Suitable medication for IBS-D sufferers

[Button43]

Hi all,

I was diagnosed as a T2 diabetic a few years ago but have been diet controlled until now.

I now have to go on to medication, but as an IBS-D sufferer, I am petrified of going on a medication which will make the IBS-D worse.

I know Metformin is the first line drug, but that alot of people suffer with diarrhoea on this, so I have already said I don't really want to start on this. The doctor mentioned that the slow release version is better to lower the chance of diarrhoea, but wondering if anyone with IBS-D is on this and how it affects your IBS?

Also is there an alternative medication that doesn't have the side effect of diarrhoea that I can discuss with my clinicians?

Thanks for your help.

 

[Diane60]

Have had IBD for over 4 years and was already taking Metformin when diagnosed. The slow release was fine with me but in
know some people do suffer when taking it. I’m not aware; nor been offered, any alternative

 

[h884]

Hi all,

I was diagnosed as a T2 diabetic a few years ago but have been diet controlled until now.

I now have to go on to medication, but as an IBS-D sufferer, I am petrified of going on a medication which will make the IBS-D worse.

I know Metformin is the first line drug, but that alot of people suffer with diarrhoea on this, so I have already said I don't really want to start on this. The doctor mentioned that the slow release version is better to lower the chance of diarrhoea, but wondering if anyone with IBS-D is on this and how it affects your IBS?

Also is there an alternative medication that doesn't have the side effect of diarrhoea that I can discuss with my clinicians?

Thanks for your help.

Good Morning Button43

I have colitis and Type 1 Diabetes. It was initially thought I had type 2 so was tried on metformin and various other medications before going onto insulin. I can understand your concerns being in a similar position to yourself.

It might be worth arranging another appointment with your gp or nurse to talk things through

 

[Button43]

Good Morning Button43

I have colitis and Type 1 Diabetes. It was initially thought I had type 2 so was tried on metformin and various other medications before going onto insulin. I can understand your concerns being in a similar position to yourself.

It might be worth arranging another appointment with your gp or nurse to talk things through

Thank you for your reply. I hope that you are doing better now on insulin/ with the correct diagnosis.

I am seeing the Diabetic nurse on Wednesday to discuss starting meds. The doctor was quite dismissive of my concerns about going on Metformin, so hoping the nurse is more sympathetic! I absolutely want to get my diabetes back under control, but I cannot go back to not being able to leave the house / being more than 2 minutes away from a toilet! So need to find a compromise.

 

[h884]

Thank you for your reply. I hope that you are doing better now on insulin/ with the correct diagnosis.

I am seeing the Diabetic nurse on Wednesday to discuss starting meds. The doctor was quite dismissive of my concerns about going on Metformin, so hoping the nurse is more sympathetic! I absolutely want to get my diabetes back under control, but I cannot go back to not being able to leave the house / being more than 2 minutes away from a toilet! So need to find a compromise.

Morning Buuton43

Thanks I am doing better on insulin. I now have an insulin pump which is excellent.

Hopefully the nurse will be more sympathetic. This is where you need to be assertive and express your concerns as you are doing here. I ended up simply saying what I was willing to do

Good luck with your appointment on Wednesday. Please let us know how you get on

 

[Antje77]

I was diagnosed as a T2 diabetic a few years ago but have been diet controlled until now.

I now have to go on to medication, but as an IBS-D sufferer, I am petrified of going on a medication which will make the IBS-D worse.

What diet did you follow for your diabetes, and how high is your blood glucose or hba1c?
Would there be room for more dietary changes if this would help your diabetes?

There are many different medications for diabetes nowadays, so if metformin isn't the right one for you there are other possibilities too.

 

[MrsA2]

@Button43
I had IBS for years. It totally went away when I went very low carb.
I used to think my ibs was triggered by lactose and/or stress but turns out it was carbs, or seed oils. I now get murmurings of ibs if I've eaten out and they've used something unexpected, probably one kind of oil or one that has been used too many times.

I've never taken metformin and am trying to stay away from it as long as possible as I definitely don't want those type of symptoms again. The joy of not needing to know where the nearest loo is is soo freeing!

 

[Melgar]

Hi all,

I was diagnosed as a T2 diabetic a few years ago but have been diet controlled until now.

I now have to go on to medication, but as an IBS-D sufferer, I am petrified of going on a medication which will make the IBS-D worse.

I know Metformin is the first line drug, but that alot of people suffer with diarrhoea on this, so I have already said I don't really want to start on this. The doctor mentioned that the slow release version is better to lower the chance of diarrhoea, but wondering if anyone with IBS-D is on this and how it affects your IBS?

Also is there an alternative medication that doesn't have the side effect of diarrhoea that I can discuss with my clinicians?

Thanks for your help.

I suffer with IBS @Button43, I know what foods trigger it. I also know what meds will trigger an IBS episode. I cannot take more than a single dose of Tylenol ( paracetamol ) as it triggers my IBS. Have you explored all the dietary possibilities, adjustments etc. Is yours triggered by certain foods as meds too? My first thought is to try the medication and see what happens. I know the pain involved and the discomfort . I swear I could pass out on the toilet it can get so bad, so I do hear you and I do understand your fear.

 

[Button43]

What diet did you follow for your diabetes, and how high is your blood glucose or hba1c?
Would there be room for more dietary changes if this would help your diabetes?

There are many different medications for diabetes nowadays, so if metformin isn't the right one for you there are other possibilities too.

I was just being more careful with carbs - not particularly doing low carb diet, just eating less bread, no longer eating pasta (which I used to have 3-4 times a week) and swapping rice to cauliflower rice and eating less chocolate etc. That sort of thing. I lost 2 stone as well, which helped.

Unfortunately my latest HBA1C is high 70s where as previously it had been high 40s/low 50s at worst.

There are certainly a couple more things I can try with my diet, but the doctor still wants me to go meds with my latest results, understandably

 

[Button43]

I suffer with IBS @Button43, I know what foods trigger it. I also know what meds will trigger an IBS episode. I cannot take more than a single dose of Tylenol ( paracetamol ) as it triggers my IBS. Have you explored all the dietary possibilities, adjustments etc. Is yours triggered by certain foods as meds too? My first thought is to try the medication and see what happens. I know the pain involved and the discomfort . I swear I could pass out on the toilet it can get so bad, so I do hear you and I do understand your fear.

Thank you for your reply. It is nice to know others understand.

I've had IBS for over 20 years - when I first got symptoms/ got diagnosed, I tried to find out what food triggered it for me, but couldn't find specific foods - some days I could eat something and be totally fine, then I could eat the exact thing again and it would affect me badly.

I've tried all sorts of things over the years, but the only things I can say that will definitely make it worse is stress and alcohol. Otherwise it's just appears to be random for me and I have to take meds for it very frequently - I am going through a period where it is just manageable for me at the moment, but so worried of any 'new' things rocking the apple cart.

 

[Melgar]

@Button43 Same, sometimes the same food can trigger it, sometimes they don't. Stress is a trigger for me too. I'm also lactose intolerant, I can drink small amounts of regular milk, but if I have too much I get IBS. FODMAP foods will trigger IBS for me. I don't drink alcohol, not because of some virtue on my part, alcohol crashes my blood sugar. I have a gastroenterologist, as I have other digestive issues such as peptic ulcers, I also have coeliac. I'm a try and see kind of person.

 

[lessci]

@Button43 , I've never had a formal diagnosis, but I've found a lower carb diet has helped with controlling my "awkward" digestion, on the whole I only get issues due to my hormones these days, although if I misbehave (especially with bread) I feel the consequences

 

[Melgar]

@Button43 Food choices have been the most significant means of reducing my IBS. I can see why a very low carb diet can work. Gluten was the most significant trigger for my IBS and since stopping foods containing any gluten my episodes have dramatically decreased. Significantly reducing FODMAPs, and taking probiotics daily, have been extremely positive for me.
Specifically, I wondered whether Metformin disrupts the intestinal bacteria in the gut. There have been studies on Metformin and the microbiome which suggest it does, other studies show that Metformin's effect on the gut inconclusive. I take my probiotics. Probiotic yoghurt works just as well, but that can, at times, give me mild IBS, likely the lactose !

I have attached a study. It's a but technical as all these studies tend to be.

https://diabetesjournals.org/care/a...formin-Affects-Gut-Microbiome-Composition-and

ed spelling

 

[Button43]

Thank you everyone for taking the time to respond to my post and the info and support you've given.

@h884 I saw the DN today and discussed my concerns and med options. Thankfully she was very supprtive and listened.

Initially, it was suggested I try the slow release Metformin and if that did give me the side effects, then they'd stop it and switch me to a SGLT2 straight away. We discussed the side effects and benefits of both. However after further discussion about my anxiety about going on Metformin SR triggering flare ups, and how this might affect my compliance, it was agreed to just go straight to the SGLT2, so I have been prescribed Empagliflozin.

 

[Melgar]

Thank you everyone for taking the time to respond to my post and the info and support you've given.

@h884 I saw the DN today and discussed my concerns and med options. Thankfully she was very supprtive and listened.

Initially, it was suggested I try the slow release Metformin and if that did give me the side effects, then they'd stop it and switch me to a SGLT2 straight away. We discussed the side effects and benefits of both. However after further discussion about my anxiety about going on Metformin SR triggering flare ups, and how this might affect my compliance, it was agreed to just go straight to the SGLT2, so I have been prescribed Empagliflozin.

I'm glad your DN listened to you. That's good to hear @Button43

 

[h884]

Thank you everyone for taking the time to respond to my post and the info and support you've given.

@h884 I saw the DN today and discussed my concerns and med options. Thankfully she was very supprtive and listened.

Initially, it was suggested I try the slow release Metformin and if that did give me the side effects, then they'd stop it and switch me to a SGLT2 straight away. We discussed the side effects and benefits of both. However after further discussion about my anxiety about going on Metformin SR triggering flare ups, and how this might affect my compliance, it was agreed to just go straight to the SGLT2, so I have been prescribed Empagliflozin.

That is good result. Really pleased you found the nurse supportive. The last thing you want is a flare up of your IBS. Good luck let us know how things go