IBS and the Presumption of Neurosis: the Canadian Experience

It's challenging to have an illness about which strangely little is known by the medical establishment. And as so many of us have discovered, when MDs are unfamiliar, the typical presumption is that the illness is either imaginary or 'stress-related,' the great catch-all.

To obtain appropriate treatment one must learn to describe symptoms in a way that suggests the need for testing to rule out urgent serious illness such as cancer - basic blood and stool tests that for many of us reveal nothing abnormal. The next step was to find a qualified specialist. Because so few GPs here have a line on local specialists, finding the best local gastroenterologist meant networking with friends and searching social media reviews.

Pleading my case

Once the expert was identified, I returned to GP and plead my case for a referral. No referral, no appointment, and there is much pressure here on GPs to avoid referrals to costly specialists. I prevailed and obtained an appointment many long months away. Happily, gastroenterology is so unpleasant that sufferers often cancel appointments. Such a cancellation allowed me to advance in the queue. Hoo. Ray.

Gastro-genius followed protocol to rule out basic, obvious issues, such as ulcer. To do so required drinking a tiny amt of chalky sweet something then submitting to twisting and turning to produce a visual. This test, too, revealed nothing abnormal, hence the need for bigger guns in the form of 'oscopies, a probe up one end and down the other while I slumbered peacefully courtesy of a concoction that includes Fentanyl, the controversial opioid killing so many drug addicts today.

When the 'oscopies failed to reveal a treatable cause, smaller guns were produced in the form of costly sand-like concoctions to ingest throughout the day and much of the night as well as some ineffectual pills called Dexilant, which were thought to last longer than Rabeprazole, which ceased to have any effect about two weeks in.

Taking control

I lasted more than a month on the punishing sand regimen, still ingesting Immodium regularly, Finally, I gave it all up. Just like that. Never pay twice, I thought. My plan was to stop everything and just observe symptoms. I wanted to look deeply at how I responded to daily events at work and home to see if I could notice a pattern and if so, possibly change it.

Even as a child my stress response was stomach upset so there was indeed history. My theory today is that escalation took some time so it made sense that de-escalation might also take time.

Taking control made me feel instantly better. After that, with a bit of effort, I started to notice certain triggers at home. When I thought about it, it was true that IBS for me escalated markedly a few years ago when we were having financial trouble, and financial trouble is pretty much synonymous with marital trouble.

We made some changes to cut costs so things improved. This gave me a breathing space which I used to identify and address a few other issues. For example, spouse would often vent about a particular client. My opinion was never welcome or sought. Once I realized this, I determined to avoid the frustrating, fruitless exchanges.

Some things one can control, others not.

Some helpful advice

Useful observation by my champion pulmonologist/respirologist: There is a connection between asthma and acid reflux, a component of IBS. It's true. I notice that if my stomach is bothering me, I will also have to manage my asthma more assiduously using breathing tests to determine when to apply more Ventolin. If my exhales on the breath meter fall below 15%, I know to apply Ventolin. Specialist also reduced the strength of my steroid puffer, which also helped my stomach.

Ultimately, both IBS and asthma are auto-immune issues and the immune system is complex. Maybe when more is known about the human immune system, more answers may follow.

In the meantime, I discussed my exploding diarrhea problem with my Bowen therapist, of all people. She had experienced the same problem when she bought her business. I'm not big on 'alternative' medicine but her therapy had actually cured some serious back and shoulder pain for me, so I was interested in her advice:

a tbsp. of apple cider vinegar an hour before meals.

That's it.

Continuing to work on stress

I've been doing this for several months now and the result has been dramatic. I now need Immodium maybe once every week and a half to two weeks and it's effective immediately - no more Immodium all-day then go to bed in between, exhausted.

I'm still applying self-absorption aka 'mindfulness' in an effort to notice stress in time to react more effectively, more positively. In this way I hope to re-train and re-educate my stress response. So far, so good. But I continue to monitor IrritiableBowelSyndrome.net for news of a cure.

For me, the toughest issue has been not being able to take long walks. We moved to a cheaper suburb, yes, but I also discovered that it doesn't provide public washrooms in parks or transit hubs or along popular pedestrian routes. I continue trying to educate authorities about IBS but I might as well be tilting at windmills.

My goal is to be able to resume regular workouts on my elliptical trainer along with floor exercises. I find exercise to be such a powerful IBS trigger that I finally gave up the workouts. Recently, I discovered a park with washrooms where I can walk in relative comfort. I will now have to work on my stress response to being places without washrooms. That in itself is a challenge.