Do you have IBS (Irritable Bowel Syndrome) and what do you do about it?

[greg10]

In a recent thread about diarrhea,

TS posted this: "I'm not very informed on all these meds and it could very well be the problem with gregory, but I am just wondering if the Dr. is also looking for other things it might be like IBS( Irritable Bowel Syndrome).   I know of 2 people on dialysis and they have both been diagnosed with this. They had continual diarreha. They are now taking medication for it. I have to wonder.. if that is something that comes along in time when on dialysis, IBS. I hope he feels better soon."

There is a recent publication http://www.ncbi.nlm.nih.gov/pubmed/21528075
that associated with the presence of irritable bowel syndrome (IBS) symptoms in hemodialysis (HD) patients:

Symptoms compatible with IBS were present in 27 (13.8%) subjects and independently associated with low post-dialysis serum potassium [OR = 0.258, 95% CI (0.075-0.891), P = 0.032], paracetamol use [OR = 3.159, 95% CI (1.214-8.220), P = 0.018], and Kidney Disease Quality of Life (KDQOL) cognitive function score [OR = 0.977, 95% CI (0.956-0.999), P = 0.042]. Univariate regressions were also performed and the reported significance is for multivariate analysis. No association was detected for age, gender, depressed mood, smoking (present or past), body mass index, albumin level, Kt/V, sodium pre- or post-dialysis level, change in potassium level during HD, proton pump inhibitor or H2 blocker use, aspirin use, residual diuresis, hepatitis B or C infection, diabetes mellitus, marital status and education level.

CONCLUSION:
This study examined potential risk factors for symptoms compatible with IBS in HD patients and identified an association with paracetamol use, post-dialysis potassium level and KDQOL-cognitive function score.

[Steve-0]

I have IBS problems so bad, alternating between diarehhea and constipation..... it got so bad, I was passing these little, extremely hard feces that ripped me up.... I had such bleeding problems that my H&H was always low.... I'm on extreme doses of Epo and Iron.  My bowel got so irritated, that some kind of ulcer formed, which bleeds like crazy and it caused by bowel to intessupt (fold in on itself)..... it's a mess in there!! I've had several colonoscopies (Which aren't much fun!) and such.  It's non-cancerous, which is good, but it's still a problem.  I take prednisone for the swelling, and that seems to keep it at bay, but I still have flare ups.  My GI doc says the situation will right itself when I have a transplant, because my bowel will be processing liquid properly and I can then ingest large amounts of water and metamucil to help the bowel.  Such a mess!


~Steve

[Jean]

Yes, I have had IBS, altho it is not so bad any more. My solution? Depends!!

[greg10]

Thank you Steve and Jean.  Some of your symptoms sound terrible!  I am sorry.

Our clinic dietitian suggested the following:
1. Imodium. This is the anti-diarrheal Loperamide, a synthetic piperidine derivative,[2] is an opioid drug used against diarrhea; available as generic form and over the counter in the US.
2. BRAT
    B = Banana
    R = Rice
    A = Apple
    T = Toast

  I can see that banana with high potassium may help if you are running low in potassium after dialysis.  The higher starch content in BRAT may somehow help with digestion as well, but be careful if you are diabetic.

BTW, in the article above, Paracetamol is also known as acetaminophen (Tylenol) in the United States; so you may want to avoid that if you have IBS and on HD.