Thursday, August 20, 2015

Reflecting on Anxiety & IBS. Or: IBS woes (not gross or TMI/cringe-worthy! Promise!)

Stress causes anxiety. Anxiety can affect IBS. 

I am going to share with you that I suffer from anxiety. I realize there is still a stigma attached to mental health issues but I think it's important that more people actually talk about it to destigmatize the subject.
"Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18% of the population." (source).
40 million people is A LOT of people. To give you an idea of how many that is: 17% of the population of the US is black (source). There are more people suffering from anxiety disorders than there are black people in America.

I have been diagnosed with Generalized Anxiety Disorder, Panic Disorder and most recently, ADD (now commonly known as ADHD - but hyperactivity has NEVER been an issue for me, just the opposite. Although my brain is definitely hyperactive, my body is more lethargic.) I take medicine to manage my anxiety as well as learned coping skills. It is a never ending struggle to manage anxiety.

Regarding stress/anxiety & IBS

."If you do diagnostic interviews, what you find is that about 60% of IBS patients will meet the criteria for one or more psychiatric disorders," says Edward Blanchard, PhD, professor of psychology at the State University of New York at Albany. (source: WebMD)
There is no direct link that definitively states anxiety causes IBS, it's more that a high percentage of people who suffer from IBS also suffer from anxiety. They are linked but not causal. I find this fascinating as someone who has struggled with anxiety for years and only recently have been plagued by IBS.


My personal experience with IBS


My IBS has taken over my life since it first manifested in mid-November of 2014. I have had to stop searching for a steady job, I had to stop taking Krav Maga classes & exercising. I have become almost completely housebound. I am tethered to the toilet as I like to say. This situation has lead me to become extremely isolated and to be frank, lonely.

To give you an idea of what my life is like. Here's a rundown of my day:

During the night, I got up around 4 am & went to the bathroom. Then, I woke up this morning at 8:15 am with an urgent need to go to the bathroom (when I say "go to the bathroom", assume I mean number 2. I don't want to gross anyone out so I'm not going into details but unless I specify, assume some sort of bowel movement. Sorry TMI.). I'm writing this blog post around 1 pm & I've gone to the bathroom six times so far today. This is normal for me. This has become my normal.

In general, every day, for at least two hours after I wake up, I can't go anywhere or do anything because I find I have to go to the bathroom frequently and urgently. Like "gotta go, gotta go, gotta go RIGHT NOW." As the day progresses, the bathroom trips tend to become less frequent and far less urgent. I can hold it if I have to when running errands. I try to not to be away from my house or somewhere I'm familiar with the bathroom for longer than two hours. Some days I go all afternoon my daily tally ends up between 10-15 bathroom trips a day. Some days I have four or five hours in a row where I don't have to go at all. The bathroom trips don't start up again until the evening and are less frequent and less urgent.

The trouble is there is no way to predict which type of day I'm going to have. Will today be a good day where after my usual morning tribulations, I'm able to go run errands, go to appointments or have lunch with my parents? Or will it be one of the other ones, where I go to the bathroom at least once an hour all day?

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I may have discussed this in a previous blog post but here is a brief history of the steps I've taken to deal with my IBS

After I saw my first gastroenterologist, he thought my pancreas numbers were a bit high so he put me on Creon, a pancreatic enzyme and to start taking a probiotic. This was in January. He also performed every test under the sun, blood tests, diagnostic tests (colonoscopy, CT scan, etc etc etc). I was then scheduled to see him again in May. MAY! Because he was a specialist, he was booked. After a month or so I decided I needed a second opinion and hoped to find a doctor I could see more frequently. Or at least one who wouldn't make me wait five months between appointments.

I saw my new gastroenterologist and she confirmed the first's diagnosis or Post Infectious IBS. She told me to keep taking Imodium regularly, to stop the Creon as it wasn't doing anything and suggested a cholesterol medicine that was known to, as a side effect, bulk up the stool (sorry, so gross, sorry). I started taking Cholestyramine but it gave me terrible heartburn and I already suffer from GERD. It was unbearable so after two weeks she stopped that medicine and put me on Lomotil, a powerful anti-diarrheal. At first I was taking one pill four times a day to little effect, I then went up to two pills four times a day but that was the maximum allowable dosage and she wasn't really comfortable with my taking that much for a long period of time. After a few weeks, it seemed the Lomotil was helping and that I could go back down to one pill four times a day. Now I take it three times a day, as my doctor has repeatedly suggested trying to take less but I've have been thinking about upping my dosage as I seem to be backsliding and not really getting a handle on my IBS, which is the whole point of these medicines.

Anyway, after being put on the Lomotil, at my next visit, she suggested I take a fiber supplement as another way to hopefully bulk up and then have to "evacuate less frequently" so now I take 2 fiber tablets in the morning and this week I've decided to start taking an additional tablet at bedtime.

Lomotil seems to help. Imodium shuts down my insides the day after I take it, which is odd but that is the pattern I've noticed since I've been tracking my medicine intake and bathroom visits. I still had a really active gut with cramping and occasional gas so my doctor prescribed me Bentyl, which is an anti-spasmodic. 

I've been reluctant to take Imodium regularly anymore because, while going the bathroom frequently is a hassle, I'd rather get it all out of my system rather than have a "shut down" like Imodium tends to produce (even if it is a day late).

I now take the Lomotil and Bently together three times a day. As I've stated I have been considering increasing my Lomotil because I'm so tired of having 12 bathroom trips a day on a regular basis.

Why am I telling you this? I can hear you, "get to the point!" Well, those of you who know me, know I tend to ramble a bit and off-topic tangents made up a lot of my conversations. So deal with it!

Well, life is stressful in general. My life is no more or less stressful than anyone else's other than it is happening to me. And that is what having anxiety or having IBS feels like. Life is happening to you, you are not living it, you are merely surviving. I don't want people to think that every single day is a struggle for me or that I'm also suffering from depression or a general malaise. But lately, IBS has added a serious burden to my coping methods I use to manage my anxiety. That's actually that's one big thing anxiety & IBS have in common - it not something you are magically cured from no matter what drugs you take, it is something you manage. You deal with it. You live with it. It doesn't just go away. It is a factor in your life every day.

With anxiety there are medications and coping methods and modalities individuals use to keep their anxiety from controlling their life. Because when my anxiety is spiking, as I put it, it feels like it is in control, not me. That I am merely reacting instead of acting. And with the IBS, I've been limited in my reactions because I'm housebound a lot of the time.

It feels like a I'm stuck in a hamster wheel, running in circles. My anxiety affects my IBS which in turn affects my anxiety which then affects my IBS. Repeat ad infinitum.

This is my life now.