Irritable Bowel Syndrome
I just visited my GP today, 17 Mar 2005, for the first time in over a year. I suffer from almost constant stomach discomfort and bowel problems, and have done for many years. I was of the opinion that these symptoms were due to my MS. I was aware that these symptoms were shared with irritable bowel syndrome (IBS) but I always put this down to coincidence.
The doctor I saw today was a locum who I hadn't seen before and she appeared to be very knowledgeable about both IBS and multiple sclerosis. After a fairly lengthy consultation she declared that my symptoms were undoubtedly IBS and had very little to do with multiple sclerosis.
I questioned this opinion, as I know of several other MS sufferers who experience the same problems. She countered this with the statistic that as many as 1 in 4 people in the UK suffer from irritable bowel at some time or other and therefore it is reasonable that 1 in 4 MS sufferers should also experience it.
Finally, I asked if there was anything she could do to improve the situation. She suggested that amitriptyline may help. Although this is an antidepressant medication it has been shown, when administered at a much lower dosage than used for depression, to alleviate the symptoms of IBS.
However , amitriptyline would need to be taken for 2 or 3 months before any indication could be assessed. So, I was prescribed Alverine, One 60mg capsule to be taken thrice daily for one month. If after a month, I show no improvement, then we move onto the amitriptyline.
Well, it is now just over a month since I started taking the alverine and I have to admit it is helping a little. I returned to see the GP, a different locum this time, and he pooh-poohed the amitriptyline but didn't suggest an alternative. I have been concerned about weight-loss as I have dropped from 11.5 stone to 10 stone despite eating like a horse. The GP suggested this was nothing to worry about but conceded that he should arrange a further blood test to check on thyroid activity. I am continuing with the alverine but I may reduce the dosage.
I visited a gastroenterologist who arranged for a raft of tests, including a hydrogen breath test, a CT Scan and a endoscopy. The endoscopy revealed some inflammation but not enough to account for the pain. He then prescribed a series of medications, none of which made any difference. Finally he admitted it could be neurological, i.e. the MS, and suggested I try taking Linseed. This has had a profound effect. The pains are still there, but not every day and they are much more tolerable.
I did, while looking into this, find a very interesting and informative site about IBS. Not surprisingly it is call About IBS.
22nd Nov 2005 I have an appointment at my local hospital for a breath test which involves several tests over a period of two to three hours. These tests measure hydrogen levels to determine the correct digestion of lactose in the small intestine. If the enzyme lactase is not present in the small bowel then lactose is digested in the large intestine and produces hydrogen leading to bloating which will cause cramps or spasms in the gut. This condition is known as hypolactasia.
30 Mar 2006 Things take a long time on the NHS in the UK, so things have not progressed a great deal. Since having the hydrogen breath test which indicated that I did not have hypolactasia, I have had an endoscopy which showed a slight inflammation of the duodenum. I also had 5 biopsies taken, all of which revealed nothing. I then had a barium meal - follow through which also revealed nothing except that my digestive transit is fairly rapid.
Only yesterday, I had an abdominal CT scan but I won't get the results until I next see the gastroenterologist which is not until early May.
I have had the alverine and since then omeprazole, hyoscine butylbromide, and colpermin. None of which helped at all. I then tried Aloe Vera juice which did take the edge off it, but little more. I now have my amitriptyline prescription which I will start next week.
I have tried the amitriptyline a number of times now, and it really doesn't agree with me. To begin with I was taking 25mg tabs and these knocked me out. Bear in mind that amitriptyline is used as an anti-depressant and as a sleeping pill. Sure I got a great night's sleep, but I could not function the following day. I then reduced the dosage to 10mg, but this really wasn't much better.