Health - Irritable Bowel Syndrome (IBS) Treatment

[Fantasian]

SWIF's brother aged 17 has had IBS for some time. He is looking for a better alternative therapy as he commonly gets quite severe pain for 2 hours periods around once per week.

He currently has undergone hypnotherapy
He currently takes Diazepam or more commonly Buscopan for the problem neither of which are particularly effect.

SWIF has advised him not to go near opiates for the pain as after evaluating SWIF's brothers personality SWIF believes this wouldnt be advisable.

ANy help would be appriciated.

[Forthesevenlakes]

swim looked around for a few things on IBS, and interestingly enough, opiates arent really mentioned as a treatment. much of the treatment seems to come from a proper diet and stress reduction. interestingly enough antidepressants might help too, according to this website:

For IBS patients with constipation, Schorr-Lesnick will sometimes prescribe small doses of SSRI (selective serotonin reuptake inhibitor) antidepressants such as Celexa and Paxil. They do not usually cause constipation. Their side effects include nausea, loss of appetite, and diarrhea.
Other older antidepressants (called tricyclic antidepressants) tend to cause constipation. Doctors usually prescribe them for IBS patients with diarrhea. These drugs include Elavil, Pamelor, and Norpramine. Other side effects of tricyclic antidepressants include dry mouth, drowsiness, and blurred vision.

antispasmodics might help, as might zelnorm (tegaserod) although the side effect profile of tegaserod sounds pretty harsh...diarrhea and blackouts?

best of luck to swif's bro. swim had a childhood friend who developed chron's disease, so he definitely feels for people with GI tract disorders.

[Fantasian]

Sorry forgot to add after i spoke with him.

SWIF's borther has also tried Amitriptyline a Tricyclic antidepressant and diclofenac an NSAID. I'll look into the other stuff you mentioned.

[INodHardOhYeah]

The problem right now is that the best medicines for controlling IBS are prescribed almost exclusively to women. Those being the 5-HT3 (serotonin) receptors in the GI tract. There are new medicines beign developed for use in both men and women but at this time are not FDA approved. A good site to check out would be http://www.aboutibs.org the site is updated fairly regularly with new info into IBS treatments and research.

Reputation Comments on this post:

	interesting, i didnt know that!
	Impressive Info

[Forthesevenlakes]

Why would the medicines be prescribed only to women? Are they steroids or other hormones perhaps?

[INodHardOhYeah]

I'm not really sure but I did find two Rx medicines which are available for men, Lotronex and Zofran, SWIF tell your brother to look into it if he hasn't, many men have been able to control symptoms (to a degree) with these meds.

[Fantasian]

umm not that im going against what you said Inod but after looking into the two drugs you mentioned i found the following.

Zofran is better known as Ondansetron
Ondansetron is an anti-emetic used in chemothearpy SWIF has atually used it himself to stop vomiting caused by heavy opiate use for chronic pain.
SWIF could not find anything linking this to IBS.

Lotronex is better known as Alosetron
This is specifically ONLY for women ruling SWIF's Brother out...

[INodHardOhYeah]

Lotronex (alosetron hydrochloride) is one of the new breed of medications for IBS, and was introduced in the United States in 2000. Lotronex is a "selective 5-HT3 receptor antagonist", which means that it works on neurons in the digestive tract, blocking the action of serotonin in the gut and decreasing motility. It is only available on prescription.
Despite its initial success, Lotronex was withdrawn from use when reports started to come in about patients who had been suffering from ischemic colitis, a potentially fatal condition where the blood flow to parts of the intestines is reduced. Some users also suffered from severe constipation as a result of taking Lotronex.
After a fight from many IBS patients, in 2002 Lotronex was once again made available in the United States. The US remains the only country where Lotronex has been reintroduced. It continues to help many patients.
As I understand it at the moment, Lotronex can only be prescribed by US doctors who have signed up to the prescribing program run by GlaxoSmithKline (the drug's manufacturers). The prescribing program exists to ensure that the drug is prescribed safely and only to those who genuinely fulfil its criteria. Doctors can enrol by visiting the Lotronex.com website.
Although Lotronex was originally designed for use in women with IBS, it is now also being prescribed to some male sufferers.


Another drug that affects neurotransmission is ondansetron. This drug blocks a different receptor, the 5-HT3 receptor, and thereby reduces colonic contractions. Thus, ondansetron (Zofran) has been effective in treating diarrhea-predominant IBS in initial studies.

Funny this was brought up, I was reading a forum about GI tract disorders and diseases the other day and I was also under the impression that Lotronex was contraindicated for use in men, but I found some afflicted persons discussing the use of Zofran and Lotronex stating it was helpful in controling IBS symptoms.

[Fantasian]

Thanks for the info SWIF will look into it.

[Forthesevenlakes]

please keep us posted on what ends up happening. swim wishes swif's brother well, and swif did the right thing to dissuade his brother from treating the ibs with opiates. despite what doctors might say, swim has witnessed firsthand people developing addictions to opiates that were being taken for strictly medical purposes. sure, they might be fun, but swim does not wish their addiction upon anyone. swim is interested to see what ends up working, and also the mechanism of action of the efficacious drugs.

[Santa]

Swim knows this is an old thread but still it's very interesting to Swim. Swim has used methadone for over 22 years and failed to withdraw everytime because of severe IBS. The pain is that bad that Swim can't work anymore. She wasn't even aware she had IBS untill trying to quit methadone (very slowly, see this thread: http://www.drugs-forum.com/forum/showthread.php?t=28053 ).
Swim can manage the WD symptoms from methadone but not the agonizing stoamchpain (bloathed staomach, pain 24 hours a day, not like cramps but just pain, sometimes going to toilet 3 times a day, sometimes 1 a week). Swim had all sorts of tests but all they could say was: you have IBS. Swim probably developed this whilst ON methadone without being aware of it. Swim also found out that US docters sometimes prescribe methadone for IBS (and can certainly relate to that because it certainly helps in her case!).
Different diets, fibers, quiting smoking or exercising helps Swim. Swim is trying to taper methadone again but is once more failing because of severe stoamch pain that lasts for months on end.
So Swim is very interested in ANY new drugs developed to treat IBS because Swim can't stand the pain much longer. Any advice is welcome.

[DrMuffy]

Some barbiturate/belladonna alkaloid extract medications are prescribed for IBS like Donnatal. Not sure if this helps, but SWIdr's friend uses this med for their IBS.

[Santa]

Originally Posted by Santa

Different diets, fibers, quiting smoking or exercising helps Swim. Swim is trying to taper methadone again but is once more failing because of severe stoamch pain that lasts months on end.
So Swim is very interested in ANY new drugs developed to treat IBS because Swim can't stand the pain much longer. Any advice is welcome.

This should have been: different diets, fibers, quiting smoking or exercising do NOT help Swim, sorry about that....
I have tried: 4 anti-depressants, benzo's, mebeverine.... no effects whatsoever..
I guess I just have to go back to methadon, I can't stand the pain anymore. I heard about belladonna but can't get my hands on that (isn't that some light opioid too by the way?). But thanks, there's some weird comfort in knowing that others have to deal wit this shit too.

[DrMuffy]

^^^^^^^^^

Belladonna is actually a member of the deadly night shade family. Some naturally occuring chemicals in the plant (atropine, Hyoscyamine, and Scopolamine) are extracted and used is VERY minute doses, such as .005 mgs(estimate), just ask SWIY's doc and maybe he will help. Also, if SWIY is suffering from major diarrhea most of the time, loperamide (Immodium OTC), which is a very potent opiate (but doesn't cross the BBB so it can not be abused), can really help. But loperamide (Immodium) can also clog one up for days at a time, so that part is not good...

[Santa]

Swim can't get belladonna and is increasing her methadon again because Swim can't stand the pain anymore and no medication has worked for her (and she tried a lot).
The weird thing is that Swims IBS always gradually fades away when Swim increases her methadondose to 70 or 80 mgs a day. And Swim does not even have diarrea, just a lot of pain and infrequent, weirdlooking stool. And Swims stomach looks and feels like she's 9 months pregnant all the time..

When Swim starts using more methadon it seems as though her nervous system slowly ''re-adjusts'' and the IBS slowly fades away after a few months (not inmediately though!). But this is not the case when Swim uses only 20 or 30 mgs of meth a day. Not even now, after Swim has used as little as 8 mgs for months and jumped back to 20 mgs a day, it doesn't really help. Why is this? Has IBS something to do with your nervous system? Does is go away as soon as Swims opioidreceptors are sufficiently filled?
And why aren't Swims receptors not sufficiently filled on 20 mgs when Swim has been on 8 mgs for weeks? You'd expect that 20 mgs would be a lot to the receptor then...
So is IBS linked to ones receptors/nervous system?..
Swim certainly thinks so. After using over 60 mgs daily for a few months Swims bloathed, painful stomach always gets back to fairly normal again. Swim doesn't understand why there is no medication that can do the same trick. (at least that way Swim would be able to get off the done!)

[DrMuffy]

Originally Posted by Santa

Swim can't get belladonna and is increasing her methadon again because Swim can't stand the pain anymore and no medication has worked for her (and she tried a lot).
The weird thing is that Swims IBS always gradually fades away when Swim increases her methadondose to 70 or 80 mgs a day. And Swim does not even have diarrea, just a lot of pain and infrequent, weirdlooking stool. And Swims stomach looks and feels like she's 9 months pregnant all the time..

When Swim starts using more methadon it seems as though her nervous system slowly ''re-adjusts'' and the IBS slowly fades away after a few months (not inmediately though!). But this is not the case when Swim uses only 20 or 30 mgs of meth a day. Not even now, after Swim has used as little as 8 mgs for months and jumped back to 20 mgs a day, it doesn't really help. Why is this? Has IBS something to do with your nervous system? Does is go away as soon as Swims opioidreceptors are sufficiently filled?
And why aren't Swims receptors not sufficiently filled on 20 mgs when Swim has been on 8 mgs for weeks? You'd expect that 20 mgs would be a lot to the receptor then...
So is IBS linked to ones receptors/nervous system?..
Swim certainly thinks so. After using over 60 mgs daily for a few months Swims bloathed, painful stomach always gets back to fairly normal again. Swim doesn't understand why there is no medication that can do the same trick. (at least that way Swim would be able to get off the done!)

Well, it definatly sound like SWIY needs medical attention for this problem. But opiates can help alot with diarrhea in numerous ways. Immodium contains a potent opiate (simalar to fentanyl, which is equivalent to 10 mgs of Methadone in such a small dose as 0.2 mgs) but Immodium only helps when it comes to diarrhea, it does not cause any euphoria and or painkilling effects. SWIdr just really recomends SWIY gets medical attention first, but if SWIY needs help after that, then try Immodium and or Immodium AD.

[Nagognog2]

Donnital is prescription only and contains atropine and phenobarbital. The atropine acts as an excellent anti-spasmodic to help the stomach and intestines chill the peristalsis. And the phenobarbital sedates the whole GI tract quite well. Works well for IBS, gastroenteritis, food-poisoning, etc.

Don't take Donnital as a recreactional. Bad idea. Save it for when you need it for the prescribed reason.

[Santa]

Originally Posted by DrMuffy

Well, it definatly sound like SWIY needs medical attention for this problem. But opiates can help alot with diarrhea in numerous ways. Immodium contains a potent opiate (simalar to fentanyl, which is equivalent to 10 mgs of Methadone in such a small dose as 0.2 mgs) but Immodium only helps when it comes to diarrhea, it does not cause any euphoria and or painkilling effects. SWIdr just really recomends SWIY gets medical attention first, but if SWIY needs help after that, then try Immodium and or Immodium AD.

Well.. Swim has already had medical attention. A ot of it too. Swim was turned inside out twice in different hospitals, by different doctors. Swim was having tubes up her ass and in her throat and all that.
Swims blood has been checked several times without any results. Swim has tried all possible medications like mebeverine, magnesium, anti-depressants, naltrexon (when she was off methadon), therapy, benzodiazepines.. you name it and Swim tried it. Swim does NOT have diarrea, just a lot of pain and weirdlooking unfrequent stool.
Swims docters don't know what to do about it since nothing serious was found and Swim still has a lot of pain, ALL the time.
Swim also has some neurological problems like cottonballfeeling in her head, twitching muscles all the time, heartpalpitations etc. But they can't find anything. Swim is tired of all the tests she's had so Swim just sticks to her methadone now. Swim is still not 100% but at least Swim can get up and do things again.

[DrMuffy]

Originally Posted by Santa

Well.. Swim has already had medical attention. A ot of it too. Swim was turned inside out twice in different hospitals, by different doctors. Swim was having tubes up her ass and in her throat and all that.
Swims blood has been checked several times without any results. Swim has tried all possible medications like mebeverine, magnesium, anti-depressants, naltrexon (when she was off methadon), therapy, benzodiazepines.. you name it and Swim tried it. Swim does NOT have diarrea, just a lot of pain and weirdlooking unfrequent stool.
Swims docters don't know what to do about it since nothing serious was found and Swim still has a lot of pain, ALL the time.
Swim also has some neurological problems like cottonballfeeling in her head, twitching muscles all the time, heartpalpitations etc. But they can't find anything. Swim is tired of all the tests she's had so Swim just sticks to her methadone now. Swim is still not 100% but at least Swim can get up and do things again.

Jeeze, if the docs cant really do anything about it, then its pretty bad. Sorry bout the Immodium pushing in SWIdr's last post (he didn't see the no diarrea part). Well there are herbal remedies which can halp with regulating bowl movemoents and such, like fennel seed (which might actually help in the long run). The methadone, can be and as SWIY knows reeally addictive, but a painkiller of that magnitude sounds "fitting" for this situation. Say, did SWIY's doctor(s) prescribe this dose of methdone, or is SWIY just self prescribing? If SWIY's doctor(s) think SWIY is in alot of pain, then maybe he should ask them for help on that subject (Since they cant really do anything else) maybe a fentanyl patch is in order, or perhaps strong oxycontins. Another question, has SWIY tried Simethicone (for bloating and such), because if SWIY's stomach is bloated and giving her trouble, that is an OTC med (Non-addictive, very little side effects, and it is OTC). But the main thing SWIdr would suggest is rest and relaxation (anxiety causes and or worsens IBS), and look into some herbal remedies like fennel seed, which can do wonders!

PS-Hang in there girl!

[Santa]

No worries about pushing Immodium, haha... Swim doesn't know simethicone but will certainly try it. Swim was not self prescribing methadon. The whole IBS-thing (or whatever it is) came out when Swim tapered methadon to 0 and became ill all of a sudden. The pain was not like in cramps but just pain everywhere, like having an ulcer all over your stomach or something. Unfortunately Swim stayed ill so after a year of painful struggle Swims doctor put her on methadone again because it was the only medication on which Swim could function. You are right about trying to relax. It does make things worse when you're stressed and i get stresed very easily.
Swim thinks all the other symptoms like the cottonballfeeling in head, the muscleaches and the twitching of little muscles might be caused by stress due to all the shit (...) she went through with the IBS-thing.
Anyway, shit happens... I will try the simethicone!

[BakaBilly]

ugh, its comforting and disturbing knowing you arent the only one living with pain.

SWIM has been suffering from constant pain for over 5 years now.

SWIM has been in and out of the ER and last time was told that they wouldnt give him painkillers if I came back because it had been the 6th time this year and he thought SWIM was there because of withdrawls.

Recently SWIM was given oxycodone for the pain but as of the last visit they told him they would take him off of it. :*(

Honestly I cant recall anytime before the oxy that SWIM felt normal on a daily basis. Why they would take this "miracle" drug from him is beyond me.

[Santa]

Jeez, if there is no other way for Swiy to feel good (normal: in little pain) than using oxycodone or methadone they should give it to Swiy!! This is ridiculous because they are taking your life away. swim knows what it's like. It really messes up your life big time to feel like that all the time. Hope they will help you!!

[BakaBilly]

Ya, if they take SWIM off the oxy I dont know what he will do. Im sure he will go back to self medication with pot, but that stuff only works to an extent and SWIM was spending upwards of $400 a month on the stuff.

SWIM is thankful for this last month however. It has been one of the good ones.

SWIM never thought anyone would give him pain killers let along "oxy".

[merc11292]

I know opiates arent recommended for IBS but i have a friend who suffered from it , was prescribed vicodin es for some type of back pain and found that it made the IBS more controllable than any medication theyd received before, it took care of the stomach pain very well and the mild constipation effects took care of the rest. They combined it with diazapam and say the IBS is now not a problem at all.

[mictihtoya]

I recommend avoiding drugs to treat IBS and trying diet and exercise.

http://www.irritable-bowel-syndrome....r-ibs-diet.htm