diarrhea to constipation to both
Moderator: talkhealth
diarrhea to constipation to both
hello! i was diagnosed with ibs-d in 2009, but also took a SeHCAT retention test then, which came out as moderate to severe malabsorption. the gastro said the scans were not diagnostic at the time, so the dx stood at ibs-d. my gp had been working as if the scan was dx and i was responding well with low doses of co-phenotrope to be able to leave the house. then i was disallowed from being prescribed co-phen by NICE, so have had codeine prescribed as an off label use. not ideal. i generally just don't go out. but within the past year I've gone from... careful if too much info 
gastrocolic Bristol stool urgent seven to almost no sensation until full of Bristol one, but the piles i seem to have acquired prevent accidents, mostly (only silver lining). i resorted to manual removal, and the urgent seven was waiting. i went to a doc with this, last August, because drastic bowl change=bad. i know, pandemics are bad. but. basically, he said there's nothing to do, ibs can change, you're fine (not my usual gp, this one). I'm now used to what i need to do, I've got gloves, I've read up on the physiology, i think i know what I'm feeling. but, should i try again, asking for help? every once in a while i feel like i shouldn't be doing this off my own bat.
gastrocolic Bristol stool urgent seven to almost no sensation until full of Bristol one, but the piles i seem to have acquired prevent accidents, mostly (only silver lining). i resorted to manual removal, and the urgent seven was waiting. i went to a doc with this, last August, because drastic bowl change=bad. i know, pandemics are bad. but. basically, he said there's nothing to do, ibs can change, you're fine (not my usual gp, this one). I'm now used to what i need to do, I've got gloves, I've read up on the physiology, i think i know what I'm feeling. but, should i try again, asking for help? every once in a while i feel like i shouldn't be doing this off my own bat.-
Dr Jamal Hayat
- Posts: 49
- Joined: Tue Mar 28, 2017 9:28 am
Re: diarrhea to constipation to both
Hi There,
Moderate to severe bile acid absorption can be treated with a medication called cholestyramine. Another option is colesevelam. If your GP is not comfortable in prescribing these medications - he can refer you to a gastroenterologist.
The need to perform a 'manual evacuation' to open your bowel - I think that's what you are alluding to-
does suggest - as you say - disordered physiology/abnormal anatomy (such as something called a rectocoele). In this regard you may benefit from have formal anorectal physiological investigations. Which test to have will depend upon access/expertise at your local hospitals.
Lastly - you can have somethnig called overflow diarrhoea - where you have leakage of loose stool (eg a bristol type 7) but also have a hard type 1 stool. The treatment for this is often a course of laxatives. You should be able to discuss this with your GP.
Moderate to severe bile acid absorption can be treated with a medication called cholestyramine. Another option is colesevelam. If your GP is not comfortable in prescribing these medications - he can refer you to a gastroenterologist.
The need to perform a 'manual evacuation' to open your bowel - I think that's what you are alluding to-
does suggest - as you say - disordered physiology/abnormal anatomy (such as something called a rectocoele). In this regard you may benefit from have formal anorectal physiological investigations. Which test to have will depend upon access/expertise at your local hospitals.
Lastly - you can have somethnig called overflow diarrhoea - where you have leakage of loose stool (eg a bristol type 7) but also have a hard type 1 stool. The treatment for this is often a course of laxatives. You should be able to discuss this with your GP.
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