Help with my Mother and IBS

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prm
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Date Joined Oct 2005
Total Posts : 4
   Posted 10/26/2005 4:47 AM (GMT -7)   

I'm new to this forum and I need help for my 77 year old Mother.  I have turned into her primary caregiver and she is now a shut-in.  She has been dealing IBS for the last 7 years since her gall bladder was removed and the doctors diagnosed her with IBS.  Since the local doctors could not help her with the IBS after all of the testing they did, she has decided not see any doctor ever again.  She has trouble sleeping with cramps and discomfort.  But the biggest problem is in the morning.  She has bowl of bran cereal (6g fiber) and about an hour later she has a piece of wheat bread (5g fiber).  Right after the bread she has 1/2 teaspoon of clear Citrucel in water.  The Citrucel has no taste and that is why she originally liked it.  45 minutes later she has an upset stomach and her whole body gets upset.  This lasts the better part of 4-6 hours, which is the perfect is timing when I come home she is still upset. 

 

She was on Metamucil for 6 years at the full dosage, but the last couple of years it made her really sick so she started to cut back on the dosage.  She is only taking 1/4 of the recommended dosage of Citrucel and she still gets an upset stomach.  The makers of Citrucel have been no help.  She drinks her 8 cups of water a day and gets about 20-22 grams of fiber total, but nothing is working.  She has one good day a month and rest are bad. She does everything the doctors originally told her, but most of it came from her experimenting and telling the doctors what she is doing.  They just kept telling saying that is a good idea, but they would not recommend anything, it is all self-diagnosis and self care.   I am at lost to help her, especially since she refuses to see a doctor.

 

Any suggestions or help would be greatly appreciated.

 

Paul


dbab
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Date Joined Jan 2004
Total Posts : 4151
   Posted 10/26/2005 4:56 AM (GMT -7)   
Hi Paul,
Welcome to Healing Well :) You sound like a wonderful son!

What is your mother having trouble with mostly? Is it diarrhea or constipation? We have many members who have had their gallbladders removed for different reasons and then end up developing IBS. I believe that a couple of people here actually take medications that help with their diarrhea symptoms as a result of the excess bile causing problems. I believe one of the medications is Questran and it works by to binding bile acids which in turn should relieve some of the diarrhea symptoms.

I know it must be really hard and frustrating not being able to help your mother because she won't see a doctor.  She sounds like she is very strong willed and you might not be able to convince her.  You might want to see if you can convince her to at least change her diet a little to avoid the foods that are causing her more problems.  Please check back in a while and I know you will get more responses from people that have more experience with this.

Take Care


Hugs, Des
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Post Edited (dbab) : 10/26/2005 5:59:50 AM (GMT-6)


prm
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Date Joined Oct 2005
Total Posts : 4
   Posted 10/26/2005 6:36 AM (GMT -7)   
Hi Des,

Thank you for your comments. She is very strong willed, but I think she is open to change if it will help her. She is on a roller coaster. One day she has diarrhea and then the next constipation. It seems like she has lots of pressure. She really eats very little. Even her 1 cup of coffee is extremely weak.

Is Questran an over-the-counter medicine or prescription only. I always wondered about the excess bile from the removable of the gall bladder.

Thanks again.
Paul

dbab
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Date Joined Jan 2004
Total Posts : 4151
   Posted 10/26/2005 6:44 AM (GMT -7)   
Actually the gallbladder stores bile and releases it slowly to help in digestion. Without the gallbladder, the bile will empty into the GI tract as it is produced. Too much bile emptying out is what causes the problems after surgery. Questran is available only by prescription in the US. I'm not sure if it is available anywhere else. High fat foods will cause more problems without a gallbladder.

I hope we get more responses soon, my husband had his gallbladder removed 6 years ago and he occasionally has problems so I have read up on it a lot but I don't have that first person knowledge.
Hugs, Des
Co-Moderator ~ IBS Forum
 
"Sometimes I'm afraid, and I don't feel that tough...But I'll stand back up" - Sugarland
 
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Keriamon
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Date Joined Jun 2005
Total Posts : 2976
   Posted 10/26/2005 7:33 AM (GMT -7)   
Gosh, that's a lot of fiber and almost all of it at once. She's probably giving herself gas from all of that, which is what makes her hurt and makes her stomach upset. Some people react worse to fiber than others and our bodies change over time. So while that level of fiber may have been fine several years ago, it may not be anymore. I think I'm the only person in history to take a fiber pill and get more constipated, not less!

Older people are especially prone to constipation, which is why prune juice is so popular among the elderly. I know my grandmother takes half a Correctol every day. If your mother is prone to constipation, try giving her something else for it because I think the fiber is probably causing her the pain/gas. There are the usual chemical laxatives, then there are other things, like epsom salts (nasty tasting, though), prunes and aloe vera. At the very least she should not have so much fiber all at one time--it needs to be spaced throughout the entire day. Personally I don't think fiber pills or fiber drinks are a good idea, since that's not a normal conduit for fiber and your body isn't made to process it that way. Fiber should come from fruits, vegetables, cereals and bread. Our bodies are made to digest fiber, carbs, sugars and proteins all at the same time. Getting just one thing at a time can disrupt it. So if she continues to drink the mix, have her at least drink it with a meal that's not also full of fiber (i.e. don't drink it with the bran cereal).

If she is suffering from diarrhea--and it's full of bile (yellow and burning)--then fiber won't help her a bit (at least it's never helped me). The Questran dbab mentioned is for bile. I take Welchol for mine. It does the same thing: binds up the bile. I don't know about the Questran, but the Welchol--while a cholesterol medicine--is not supposed to interact with most other drugs, meaning people can take it that can't take a lot of other medicines due to drug interractions. It is a prescription and she'll probalby have to see a G.I. to get it, since it's not well known among G.P.s for its bile-binding properties. But my mother-in-law and I are both on it and will sing its praises all day long. My mother-in-law was almost crippled by her constant diarrhea: every time she ate, she had immediate diarrhea. Now she only has that problem occasionally (probably when she eats foods she's not supposed to eat); for the most part she is able to travel and eat out again.

Also, I have had some success with calcium pills too. They don't combat bile, but absorb excess water in stools--which can be caused when fats are not digested because there's not enough bile (all roads lead to diarrhea for those post-gall badder). Your mother is probably already on calcium supplements, but not all supplements work for IBS. The kind others recommend on this board is Caltrate 600 with Vitamin D (or it's generic equivalent). It has the proper balance of magnesium and calcium. Magensium is in there to keep normal people from getting constipated by calcium. So if your mother is on calcium and is constipated, check the calcium supplements; she may need a different kind with more magensium. If she has diarrhea, try the Caltrate 600 because it has less magensium than many other brands and helps absorb excess water (otherwise the extra magnesium in another brand may be contributing to her diarrhea). You'll have to talk to the doctor that put her on calcium and see if it's okay to switch her--she may be on a certain kind because it provides more calcium than other brands and she needs that level of calcium.

Also, if she suffers from diarrhea, does she drink a lot of caffeine? Caffeine is a trigger for some people with bad gall bladders and I can tell you from experience that even after having my gall bladder out, caffeine still does not agree with me. She's not having a cup or three of coffee in the mornings with her bran cereal is she? She may want to try switching to decaf. That's decaf everything: coffee, cokes, black tea. Herbal teas, including green tea, don't have enough caffeine in them to bother me, but she may want to go completely cold turkey to see if it helps, then work her way up slowly to see what tolerance level she has. Also, carbonated drinks aren't too terribly good for people with IBS since they can cause excess gas, so the cokes may need to go all together.

What amount of fat/grease does she consume during the day? Is she fond of frying everything? Does she drink whole milk? Is she one of those grandmothers who makes Sunday cakes with Crisco and real butter? Fat is a tricky customer. People without gall bladders can't digest fats properly (either too much bile or not enough), so they wind up with diarrhea. However too little fat causes constipation in anybody. So, if your mother is on a low-fat diet and is constipated, try upping her fats. If weight is an issue, then have her eat fat, but in very small portions (you may want to consult with a nutritionist, especially if she has other problems to manage, like diabetes). The best kinds of fats are fish, eggs, olive oil, avacados and whole milk products (milk & cheeses), butter and cream. Fried food is greasy and does not help weak stomachs, so it's not a good fat. Nor are potato chips or many kinds of crackers--again greasy. Red meats are harder to digest and should be eaten more sparingly--chicken is the best commercial land animal to consume. Pork falls after chicken but before red meat. Venison is not quite as good as fish, but better than commercial chickens. If, however, she suffers from diarrhea, have her decrease her fats. I controlled my bile diarrhea for almost a year by staying very low-fat, low-calorie. Your mother, though, cannot do this if she is already thin or underweight. And she probably can't do it if she's diabetic, since low-fat foods are crammed full of sugar. She will need the Questran or Welchol to bind up the bile so she can eat the amount of fat that she needs.

The only other major trigger food I can think of are apples. Apples and apple juice are bad for IBSers for some reason; they just produce too much gas. I think, however, that cooked apples do not cause most people problems. And raw apples are not as bad as apple juice--which seems to be concetrated gas cramps in a bottle.

One last word of advice. Go to a lawyer and get a Power of Attorney drafted. You and your mother will have to sign it in the presence of witnesses and a notraty (you can sign it at the attorney's office). This will allow you to have complete and total access to her medical records. Which means even though she won't go to a doctor, you can go for her. Once you have that document, you can take it with you and go see one of her previous doctors and talk to them about her problems and about what you are doing to try and help, etc. I don't know that they will prescribe her medicine without seeing her, but you can at least discuss changes to her diet and medicines with a doctor. Just tell the doctor that you are there on behalf of your mother who is house-bound. They may can even set-up a house call for her or a home health care nurse to check on her medical condition occasionally.

I hope this helps. Lord knows everyone of us on this board know what it's like to hurt and to go to the bathroom too much or not enough and to be afraid to go out in public (which, by the way, older people also frequently suffer from depression, so if you get her to feeling some better physically, and you suspect she may be depressed or anxious, you may want to have her see a mental health professional). I think she'll find, though, that she's not alone when it comes to other people her age; digestive tract problems are a frequent occurance among older people. You may try and encourage her to join a senior center or senior activities so she can commiserate personally with people who will understand not only her stomach problems but everything else that comes part and parcel with old age--aching joints, inability to sleep, loss of taste buds, friends who pass away. Complaining about anything and everything is a God-given right of retired people, so let her exchange it with others who can sympathise and return fire! She'll feel better for it.

7Lil
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Date Joined Apr 2005
Total Posts : 3269
   Posted 10/26/2005 8:17 AM (GMT -7)   
Hi Paul,
Welcome to the site!
You have recieved great information already. I would just like to add that I am pretty sensitive to fiber so my doc suggested I take Psyllium instead of Metamucil or Citrucel (etc.). Psyllium is much easier on the gut and can usually be found at any health food store.
Keep posting!
Co-Moderator for the IBS Forum
 
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prm
New Member


Date Joined Oct 2005
Total Posts : 4
   Posted 10/26/2005 10:20 AM (GMT -7)   
A few more comments on my Mom. She does cook some fat and does fry food. Most of it is for me, as she eats very little. We are both on low fat diets, which has helped immensely. Only skim milk in the house and she only has 1 or 2 cup of coffee a day.

I have taken care of the lawyer and do have the Power of Attorney. I never thought I could use that though for talking to the doctor.

I do have question - I thought that Metamucil contained Psyllium which is binding. That is why she got away from it. Does Psyllium come in pill type form, or only a power mix?

Thank you to everyone so far on the comments.

Paul

7Lil
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Date Joined Apr 2005
Total Posts : 3269
   Posted 10/26/2005 10:28 AM (GMT -7)   
I'm not sure about Metamucil having Psyllium. Maybe it does have it but isn't soley it. I can't imagine my doc would tell me to take Psyllium instead of Metamucil if they were the same thing. ??? (You got me thinking.)
Anyway, Psyllium comes both ways... pill or powder.
Co-Moderator for the IBS Forum
 
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prm
New Member


Date Joined Oct 2005
Total Posts : 4
   Posted 10/26/2005 7:07 PM (GMT -7)   
I guess I made some mistakes that my Mother corrected. She has one eggo waffle for breakfast at 6am. Then the Citrucel around 7am. about 45 minutes later is when her stomach gets upset. At 8am she has her bran cereal and then around 9:30 she has her wheat bread. As she told me the biggest problem is the gas. She has gas most of the day and pressure and discomfort. During the night she also has quite a bit of discomfort. She is confused that the fiber in the morning that she has could be causing all the discomfort, especially in the evening. Anyhow that is my new updated problem to address. The excess gas and the morning discomfort from the 1/4 teaspoon of Citrucel.

Thanks again,
Paul.

dbab
Veteran Member


Date Joined Jan 2004
Total Posts : 4151
   Posted 10/26/2005 9:21 PM (GMT -7)   
Paul,
That seems to be a problem with fiber... the gas and it comes from a lot of sources of fiber rich foods. Just take a look at beans and green veggies. Full of wonderful fiber however these are the foods that are known for the gas and bloating. I take Beano when I am going to eat anything that I know will cause gas and I have had a lot of success with it. She may want to give that a try or if that doesn't work, many others get relief from Gas-X. Just remember Beano is taken before a meal (about 15-20 minutes works for me) and Gas-X is usually the relief after the fact.
Hugs, Des
Co-Moderator ~ IBS Forum
 
"Sometimes I'm afraid, and I don't feel that tough...But I'll stand back up" - Sugarland
 
Please help Healing Well continue to help others by donating  http://www.healingwell.com/donate
 
 

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