most times I urinate during the day. They are not watery or loose in consistency. I do have a LOT of pain and gas all the time. What are your thoughts? I have had a colonoscopy and a CAT scan of my entire abdomen so have not been found to have IBD. Thank you for your advice.
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According to the Rome criteria
IBS-D is 3 or more bowel movements a day
IBS-C is 3 or less bowel movements per week.
Sounds like you are IBS-D.
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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 had thought it was more of an issue as to how hard/soft the stool was. I would say I average 3 BM's per day, but they fall under the category of 'C' based both on appearance and hardness/straining. I had found a chart breaking down all BM's into 7 categories and almost all of them fall under the 'C' classification. Would this not be IBS-C, then?
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Likely IBS-C and Fructose Malabsorption
Undiagnosed and going through testing process
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IN chinese medicine, the definition of constipation is less than one bowel movement per day or difficulty or incomplete evacuation. This makes more sense to me than that rome criteria. And of course they take in to account whether or not the stool is soft, hard, loose, or dry to make a diagnosis. Constipation can be from many things for example an excess condition (too much heat drying up the fluids) or a deficiency condition ( not enough blood/fluid or digestive fire to move the bowels- this constipation will tend to have soft normal type stools difficult to evacuate) or it can be from some sort of stagnation that needs to be moved.
My opinion is that its impossible to categorize IBS in to IBS-D, C and A.
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If you'd like to know the chinese interpretation of this they would most likely cause it (liver overacting on spleen/stomach). In many people it will further affect the intestines but in your case its not. This type of IBS is usually mostly affected by enotions like anger or stress, hormones, or some sort of stagnation that is not allowing the Qi of the stomach to properly descend and the Qi of the spleen to properly ascend causing cramps, bloating, and pain.
what kinds of foods are you eating?
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It is difficult to define IBS-C. The Rome criteria is based on motility and form. I thought I was IBS-C for many years until a GI doc straightened me out  He also told me that docs that listen to what patients think they are (IBS-C or IBS-D) can be misleading some times resulting in the wrong treatment. If you are in doubt talk to your GI doc.
Here is a more complete definition:
Constipation is difficult to characterize as it has varied meanings to different people. It is often based on a patient's impression that their bowel function is not normal. Defining constipation in a scientific manner has been problematic. Currently, the Rome III criteria are the most widely accepted means used to define constipation. At least two of the following conditions must be present for at least 3 months:
- Straining during defecation > 25% of the time
- Lumpy or hard stools > 25% of the time
- Sensation of incomplete evacuation > 25% of the time
- Sensation of anorectal obstruction > 25% of the time
- Manual maneuvers to facilitate defecation > 25% of the time
- < 3 bowel movements/week
You might have to keep a detailed stool diary for a few weeks to figure it out.
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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 believe it is all perception. It is what you feel is your problem. I have 2-3 BMs a day but they are perfect consistency until I get D for eating wrong or for no reason. That will be followed by what technically isn't C but I feel it is and if I don't evacuate fully I get D again. A really bad GI doc I saw recently told me I didn't have D or C. I went speechless. I decided you do if you feel that you do.
You don't necessarily have to be C or D to have IBS, as long you have one from time to time and a lot of classic other IBS symptoms more often. I am IBS-A obviously but if you never, ever get C then you are probably IBS-D.
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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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that is very interesting, I am pretty sure I was A then, although pseudo-D seems likely as well, nevertheless the remedy is for both conditions adherence to Heather's diet and probably fodmap too, it's not as if there's different things to do/take if one suffers from one or the other, so at the end of the day, immaterial really whether one is C or D or A?!
something else I've been wondering about is that IBS itself can be exarcebated by stress and people suffering with such digestive woes often have a nervous disposition, ie it has been traced back to the gut-brain connection. my question would be, lactose and fructose intolerance, and having to restrict galactans and fructans, etc these cannot be improved through hypnosis or relaxation right, only by adequate diet?
also lactose intolerance is obviously something that comes with age to many of us. is that the case with other fodmaps or are they with us from birth usually etc? (I remember that as a child when I had no IBS I still had bloating very often)
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Susie, born in 1985,
(pseudo-)D and bloating April 2007-December 2010, now stable
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From the posting on this board it seems there can be a difference between the subtypes particularly the amount of IF that can be handled. In particular, individuals with IBS-C have methanogens in their colonic flora which produce methane gas in the colon. The degree of C increases with increasing methane production. This fact has been suggested as a useful biomarker for distinguishing IBS-C from the other IBS subtypes. However, as of yet there is a poor understanding of how to manage mathane production in individuals with IBS-C.
Hypnosis is unlikely to be helpful for malabsorption problems as these are physical problems. FODMAP malabsorption is not the direct cause of IBS. Even non-IBS individuals can have difficulties with some FODMAPs. If hypnosis worked on FODMAP symptoms then it would work for managing GI discomfort in individuals that don't have IBS. So far this has not been demonstrated to be the case.
Yes - lactose intolerance increases with age. So far I have not seen any information that suggests problems with other FODMAPs increases with age too. It is early days in understanding the mechanism behind FODMAP problems. Hopefully future research will give us a better understanding.
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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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