foodless in CT

I have a meeting set up with a temp agency today and I thought it would be good if I weren’t passing out in their bathroom. Hence, no breakfast for me this morning. I don’t like skipping meals, it makes me irritable and lethargic but last night was horrible. I was about 10 minutes into dinner when I got massive cramping lower down. I stopped eating and took a bentyl (my first one). I ate a little more when the first wave of cramping subsided but my appetite finally gave up when the pain started again, and again. Within an hour I was in the bathroom drenched in sweat, huddled on the toilet, retching into the trash-can and hoping the whole thing would just get over with. I lose track of time when things get that bad – it felt like an hour but I think the whole thing lasted only about a half hour acutely. When it was over, I felt deflated, sweat-soggy, cold and shaky for the rest of the night. Times like that, yes I will happily take a Donnatal…well, a quarter of a Donnatal.

And this, in a nutshell, is a BIG part of why my life is so very small now. Even if it’s not a bad day re: joint pain, fatigue, migraine, and endo/etc., you just can’t go anywhere if experience indicates that any gut cramps might turn into those gut cramps. Oh I suppose I could go places and just not eat, however while the no-food strategy works for the duration of a job interview, it is not a practical option in most situations. So I prefer to eat and thus stay close to home or at home. Ideally, I also prefer to be able to take the medicine I need to help ensure that I at least won’t pass out from pain when my gut is launching quasi-digested food into the toilet 5 to 8 times a day. But without the hyoscyamine, I’m stuck fiddling with new meds and hoping one of them (timed right and taken at a high enough dose) works right. For the rest of this week, I’m planning to premedicate with the bentyl (20 mg instead of 10) rather than wait and risk another one of those horrible episodes.

In the meantime, I present for your reading pleasure a relevant (for me at least) abstract.

Simrén M, Abrahamsson H, Svedlund J, Björnsson ES. 2001. Quality of life in patients with irritable bowel syndrome seen in referral centers versus primary care: the impact of gender and predominant bowel pattern. Scand J Gastroenterol. 36(5):545-52.

BACKGROUND: Quality of life (QOL) is reduced in patients with irritable bowel syndrome (IBS) and little is known about differences in QOL in relation to referral status, gender and predominant bowel pattern in IBS patients. This study aimed to explore these relationships. METHODS: 343 patients with IBS according to the Rome I criteria (251 females, 92 males) completed five different self-administered questionnaires to evaluate QOL. There were 119 patients with diarrhea-predominant IBS (IBS-D), 93 with constipation-predominant IBS (IBS-C) and 131 with alternating constipation and diarrhea (IBS-A). The study group comprised 209 hospital outpatients and 134 primary care patients. The questionnaires were mailed to the patients with an overall response rate of 88%. RESULTS: QOL was reduced in hospital outpatients compared to primary care patients, but only in females. IBS subgroup (IBS-D), physical fatigue and general health independently predicted referral to a gastroenterologist. Females had lower QOL than males. No differences, except in severity of diarrhea and constipation, were observed between IBS subgroups. Perceived fatigue was related to well-being, psychological and gastrointestinal symptoms. Independent predictors for fatigue were depression, trait anxiety, general health and vitality, along with eating dysfunction and female sex. CONCLUSION: IBS female patients seen in referral centers versus primary care is a highly selected group with reduced QOL. QOL in IBS is affected by gender, but not by subgroup. Our findings have implications for the generalizability of results in IBS trials. Fatigue is a common symptom in IBS that correlates to general well-being and psychological and subjective gastrointestinal symptoms.

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