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diarrhea to constipation to both

Posted: Mon Apr 19, 2021 10:27 pm
by cathytoss
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 :oops: :roll: 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.

Re: diarrhea to constipation to both

Posted: Tue Apr 20, 2021 9:49 pm
by Dr Jamal Hayat
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.