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Irritable Bowel Syndrome
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Posted 2/2/2006 10:39 AM (GMT -8)

New to the forum. Lots of great info posted here!

Here is my problem/story:

I'm 46 yrs old (male) and have been extremely healthy my entire life. Never even had a stomach ache in the last ten years. 5'9" tall and 160 lbs, vegetarian for last few years. I have a physical every year and everything has always been perfect.

Last August, I had an old root canal tooth crack, and it become loose. Went to my dentist and he suggested having it pulled and putting in a dental implant (and getting a new tooth). I scheduled the appointments, but it took 3 months until the tooth was pulled. When I finally got to the Orthodontist, he said that there was a lot of infection, and after he pulled the tooth (and placed the implant-same day) he gave me a 10 day course of antibiotics (amoxicillin).

Shortly after the antibiotics were finished, I started having very infrequent indigestion problems. Maybe once or twice a week, fairly mild. This lasted for a few weeks, and then the problems became more frequent and more severe. The symptoms were all over the place, ranging from severe bloating, to cramping and heartburn. Never a consistent pattern really. Worst part was the discomfort around bed time.

Sometime in mid December, it got pretty bad and I went to my GP. He listened to my symptoms for 5 mins and handed me 5 weeks worth of Achiphex (even though heartburn was only one of my problems). I took the pills for about 10 days, and the relief was somewhat random, never consistent.  In late December, my symptoms got worse, so I stopped taking the Achiphex.  I had VERY bad attacks of nausea, cramping, stomach bloating/pain, alternating constipation/diarrhea/gas. My appetite went to zero and I started losing weight. I had trouble sleeping (probably due to the anxiety of not knowing what was wrong!)

Went back to the GP (and a Gastro specialist) and they ordered a whole bunch of tests: stress test, chest X-ray, Barium Swallow, Ultrasound, CT Scan, Blood work (thyroid function, liver, C-diff, etc), stool samples (for parasites) and the only thing that came back showing a problem was that I have a small Hiatal Hernia.

Early January- things still not good! Back to the GP and he prescribed Levsin (.125 mg twice a day) and he told me to stick with the Aciphex. The Levsin seemed to help a little, but my prescription ran out a week ago and my symptoms haven't really changed a whole lot.  I used the Achiphex maybe 4-5 times per week, with mixed results.

It is now late January, and my symptoms are still bad (premature fullness, tightness in chest, bloating,cramping) and occurring every single day! Every meal is an adventure, even though I have tried to be as IBS friendly as possible. Since my diet is fairly low in fat anyway, it hasn't seemed to help much. I don't drink coffee, and I avoid dairy whenever possible. I have lost about 10 lbs..probably because I am so nervous about eating anything that will trigger my symptoms!

So here is my question: Is it possible that the infection from my bad tooth (or the antibiotics prescribed for that infection), killed off my good gut flora? Have the bad bugs taken over in the last 8 weeks and been causing all of these problems?

My GP/gastro/dentist all basically laughed when I suggested this!

I have taken Probiotics on and off for the last few weeks, but not consistently.

Should I be looking at some digestive enzymes also? And how long should it take for the probiotics to have an effect?

Any insight would be greatly appreciated!
Posted 2/2/2006 10:50 AM (GMT -8)
Hi Zaphod,
Welcome to HealingWell! :-)
IBS usually starts after someone has had surgery, food poisoning or a course of antibiotics. For you I think it was the course of antibiotics that killed off your "good bacteria" (flora). Did your doc not prescribe probiotics along with your antibiotics? If not, I think that should be your first move... get some probiotics and start taking a few billion (live cultures) per day. You can also try taking calcium which will help with the D and cramps.
Take care....
Posted 2/2/2006 11:00 AM (GMT -8)
you might want to get tested for c-difficil too.

i had bacterial overgrowth, was given antibiotic for it and now i am SO much better.... i was taking probiotics and all but my body wasn't getting rid of the bad stuff so it wasn't helping me. i was put on Xifaxan for two weeks. (it is an antibiotic that goes right to the small instestine and gets rid of the overgrowth) then i started upping my acidophilus intake and now i am actually normal again. (i get a few episodes--but nothing like i was for about a year straight)
prior to the overgrowth i too was on antibiotics for other stuff...
i hope you get better soon, and definetly get checked out.
Acidophilus is fantastic--but get the good refriderated kind!!!
(the bacterial test was called a hydrogen breath test or lactulose breath test. my new doctor does not do them and my old doctor was running out of options, that is why i had it done. and for c-diff you poop in some bottles...no big whoop)
take care!!!
--bunny
Posted 2/2/2006 11:17 AM (GMT -8)
I think you need to fire your g.i. I'll spare your GP and dentist, since that's not really their realm of expertise.

Antibiotics kill off ALL of the bacteria in your intestines, the good the bad and the ugly. This is a known fact. Get on Google and look up "antibiotic-associated colitis". That is the term for when the antibiotics kill off everything and give you diarrhea. Diarrhea during a round of antibioitcs is so common most GPs will warn you that that's a side affect before you even take it. Really GOOD GPs will tell you to take probitiotics while on antibiotics in order to keep from having problems later.

When most people come off the antibiotics, they go back to being normal. Some people, however, get an infestation of bad bacteria that takes root in the absence of good bacteria, and that's when you get long-term colitis (also known generically as IBS).

You need to be checked specifically for C. difficile (stool sample). It is the worst of the bad bacterias and when it gets in there, it's hard to get out. You usually have to take antibiotics again to get rid of it while taking probiotics to put the good stuff back in. Even if you don't have C. diff., you may have other bad bacterias in there.

My suggestion to you is to hit the probiotics and hit them hard. I reaserched this stuff back in the summer when I thought that my IBS might have been caused by this--not that I could get a g.i. to check me for it without doing an EXPENSIVE and invasive colonoscopy first--hello, stool samples are cheaper and easier, do them first! I read one dr's website and he said that when he prescribes antibiotics, he has his patients take triple or more doses of probiotics to counter the loss from the antibioitcs. For c. diff. he recommended even more. We're talking BILLIONS of cultures; most pills have between 15-100 million a pill. He was all for hitting them heavy to combat the bad bacteria.

The only drawback to probiotics is that they can give you gas. You may have to work your way up to multiple doses. Most people adjust after a week or two and are no longer gassy. I get gas cramps when I take acidophillus by itself, but I didn't have a problem with Digestive Advantage or Culturelle or even yogurt; maybe too much acidophillus just bothers me.

If you have c. diff., I don't know that taking probitioics alone will help you; I think you really need the antibiotics too. It's very hard to get rid of and there are plenty of people who have to take multiple rounds of antibiotics before they finally get rid of it. There's also a super strain going around that's resistant to antibiotics (scary!). But if that's not your problem, then you should notice some improvement within a month or less. It can take some time to get the bad stuff moved out, but if you keep on the good stuff, it should win out in the in.

Mind you, I am not a doctor (and I don't even play one on t.v.), but I have never heard of anyone overdosing on probiotics. Now, the way I understand this thing to work is this: you have lots for sale on your intestinal walls. Bacteria buy these lots and move in. Like any subdivision, there's only so many lots available. Bacteria that can't find a lot for sale cruise on by and if they never find anything, they leave the country (i.e. you evacuate them). If I remember correctly, bacteria are only conentrated in a certain part of your small intestines--they're not supposed to live at all in your large intestines and if they do start squatting there, that can cause IBS. When bacteria die, their lot becomes available and some other bacteria moves in. This may be bacteria born next door, or it may be a newcomer driving by, having a looksee. When you take antibiotics, this is like the black plague coming through and it kills almost everyone. The bacteria who survive reproduce and their offspring move into the vacant lots. If bad bacteria is what survives, you get "urban decay." If bad bacteria comes driving by, they can set up house, reproduce and cause the same thing to happen (bad bacertia come from all sorts of things naturally; you can't avoid them really). However, if you take probiotics after the plague, then good bacteria get first dibs on the lots and they move in and you have urban renewal. If you already have urban decay going on, you have to keep those good bacteria coming by so they can snatch up lots as bad bacteria die and they can get a toehold in the settlement. Then their offsprings are positioned to grab up new lots. This, obviously, takes a lot longer than getting the good bacteria in right at the beginning.

Yes, I often use metaphors to describe IBS problems, lol. The gist of it is, however, that if you don't have a place in your intestines for bacteria to implant, it will pass on through your system, thus making it impossible to overdose on good bacteria. They only live in your intestines, and don't get in your blood stream, so they shoudn't interact with any mediciations. Since they are good bacteria, they don't even interfere with your getting treatment for an infection (i.e. you can take them at the same time as you take antibiotics).
Posted 2/2/2006 11:27 AM (GMT -8)
Keri, Xifaxan is an antibiotic designed specifically for the intestines to kill off bad bacteria (ex. e-coli) from foods that are causing diarrhea, etc. The doctor does have to make sure that is what is causing the diarrhea.
Posted 2/2/2006 12:40 PM (GMT -8)

I submitted a stool sample for C-Diff on Monday per the Gastro Doctor.

I have not received any results.  I don't know how long that should take.  I assumed they were negative, because they never call you unless there is a positive result!

I thought that C-Diff mainly causes watery stools and diarrhea.  My stools are mostly just soft.

As for the Probiotics- I will try to get some tonight on the way home.

I feel better just reading some of these replies!

Posted 2/3/2006 9:55 AM (GMT -8)
When I was having my problems, I never had water in my stools, only soft, "flaky" looking stools. Mind, you, I don't know what was really the cause of my problem, but all of this stuff manifests in so many different ways. I liken saying "I have IBS" to "I have cancer". Well, what kind? What caused it? Fast or slow metabolizing, turmor or non-tumor? "IBS" is a similiarly generic term that can be caused by many factors and manifest itself in many ways. Me, mine is caused by not having a gall bladder. Some people's are caused by bad bacteria--including yeast overgrowth--some people have fuctional and/or muscle problems, some have parasites, some have food allergies. Unfortunately, there's not a lot out there in the way of definitive tests to tell you exactly what your root cause is, so you have to figure a lot of it out for yourself by process of elimination or drugging (i.e. you take probitiotics, they work, you probably had bad bacteria or yeast overgrowth).

Call your doctor, ask what yoru results are and fuss they haven't called you sooner. I hate it when no one lets you know what your tests results are, even if they're all good. Mind you, stool samples can take 3+ days, so I have read.
Posted 2/3/2006 10:08 AM (GMT -8)
Keri -Thanks for the advice- I will try to call today. Unfortunately, the darn Gastro Doctor is part of a big group and I'm usually on hold for 15 mins listening to a recording telling me how important my call is....

Had a bad night last night, and having a bad day today. Seems like anything I put in my stomach is causing distress, mainly nausea, chest tightness and some cramping.

By the way, I am taking some herbal stuff for parasites even though the original stool samples were negative. Gonna give that a shot for a few weeks, and then move on to something else.
Posted 2/3/2006 11:17 AM (GMT -8)
I hope you aren't coming down with gall bladder problems. The doctors always gave me heartburn medicines for mine even though I never had any heartburn. Said it would help with the "feeling too full" after eating a little, since that was only indigestion. No, that was a known symptom of a bad gall bladder. I've had indigestion before and that feeling wasn't the same.

But given that you just had antibiotics, I'm almost sure the connection is there.
Posted 2/3/2006 11:24 AM (GMT -8)
You know what, I never really thought about it, but I had an ulcer and was given the Prev Pack to take, and got really sick from it. So then they substituted the Previcid with Nexium. So it was 4 pills of Amoxicillian, 2 pills of Braxium (or something like that), and 1 Nexium a day. Did the ulcer go away...yes, but I will be darned if that wasn't when my IBS showed up. And even after Flora rebuilding, I am still all screwed up.

How much do we wanna bet that the excessive use of the Amoxicillian over a given period of time, doesn't only kill the bacteria, and the good Flora, but it actually hoses up something. I mean, how many of us here have not been on Amoxicillian sometime during our IBS lifetime? I know I have been on it about 4 times, and felt worse after each set. I wonder...
Posted 2/3/2006 12:47 PM (GMT -8)
Keri- I had considered Gall Bladder for a time. But my CT and Ultrasound came back clean. I think they could try a few more things, like the Gall Bladder function test where they inject you with something that stimulates the GB and then they watch it on the CT and see if it is functioning properly(releasing bile, etc). Someone here at work had that done and her GB was only at 5%, so they took it out and she was fine after that. The other GB thing could be a blockage caused by something other than a gallstone. This would make the bile get into places it should not be.

I'm trying like hell to figure out what has killed off my appetite. It seems like IBS wouldn't really kill my appetite- or do you think this is now a mental thing, being afraid to eat because of the bad reactions I'm having?
Posted 2/3/2006 12:52 PM (GMT -8)
I know for many IBSers the reason for weight loss is caused by us being afraid to eat. So maybe you are right - it could all be mental. Just my opinion.
Posted 2/3/2006 2:40 PM (GMT -8)
I agree with Lil. When food makes you sick, you quit eating. When I had a 3-week long gall bladder attack, my daily food ration included a bowl of corn pops. That was it all day long for the better part of 3 weeks. Anything else made me feel sick and I hurt so bad I didn't have an appetite anyways.

Check out my post on gall bladder disease and see if any of that sounds familiar. I also mention getting a hidascan, which is the test you're talking about. That's what diagnosed my malfunctioning gall bladder. But it took 5 years to show up on a test; previous tests seemed to have caught it on one of its good days rather than one of its bad ones.
Posted 2/6/2006 7:24 AM (GMT -8)
lol, I am usually afraid to eat, but if I dont eat I get sick, so I have to snack all dang day, and I gained weight; but am stable now, cant go up or down.
Posted 2/6/2006 8:16 AM (GMT -8)
Yeah-eating has become a real problem for me. I've lost 13 lbs, and can barely tolerate more than maybe 1000 cals a day.

I've really been hitting the research hard lately, trying to figure this out. I'm not so sure about the IBS diagnosis anymore- I'm now leaning toward stomach/acid/gut bacteria problems. Last week I had HORRIBLE acid reflux 2 or 3 days in a row. The Aciphex didn't even touch it. I was guzzling Pepto and eating tums to try to get it under control. Friday night I slept for maybe 2 hrs.

I've read elsewhere that other people have these cyclic problems(just like me)- raging heartburn for a few days, then premature fullness for a few days, then nausea etc. and then back to the heartburn.

I am really convinced that this is related to my bacterial flora being messed up. I would not be surprised to find out that I have a bacterial overgrowth which is causing the cycle: based on what foods I eat. Too many carbs cause the horrible heartburn(via gas production). Too much fatty food causes the premature fullness...and so on. I think in a normal person the bacteria is balanced so that it doesn't really matter what you eat (within reason). The good bugs just digest everything and keep things moving.

I was hitting the soluble high carb/low fat thing pretty hard to help with the IBS type symptoms. At first, this was working OK (not great). But about 1 week into it- that's when the Horrible heartburn started.

I almost feel like walking into the Doctors office and demanding that they perform a Glucose/Lactulose breath test to check for bacteria. Seems like a simple inexpensive test, and if it is positive, the targeted antibiotics are usually quite effective.

For now, I am taking ~10 billion organism probiotics every day. I have to really hang in there and hope that I see some incremental improvement over the next few weeks.
Posted 2/6/2006 10:11 AM (GMT -8)
Just so you'll know at the doctor's office, bacteria inbalance, etc. IS labeled as "IBS". Like I said, that word is a catch-all for any digestive tract disorder that is not exclusively an IBD or acid reflux. Excess bile from having no gall bladder = IBS. Yeast overgrowth = IBS. Bacteria imablance = IBS. C. difficile = IBS. Intestinal motility issues = IBS. Food allergies = IBS. Don't know what you're deal is = IBS.

BUT, just because they say you have IBS, doesn't mean necessarily that it's untreatable. Depends on what's causing your IBS. If you have a bacteria imbalance causing your IBS (basically causing you to have an irritated bowel), then there are ways to fix that and you can be free from IBS for good (although you'll have to be extra cautious with the antibioitics in the future).
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