Ah, IBS! The fun, the joy, the explosive diarrhoea! Aren’t you just quivering in excitement?
IBS, or Irritable Bowel Syndrome, is the medical term for “something is wrong with your digestive system but we aren’t really sure what.” It is not to be confused with IBD, or Inflammatory Bowel Disease, which is both more easily diagnosable because there are clear physical markers, and far more serious.
That’s not to say that IBS isn’t hellishly annoying and painful – it’s just unlikely to be fatal. What it will likely do is cause massive swelling, keep you on the hop between diarrhoea and constipation, possibly put some mucus in your poop, and make you unable to eat a wide variety of foods without horrific pain. Also, nausea. For no reason.
Doctors have never been able to nail down a cause of it and it seems like it has really become an umbrella term for digestive systems that are a bit delicate, sensitive, and easily upset. I apparently have it, but I also have a completely normal result for colonoscopies, endoscopies, and whatever-other-method-of-sticking-tubes-down-your-throat-and-up-your bottom-oscopies they can think of. For me, and for many in my position, the bowel difficulties are caused by endometriosis growing on or near the intestine, and doctors happily cover it with this wonderfully useful catch-all phrase – IBS.
Dealing with IBS
So, what to do if there is something like this going on in your piping? The first and best way it to look at changing your diet. I recommend the Low FODMAP diet, which I have discussed here, because it allows you to figure out what your main triggers are. Bear in mind, however, that it may not solve all your problems. I still manage to have plenty of stomach upsets even avoiding my trigger foods. What it will do is make sure that you aren’t suffering more than necessary by putting foods that will irritate your bowel straight into it.
In terms of dealing with the symptoms, I’ve discussed relief from constipation and bloating here. To my intense annoyance, there really isn’t much you can do about diarrhoea except ride it out. You can eat foods that you know will constipate you but then you have the risk that everything will swing the other way, and, let’s face it, most of what will constipate you is not healthy. If you are in serious pain and popping codeine for relief, you’ll probably find that swings you round into constipation territory too.
If you find that your poop is so liquid that you are suffering from faecal incontinence (i.e. you can’t hold it in or you don’t notice that little bits are slipping out), I recommend a good, thick panty liner such as the Tena brand. Designed specifically for incontinence rather than periods, they are long, thick and hold stacks of liquid. Importantly, they also hold in smells. They will hold the little brown demons off your clothes until you can get to a toilet. Keep a spare pair of clean undies and a pad in your bag as well (I’d recommend carrying those at all times with endo anyway). It may be embarrassing for you to buy and carry big old incontinence pads, but trust me, it is more embarrassing to poo your pants in public.
If you do suffer from faecal incontinence because of IBS, or for any other reason, you should not feel guilty or bad or embarrassed. I say this knowing that the few times it has happened to me I wanted to die of humiliation and no one even knew about it. It feels icky and you feel like a child who can’t even control their own bodily functions, but plenty of adults suffer from it and it is not something you can help or control. You are not gross or weak or pathetic – you are suffering from a disease and it is not your fault.
If you suffer from nausea, there are prescription medications like maxalon that can help deal with it. However, some of these can interact very badly with pain medications, so double-check before you dive in using them. Try ginger tablets or ginger chews to keep the sensation at bay, and double up with peppermint or lemon and ginger tea (peppermint reduces colon pain and lemon and ginger settles the stomach).
Finally, of course, consider what can be done to deal with the root cause, if you know what it is. If it is endometriosis, talk to your surgeon about whether there is any point attacking it surgically. There may not be. Like with endo anywhere else, removing it is no guarantee that it won’t just go back. Further, the intestine is such a delicate area that some surgeons prefer just to do a straight-up bowel resection than attempt to remove it, especially if it is small or deeply embedded. Either way, bowel surgery is risky, so you want to be fairly certain that there will be a tangible benefit before going in. It may be that sufficient medication can reduce the endo growth on the bowel enough to provide you relief from symptoms.
Of course, it may not, and IBS may become yet another unfortunate part of your reality when living with endometriosis. What fun, eh?
Do you suffer from bowel-related complications for your endo? Have you been officially diagnosed? What’s your best method of relieving the symptoms? Let me know in the comments.