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.