Stomach issues no meds

[ickihun]

I have never been able to take any kind of sweetener, especially aspartame and was always told I was just fussy, but these products have always made me ill for days after accidentally taking the (not reading labels properly). I have recently tried Stevia and that was even worse! A tiny amount on the end of my finger, just to try it and I was flattened for 3 days. My daughter-in-law, also T2 had the same result. This, then, is not the reason for my bowel problems.

After a colonoscopy some years ago (which actually did find cancer, but that was fixed, and so far hasn't returned), the surgeon suggested that the problem was Metformin. I stopped taking it, the problem didn't go away very much and my blood sugars skyrocketed, and I developed even worse liver problems than I'd had before. So, I went back on Metformin and, for a while, the bowel issue remained quite calm, but it's all back now and only controlled by taking Loperamide - which a doctor, some years ago now, told me was safe to take regularly and long term.

However, recently I've been wondering about that advice since she also recently told my daughter-in-law that my grandson, aged 12 and very much overweight and totally unable to stop himself finding/obtaining somehow, anything sweet, including packets of sugar from the store cupboard or shop, was absolutely fine and she should just let him eat sweets etc until he decides not to, all by himself! His late father (not my son) was also T2 which we figure places him at high risk. That can't be right and so I wonder what else she was not right about.

Does anyone know anything about Loperaminde?

Loperaminde is immodium.

 

[ickihun]

On stopping metformin I have occasions of diarrhea or constipation which was diagnosed as IBS whilst still taking metformin. It's reduced it a fraction but not totally. My dietician is wondering why I have IBS. I still get it on veg and milkshake diet. Less due to less going through my system but still happens.
Mine too has only developed since far less carbs.
However my up coming full bypass op has high rates of resolution.
Currently using meberine.

 

[Annb]

Loperaminde is immodium.

I realised that Loperamide and Immodium are the same thing but have only just discovered that it is an opioid and now wonder if it is safe to continue using it when I also from time to time have to take co-codamol (not often, but I wonder about the amount on those days when I have to take both). I should ask my current doctor about this, but getting an appointment these days is all but impossible. I take 2 x 30/500 mg usually only once in 3 or so days but when I do they knock me out and I sleep for most of the day. Maybe the extra opioid is enough to knock me out and maybe is just a bit too much

 

[ickihun]

I realised that Loperamide and Immodium are the same thing but have only just discovered that it is an opioid and now wonder if it is safe to continue using it when I also from time to time have to take co-codamol (not often, but I wonder about the amount on those days when I have to take both). I should ask my current doctor about this, but getting an appointment these days is all but impossible. I take 2 x 30/500 mg usually only once in 3 or so days but when I do they knock me out and I sleep for most of the day. Maybe the extra opioid is enough to knock me out and maybe is just a bit too much

Call any pharmacist and they will advise. But if your prescriber issues both it may have been checked as OK already but wise to double check.

 

[Bogie]

First, as mentioned in another reply post, get the Colonoscopy. If not for the immediate reason, you should anyway. No big deal. I've had 3 done over the years, along with a Sigmoidscopy (same but only to the first "sharp corner" of the colon), due to keeping an eye on my IBS. Too many people ignore getting one for "embarrassment" ... better a bit embarrassed (and it isn't - don't forget that the doctor and those doing it do this all the time) than finding that you have colon cancer later in life and too late to do anything about it.

That said, I am a Coke Zero drinker. About a month ago I went through a bad bout of diarrhea for almost a week. Despite having mild IBS I haven't had diarrhea for over 50 years, so I knew something was up (or should I say "down and out"). One thought I had was the Coke Zero as I was drinking too much of it (it makes you thirsty so you drink more). So I quit, took extra strength Imodium, and everything cleared up (solidified). Coincidence? Don't know. Could just have been a stomach bug as I heard of other people with the same symptoms.

Of note .. I am back drinking Coke Zero, but a lot less of it. Replaced the difference with a Lemonade sweetened with Erythritol,
Sucralose, and Acesulfame Potassium. I was also drinking it before as it is only 8 carbs per 250 ml and low in Sodium. Only available in Canada (Sunrype Slim Lemonade).

Your BG readings look great. I usually run in the 5s to 6.7 in morning wake-up. 6s to low 7s if I have a late night snack (midnight). Missed lunch today - and my meds - (busy working and time flew by) and I was 4.3 late afternoon and felt like it ... then took a late lunch

My HBA1c is still in the mid 6s (6.5) so I need to tighten my diet a bit.

Managing without meds and just the LCHF is impressive - keep it up! I am on meds (Jardiance).

On the Probiotics ... certain ones can give you Diarrhea as they are "cleaning house". I take Probiotics in vegetable capsules to help lessen the pain of IBS. Not every day though.

 

[Mobbo]

Hi I’m T2 since Feb 18 my last HbA1c was 39 I’m low carb since Feb and have lost over 4 done in weight but recently my guts have been giving me a hard time . I keep getting bouts of really bad diarrhoea . It lasts for about 24 hrs then goes . But it seems to return after about 2 to 3 weeks . I’ve never had a problem with this until diagnosis . It’s really messing me about at work. Could this be related to the LCHF diet or could it have something to do with ketones . My bloods were in the mid 5s to low 6s for ages now they are in the low to high 6s . I’ve been on hols and maybe ate or drank a few more carbs than normal but I think it was still under 50gr a day . The other thing I thought it might be is . I drink Coke Zero and I’ve been reading stuff that the aspartame in it can affect your guts bad .
Any thoughts or experiences would be greatly received . The doc wants me to have a colonoscopy , but I’d rather not

 

[SimonCrox]

Call any pharmacist and they will advise. But if your prescriber issues both it may have been checked as OK already but wise to double check.

I suspect that there is an interaction. I have prescribed a lot of loperamide over the years, really big doses for people who have had a lot of their bowels removed, and never run into problems. I looked on the SPC in the past and no problems were mentioned; now when I look, 1 in 1000 patients get sleepy on it, and there are other problems that have only just been recognised.
Like me, the prescriber might not have been aware of these advances in knowledge. This group keeps me on my feet - thanks.
Codeine in cocodamol is interesting cos it works by being matabolised into an active drug - most people do this at an average rate, but about 6-8% do not change it to active very well (so it does not work) and a similar percentage change it to the active form more rapidly and so get side effects more easily.
Best wishes
PS I get so constipated on co-codamol that I wonder if one needs to take loperamide if on cocodamol??

 

[ickihun]

I suspect that there is an interaction. I have prescribed a lot of loperamide over the years, really big doses for people who have had a lot of their bowels removed, and never run into problems. I looked on the SPC in the past and no problems were mentioned; now when I look, 1 in 1000 patients get sleepy on it, and there are other problems that have only just been recognised.
Like me, the prescriber might not have been aware of these advances in knowledge. This group keeps me on my feet - thanks.
Codeine in cocodamol is interesting cos it works by being matabolised into an active drug - most people do this at an average rate, but about 6-8% do not change it to active very well (so it does not work) and a similar percentage change it to the active form more rapidly and so get side effects more easily.
Best wishes
PS I get so constipated on co-codamol that I wonder if one needs to take loperamide if on cocodamol??

I have IBS but codeine constipated me because..... IBS can cause either constipation or diarrhea bouts. I never know which kind I'm going to have.

 

[Annb]

I suspect that there is an interaction. I have prescribed a lot of loperamide over the years, really big doses for people who have had a lot of their bowels removed, and never run into problems. I looked on the SPC in the past and no problems were mentioned; now when I look, 1 in 1000 patients get sleepy on it, and there are other problems that have only just been recognised.
Like me, the prescriber might not have been aware of these advances in knowledge. This group keeps me on my feet - thanks.
Codeine in cocodamol is interesting cos it works by being matabolised into an active drug - most people do this at an average rate, but about 6-8% do not change it to active very well (so it does not work) and a similar percentage change it to the active form more rapidly and so get side effects more easily.
Best wishes
PS I get so constipated on co-codamol that I wonder if one needs to take loperamide if on cocodamol??

I try not to take co-codamol any more than necessary (ie only when I can't bear the pain of my arthritis any more. It puts me to sleep fairly quickly although it doesn't do an awful lot for the pain, but an hour of respite does well enough.) Lower doses of codeine - 15/300 - don't help at all. It is just on these days when I have to take co-codamol AND my bowel is playing havoc that I take the Loperamide and that is when I wonder if I am taking too large a dose. Co-codamol alone doesn't fix it so I don't sleep because my bowel is churning and over-acting.

What are the other problems that have only just been recognised?

Thanks for the information.

 

[SimonCrox]

I try not to take co-codamol any more than necessary (ie only when I can't bear the pain of my arthritis any more. It puts me to sleep fairly quickly although it doesn't do an awful lot for the pain, but an hour of respite does well enough.) Lower doses of codeine - 15/300 - don't help at all. It is just on these days when I have to take co-codamol AND my bowel is playing havoc that I take the Loperamide and that is when I wonder if I am taking too large a dose. Co-codamol alone doesn't fix it so I don't sleep because my bowel is churning and over-acting.

What are the other problems that have only just been recognised?

Thanks for the information.

It is always difficult with any medication - the more one investigates the more one finds, both positive and negative.
So, I have given up to 96 mg per day loperamide (like a fair bit more than recomended), and so have others; this was for very severe diarrhoea that was leading to dehydration and renal impairment, so there was a very valid reason for this prescription.
Newer problems include that it is metabolised by the liver, so use with caution in people with significantly impaired liver function.
It has caused major bowel problems in some folk with AIDS - thankfully less common in UK than in some other countries.
IN OVERDOSE it causes ECG abnormailities (prolonged QT interval), and an abnormal heart rate and rhythm (torsades des pointes); this is highly unlikely to be a probelm in normal use, but if I was to ever go for the excess doses in the future, I would check ECGs.
The drowsiness is a more common problem ( 1 in 100 to 1 in 1000) than other problems above, and several different skin rashes that are associated which affect less than 1 in 1000.
Painkillers are a problem. paracetamol does not do very much; codeine etc have problems with constipation and anti-inflammatories have multiple problems such as stomach ulcers, renal impairment, strokes, heart atacks, asthma and probably some that I have forgotten. Good old distalgesics worked by helping folk to sleep, so they worked, but not in the fashion intended; many people found them really helpful, but deaths from paracetamol overdose have plummeted since removing them from the market..
Best wishes

 

[Annb]

It is always difficult with any medication - the more one investigates the more one finds, both positive and negative.
So, I have given up to 96 mg per day loperamide (like a fair bit more than recomended), and so have others; this was for very severe diarrhoea that was leading to dehydration and renal impairment, so there was a very valid reason for this prescription.
Newer problems include that it is metabolised by the liver, so use with caution in people with significantly impaired liver function.
It has caused major bowel problems in some folk with AIDS - thankfully less common in UK than in some other countries.
IN OVERDOSE it causes ECG abnormailities (prolonged QT interval), and an abnormal heart rate and rhythm (torsades des pointes); this is highly unlikely to be a probelm in normal use, but if I was to ever go for the excess doses in the future, I would check ECGs.
The drowsiness is a more common problem ( 1 in 100 to 1 in 1000) than other problems above, and several different skin rashes that are associated which affect less than 1 in 1000.
Painkillers are a problem. paracetamol does not do very much; codeine etc have problems with constipation and anti-inflammatories have multiple problems such as stomach ulcers, renal impairment, strokes, heart atacks, asthma and probably some that I have forgotten. Good old distalgesics worked by helping folk to sleep, so they worked, but not in the fashion intended; many people found them really helpful, but deaths from paracetamol overdose have plummeted since removing them from the market..
Best wishes

I have had NAFLD for years (which I was told I could do nothing about) and now have cirrhosis - not badly but it is there. Am I making matters worse by my use of Loperamide? The only improvement I can make to my bowel problem is to reduce carbs to pretty well zero, but then it seems to exacerbate my gastritis (for which I have taken Esomeprazole for even more years than I have had a fatty liver. I don't know if there is any relationship there.)

I spoke to my GP about this some weeks ago but she asked me to speak to the hospital dietician, which I know from past experience is a waste of time and energy because she cannot countenance low carbing and just accepts that I can do nothing about fatty liver or excess weight (17 stone a week ago - for a 5'5" woman that's a lot). Low carbs which don't cause gastritis would be the answer, and also don't contain nuts which I have a problem with. But she has no advice to offer on that.

The only choice I seem to have is to keep taking some carbs and the Loperamide to, at least, make me a little more comfortable and to allow me to leave the house from time to time. But am I putting my liver at even more risk by doing that?

 

[SimonCrox]

I have had NAFLD for years (which I was told I could do nothing about) and now have cirrhosis - not badly but it is there. Am I making matters worse by my use of Loperamide? The only improvement I can make to my bowel problem is to reduce carbs to pretty well zero, but then it seems to exacerbate my gastritis (for which I have taken Esomeprazole for even more years than I have had a fatty liver. I don't know if there is any relationship there.)

I spoke to my GP about this some weeks ago but she asked me to speak to the hospital dietician, which I know from past experience is a waste of time and energy because she cannot countenance low carbing and just accepts that I can do nothing about fatty liver or excess weight (17 stone a week ago - for a 5'5" woman that's a lot). Low carbs which don't cause gastritis would be the answer, and also don't contain nuts which I have a problem with. But she has no advice to offer on that.

The only choice I seem to have is to keep taking some carbs and the Loperamide to, at least, make me a little more comfortable and to allow me to leave the house from time to time. But am I putting my liver at even more risk by doing that?

Sorry to hear about the NAFLD and cirrhosis.
So with some drugs such as loperamide, one swallows the tablets, and after getting absorbed from the guts, they go through the liver which breaks them down and reduces the level a bit. But there would be slightly less breakdown of the loperamide in you so more would get into the system. Hence you might find that you are more prone to side effects of loperamide such as drowsiness.
The loperamide is not known to upset livers.
I don't think the esomeprazole has any link to fatty livers, but 1 in 10 to 1 in 100 get diarrhoea or constipation. Sorry.Esomeprazole and related drugs are really good for acid suppresion and noticeably better than the older ranitidine which however does not cause diarrhoea.
best wishes

 

[Annb]

Sorry to hear about the NAFLD and cirrhosis.
So with some drugs such as loperamide, one swallows the tablets, and after getting absorbed from the guts, they go through the liver which breaks them down and reduces the level a bit. But there would be slightly less breakdown of the loperamide in you so more would get into the system. Hence you might find that you are more prone to side effects of loperamide such as drowsiness.
The loperamide is not known to upset livers.
I don't think the esomeprazole has any link to fatty livers, but 1 in 10 to 1 in 100 get diarrhoea or constipation. Sorry.Esomeprazole and related drugs are really good for acid suppresion and noticeably better than the older ranitidine which however does not cause diarrhoea.
best wishes

Thanks so much for a really informative and helpful reply. I'll continue with the Loperamide as required and keep looking for low carb meal alternatives. By the way - I weighed myself today and am now getting on for 18 stone - three quarters of a stone in one week! I have to do something. Almost zero carbs is the answer - gastritis or not.
Thanks again.

 

[donnellysdogs]

Gastritis is helped enormously by avoiding all tomatoes and tomato products and totally avoiding onion- even in powder form...

 

[Chronicle_Cat]

First, as mentioned in another reply post, get the Colonoscopy. If not for the immediate reason, you should anyway. No big deal. I've had 3 done over the years, along with a Sigmoidscopy (same but only to the first "sharp corner" of the colon), due to keeping an eye on my IBS. Too many people ignore getting one for "embarrassment" ... better a bit embarrassed (and it isn't - don't forget that the doctor and those doing it do this all the time) than finding that you have colon cancer later in life and too late to do anything about it.

I agree. My mom is a Stage 3 colon cancer survivor (no family history prior). I've had 6 colonscopies in 18 months (I'm very high risk) and follow up bowel surgery 1 1/2 years ago. My 31 year daughter had her first colonscopy at age 31 because of our family history and IBS. I had so many colonscopies in a short time because a rare but dangerous large aggressive polyp (which **always becomes cancer***in time) was detected and removed (it kept growing back after colonscopy removal, hence the eventual surgery). I was cancer free. We chose to treat it aggressively because of my mom's history. I hopefully will never have to go through cancer like my mom. She has been in remission now for 6 years but the 2 years of chemotherapy were hell. I'd far rather have a colonscopy/colonscopies that go through chemo like my mom. Actually colonscopies aren't bad at all, the hardest part is the prep before -stay near a bathroom because you take medicine to wash out the colon. Most people are asleep during the actual proceedure - I'm awake during the proceedures because of my sleep apnea.

The govt here (Ontario, Canada) is urging everyone over 50 to have 1 baseline colonscopy at age 50, many people will never have to have another one again. The death rate is shockingly high for a very preventable cancer (it's slow growing and it takes quite a bit of time for the bad type of polyp to become cancerous).

 

[Annb]

I agree. My mom is a Stage 3 colon cancer survivor (no family history prior). I've had 6 colonscopies in 18 months (I'm very high risk) and follow up bowel surgery 1 1/2 years ago. My 31 year daughter had her first colonscopy at age 31 because of our family history and IBS. I had so many colonscopies in a short time because a rare but dangerous large aggressive polyp (which **always becomes cancer***in time) was detected and removed (it kept growing back after colonscopy removal, hence the eventual surgery). I was cancer free. We chose to treat it aggressively because of my mom's history. I hopefully will never have to go through cancer like my mom. She has been in remission now for 6 years but the 2 years of chemotherapy were hell. I'd far rather have a colonscopy/colonscopies that go through chemo like my mom. Actually colonscopies aren't bad at all, the hardest part is the prep before -stay near a bathroom because you take medicine to wash out the colon. Most people are asleep during the actual proceedure - I'm awake during the proceedures because of my sleep apnea.

The govt here (Ontario, Canada) is urging everyone over 50 to have 1 baseline colonscopy at age 50, many people will never have to have another one again. The death rate is shockingly high for a very preventable cancer (it's slow growing and it takes quite a bit of time for the bad type of polyp to become cancerous).

I agree - colonoscopies are not all that bad - apart from the prep, which is a bit fraught, but not really painful, just very inconvenient. Even if you are not asleep during the procedure, it's OK. Endoscopies are worse for me - swallowing the tube is very difficult - but even so, not something to avoid. And, of course, if your surgeon does find a problem, it can be dealt with, so the earlier the better. In my case the surgeon found a couple of malignant polyps and cut them out. That was 8 years ago and, while I still have colonoscopies every couple of years to check, so far, no more polyps. Long may it last. If there is cancer there, a colonoscopy is the least of the problems!

 

[Chronicle_Cat]

Endoscopies are worse for me - swallowing the tube is very difficult - but even so, not something to avoid. !

I agree I also have to have endoscopies on a regular basis (due to my GERD - gastro esophaghal disease and Barrett's esophagus which puts me at risk for esophagal cancer) and I have to have them while awake due to my very severe sleep apnea. They are much more uncomfortable than colonscopies which you can't feel even if you are awake, the fibre optic cable is tiny. My GI prefers to do both procedures on the same day, one after the other - he calls it "top and tail" - got love a specialist with a sense of humour. I'm on a every two year schedule for both (unless they find another dangerous polyp) and I'm a frequent polyp former. (There is always at least one new one, often more every time it has been done, I've had about 15 removed so far in the last decade.) I did tell him that the upside of the surgery was that at least it will be quicker now, should only take 1/2 the time (I had 1/2 of my colon removed with the surgery) - he laughed.

 

[glendarella76]

Try taking Probiotics for 30 days and see if that helps.

 

[Annb]

I agree I also have to have endoscopies on a regular basis (due to my GERD - gastro esophaghal disease and Barrett's esophagus which puts me at risk for esophagal cancer) and I have to have them while awake due to my very severe sleep apnea. They are much more uncomfortable than colonscopies which you can't feel even if you are awake, the fibre optic cable is tiny. My GI prefers to do both procedures on the same day, one after the other - he calls it "top and tail" - got love a specialist with a sense of humour. I'm on a every two year schedule for both (unless they find another dangerous polyp) and I'm a frequent polyp former. (There is always at least one new one, often more every time it has been done, I've had about 15 removed so far in the last decade.) I did tell him that the upside of the surgery was that at least it will be quicker now, should only take 1/2 the time (I had 1/2 of my colon removed with the surgery) - he laughed.

It must be a standard saying amongst surgeons - my surgeon calls it a "top and tail" procedure as well. Last time he did it I was very relaxed and sleepy for the endoscopy - I actually dozed off soon after he started but I woke up when he started the colonoscopy and was wide awake all through it. The team all seemed to have a fit of the giggles while it was going on, which was a puzzle to me at the time but afterwards I was told that there had been a fire alarm causing them to evacuate the theatre while I had the endoscopy and they brought me back in for the colonoscopy, which was why I was so wide awake (the sedative they had given me had worn off). They all thought it was very amusing that I should have slept through the whole evacuation. I suppose that surgeons and theatre staff develop a different sense of humour to me. As long as someone was having fun ....