IBS & Testing

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keriza71
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Joined: Mon Apr 08, 2019 7:10 pm
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by keriza71 on Mon Apr 08, 2019 7:25 pm

IBS & Testing

Having suffered IBS type symptoms over many years (I’m now 47), I was finally diagnosed with H Pylori in 2012, eradication therapy successful, yet some symptoms remained & over the past few years have bounced around on various PPI’s. Currently 20mg omeprazole once daily. 18 months ago I returned from a holiday abroad with diarrhoea, abdominal pain (moves around, upper/lower abs), wind/trapped wind. GP did lots of blood tests & stool tests incl calprotectin, h pylori, all clear. Gallbladder ultrasound also clear with miniscule fatty liver. No red flag symptoms. Problems seemed to resolve themselves suggesting anxiety re symptoms had been making everything worse. Since then periodic symptoms, resolving after a couple of weeks & fine for months. Symptoms now back for 3-4 weeks, again discomfort lower or upper abs, urgency of BM’s sometimes, loose BM’s 2 or 3 times a day, gassy pains in intestines often on left groin area, lower back discomfort with the wind pains, all resolved by the 2nd or 3rd daily BM, mostly. I get 2-3 days symptom free most weeks. Usually fine when sleeping, everything seems to calm down although sometimes wake up with painful wind which resolves when passing. Will GP suggest doing all the tests over again, 18 months later?? Or assume still IBS? I realise the symptoms can change a bit. It’s really getting me down, considering a CBT in my town who specialises in gastroenterology CBT! Thank you!

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Dr Mani Naghibi
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Joined: Tue Apr 02, 2019 10:51 am
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by Dr Mani Naghibi on Mon Apr 08, 2019 9:36 pm

Re: IBS & Testing

Hi Keriza,
You are describing classic IBS symptoms and the most common IBS pattern. Though it seem this was triggered by an acute episode on holiday, so best called post-infectious IBS. Bowel habits in IBS can alternate between loose and hard stools (while some people have predominance of one over the other). The bloating and relations of symptoms to stress is also really well recognised in IBS. The presence of H.Pylori and its eradication is often in parallel to the underlying IBS, and not the driving cause.
Your GP/doctor is quite right to rule out gall stone disorders, as they can mimic some of your symptoms.
The longterm use of PPI can increase the chance of imbalance of bacteria in the GI tract (called small intestinal bacterial overgrowth - note this is not an infection, rather an imbalance). What is the reason for the longterm PPI? Can you wean off? You can discuss a diagnostic test for this imbalance with your GP, often a breath test. This condition can be treated.
Given the symptoms started acutely in your 40's, coeliac disease is unlikely, though should also be ruled out with a simple blood test once. Other standard blood test like inflammatory markers, blood counts, liver test should also be done along with a stool calprotectin as a powerful test for inflammation in the bowel. These are easy enough to repeat a 2nd time if the symptoms suddenly reappear.
Worth mentioning that PPIs can be a direct cause of diarrhoea. A trial off or switch to Non-PPI acid suppression can be helpful, guided by your GP.
CBT is a good option for IBS, though you may consider diet changes, increased exercise and probiotics an easier choice. Great results have been achieved for IBS with the low FODMAP diet, best carried out under the supervision of a trained dietitian.
Dr Mani Naghibi
Gastroenterology Consultant

http://www.talkhealthpartnership.com/on ... aghibi.php

keriza71
Posts: 4
Joined: Mon Apr 08, 2019 7:10 pm
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by keriza71 on Mon Apr 08, 2019 10:07 pm

Re: IBS & Testing

Dear Dr Naghibi,
I very much appreciate your response, I am seeing my GP tomorrow morning so I’ll be able to discuss with her your thoughts. She has mentioned weaning me off the PPI before - to be honest I’m not sure why I’m still taking the PPI, I think my GP in my previous town just put me back on it after a month off it, to allow for H Pylori testing, so I have successfully weaned off it before. 18 months ago I had negative results for full blood count, coeliac, Crohn’s & IBD. Thank you very much indeed for your time, hopefully I’ll be a little bit further forward after tomorrow.

Kind regards,
Keri

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Dr Claire Mansfield
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Joined: Tue Mar 28, 2017 9:32 am
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by Dr Claire Mansfield on Tue Apr 09, 2019 12:19 pm

Re: IBS & Testing

Hi Keri

As you and Dr Naghibi mention, anxiety may be contributing to your condition, so therapy, whether CBT or another form of talking therapy, might be a good way to think about how anxiety might be impacting you, and any changes you might want to make. Similarly, your condition itself might be contributing to stress levels as it sounds as if you have been experiencing some really difficult symptoms. There are loads of resources on the internet about how to find a therapist near to you, or your GP may be able to signpost you to a local organisation.

Good luck,
Claire
Dr Claire Mansfield
Chartered Counselling Psychologist - CPsychol, PsychD, MA, BSc

http://www.talkhealthpartnership.com/on ... sfield.php

keriza71
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Joined: Mon Apr 08, 2019 7:10 pm
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by keriza71 on Tue Apr 09, 2019 2:02 pm

Re: IBS & Testing

Hi Dr Mansfield,

Thank you, I’ve contacted a local CBT who specialises in gastrointestinal disorders, hoping to hear from her soon. My GP has today suggested I stop taking omeprazole, I’ll take ranitidine in it’s place for a couple of weeks & see what happens. Unfortunately my local surgery doesn’t have the ablity to test for SIBO.

Kind regards,
Keri

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