Living with the Two Faces of IBS: Constipation and Diarrhea

Living with the Two Faces of IBS: Constipation and Diarrhea

Coping with IBS constipation and diarrhea is like talking to someone with multiple personality disorder. In the first part of the classic movie The Three Faces of Eve the shrink never knew who was going to answer him next: Eve Black, the bold seductress, or Eve White, the meek jelly-soft wife of an abusive husband. With IBS, no matter what I eat, I never know which attitude my bowel will assume: the slow, uninspired stool of constipation, or the angry, explosive blast of diarrhea that doesn’t always give me enough time to reach the restroom. IBS always leaves me guessing. You might say it’s an exciting life, one that comes from unpredictability. But I’d prefer a kind of adventure I can use to entertain others. To put it bluntly, crap makes an unpleasant party favor, not to mention an appetite-killer at the dinner table. What’s a writer to do? If I have to live with something, it’s easier if I can make it funny.

It's a balancing act

A careful and perceptive researcher, I’ve always pored over and absorbed basic information about the topic at hand, knowing that peeling back the deeper layers would reveal complexities and contradictions. There is no better example than multiple sclerosis, a bewildering neurological disease I’ve lived with for 20 years. But being an IBS sufferer is no less perplexing. I’ve read the basic literature. I’ve used the FODMAP lists. I know what my trigger foods are. But that newfound knowledge doesn’t change what drives my food choices. I didn’t expect it to cure the affliction, but I’d at least hoped for some inspiration. A little more self-discipline. At my age it’s hard to find those.

At best, it’s a balancing act. For example, I’m learning to anticipate when to start taking the laxatives. I know that if I eat a generous helping of pasta two days in a row and some more starch besides, I can count on having no bowel movement on the third and fourth days, if not the fifth and sixth. Best not to let it go much past day two without drinking Smooth Move tea before bedtime. If I catch it at just the right time I’ll almost guarantee a bowel movement within 12 hours. But being stingy with the laxatives into day three is just asking for trouble. Wait that long and I’ll be taking Smooth Move plus Miralax every day for three more days before my bowel starts showing signs of life again. And that’s what sets me up for bowel incontinence.

Nobody likes to drop liquid feces onto a light beige carpet, even if you’re alone. It stains, it stinks, it’s hard to clean, and it’s horrifying to experience that particular lack of control. I have a vague memory of pooping my pants soon after being potty trained. That was the last time I ever did that. I was at home with my mother nearby. I remember feeling upset and humiliated, even at that tender age. But it happened twice during the past two months at age 60. I imagined numerous other horror scenarios. It could have happened in public, at the grocery store. I don’t own adult diapers, and even if I did, when would I know to wear them? This is such a rare thing to happen. But I think I know why.

Looking for stability

Eating stimulates the bowel and breakfast is what usually breaks down the wall 12 hours after taking a laxative. But those two times I lost control seemed to be the result of eating too much all at once. Pressure pushed the watery stools past the harder stuff. The result was something akin to power-washing the living room carpet.

I’ll try to retain the lesson learned: Eat a light breakfast the morning after the laxative. Just a cup of coffee can be enough, and with much less trauma.

There was a third personality in The Three Faces of Eve: Jane, a stable, normal woman. That’s the persona that prevailed, providing a happy ending for all. I’m hoping for a mood adjustment along the same lines. Wish me luck.

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