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Chris,
I sure empathize with you as well, since I found that the diet alone did not entirely solve my ibs. The anxiety factor is equally as important for me. My symptoms didn't really get under control until I worked pretty hard on the anxiety part.
What has helped me most is cognitive behavioral therapy. I found a psychologist here in Toronto who did a study on ibs. Half of the subjects were given an SSRI and the other half were given cognitive behavioral therapy (CBT), the gold standard in terms of therapy for anxiety. (I am a social worker and psychotherapist myself.) The results were that both were significantly helpful, but the CBT was significantly more helpful than the SSRI. This study is in Heather's archives if you are interested. The psychologist is Dr. Shelagh Emmet.
So I worked with her on CBT and found it made a great difference in my symptoms. Most of the time I am virtually symptom free.
Re-tricyclics, if you find the minimum dosages in which they come are unnecessarily high, I discovered that there are (rare) pharmacies that are compounding pharmacies, which means that they will create capsules of an anti-depressant from scratch in as small a dosage as you need, as long as the basic element for that medication is available in its raw form.
Am I right that you have not had a colonoscopy yet? I understand from my medical folks that that is pretty crucial for ruling out anything else nasty that could be going on. I've had it twice and it's yucky but . . .
Good luck with all this.
Best wishes,
Linda
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Chris,
I really sympathize with you. I'm sorry that things aren't helping so much. Sounds like you're really working towards recovery-- I can imagine your frustration.
Just a few suggestions, though I don't know how much they may help: I had to cut out anything peppermint. I had started taking peppermint capsules and drinking tea when I started the IBS diet, but stopped when I started getting some heartburn type stuff (which I never ever had previously in my whole life!) Ironically, when I quit them some symptoms (gas, bloating, D) went away. Apparently I don't "do" peppermint so well. (I also can't tolerate Altoids, which I LOVE!)  Maybe you have a similar reaction? If you're using stuff like that, maybe that's why you can't stabilize on the limited "what to eat when you can't eat anything" and other spartan diets? Check what else you're consuming when you do the elimination diets (periphery things- meds, teas, drinks?)... maybe it's the stuff you're not thinking about that's causing a problem?
I can't tolerate carbonation of any kind-- BIG BUMMER. And that's a development that's happened since my diagnosis. I also can't do anything with any artificial sweetners (except Splenda). Have you looked into those?
Well, I don't know that any of this will help, but maybe...? 
Good luck.
*jen
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Chris hang in there - it isn't easy to have IBS.
You have gotten alot of great advice, but one more piece of advice. Have you and your wife gotten counseling over this? Your marriage sounds like a stress in your life. Even getting couseling for yourself should help you deal with stress better and should help your IBS.
Hope you feel better soon.
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Man Chris I sympathize with you soo much. It took 2 1/2 months of D and no answers from the GI Dr. or my own physician. Then I found Heather's website and tried it. Balance out and now I've been doing okay. I mean okay from the D. Now I'm C and D. Try a probiotic? or acidophilus? It may reduce your D naturually. The Dr. wants me to do paxil, I'm refusing any ssri's right now. I believe I can make it.
How about a calcuim supplement? I know how you feel right now, more stuff to try and it's endless. I lost a tremendous amount of weight over 53 lbs and I wish I would of found out about this sooner, the things to take to stop the D or at least get it under control. Try a different fiber supplement? Maybe acacia is not the one for you? I know you'll get it under control have faith in your body and try not working out too much sometimes this can bring more b/m's on. Please hang in there, you've got to get a GI dr. they specialize in this more than your reg. Dr.. Is there a local institution for digestive disorders near you? If so contact them, they may have a referral support group for good Dr's. Good Luck your in my prayers.
Sherri
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Hi Chris - I am just so sorry you're feeling awful and not seeing improvements. I really wish I had a magic way to make you all better.
I would pursue some of the anti-depressant / anti-anxiety meds option. These can really work wonders for some people. I'd also try the hypnotherapy tapes - especially since anxiety seems to be playing a big role for you, and the tapes are truly unsurpassed for addressing this angle.
I'm not sure increasing exercise would help, unless you really notice a lot of stress-reduction from this. If you're not doing something like a daily yoga practice, tai chi, meditation, etc. you might try to add this in.
I have heard from a doctor that someone with diarrhea-predominant IBS who still has chronic diarrhea after working their way up to 12-15 grams a day of a soluble fiber supplement does not have IBS, but some other underlying problem. I don't know if this is true, but it was an interesting statement, and I thought I'd share it for what it's worth.
I think it's really noteworthy that you do notice an improvement when you're just eating rice. That would surely point to some type of food problem triggering your symptoms.
The other thing you might want to try is the York food allergy tests - see this site http://www.yorkallergyusa.com/
I'm not totally comfortable recommending this test, but I have seen a preliminary clinical trial on its use for IBS patients, conducted by PJ Whorwell, who is one of the UK's leading researchers into IBS. The study has been submitted to Lancet and may be accepted for publication later this year. When/if that happens, I'll publish it in the IBS Newsletter. But the study was controlled, and the results were really impressive, so you might want to look into this testing.
I'm so sorry I just don't know what else to say. I really do hope you're feeling better soon. Please let me know if there's anything I can do to help.
Hugs,
Heather
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Heather is the Administrator of the IBS Message Boards. She is the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!
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Hi Laura -- you mentioned that switching your water helped you. I was wondering what the theory is about switching to those waters -- don't think i have ever heard of that -- and what did you experience?
Thanks !
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Hi Chris, sorry to hear you're struggling.
I know some people have problems with them, but I'm IBS-d and I'm on SSRIs and couldn't live without them. Starting them helped my IBS as did getting rid of underlying depression. If you get worked up taking stuff, then maybe you haven't given them a chance.
Thinking along those lines, you need to give the soluble fibre supplements more of a chance. My doc put me on these before I'd even had a confirmed IBS diagnosis and they made more difference than anything else, bar Immodium. It takes a while to get the full effect from them, so make sure you take them regularly.
Also, have you tried Immodium? This stuff allows me to live my life without always having to think about my IBS. Maybe start on a low dose to see if it likes you?  !
And you're right, combating stress is a biggie. I read something in my latest wedding magazine that I think applies to life in general and definitely for IBS-ers: To keep calm, don't sweat the small stuff. Then make the big stuff smaller. It's a good maxim for life. I also find yoga very relaxing (though I don't do enough these days!). Plus, just taking time for yourself. Make your bedroom a haven. Read books. Take hot bubble baths (with the books!).
Oh, and try Chamomile Tea. I can't have peppermint and this stuff is my lifeline for attacks. It's also really relaxing.
Hope this helps.
Linz
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