Diarrhea when I feel nauseated?

[SarahAnne]

I've been having a real struggle lately, just got over "suspected SIBO" and now I'm starting to have symptoms again. I wake up, usually early, with terrible D. I feel better after I've cleaned out, it's like doing a scope prep nearly every morning. Then I start to get horrible hunger pains. I usually have to go again 20 minutes after I eat. All day long. By the end of the evening, I am almost painfully distended, sometimes I even feel a "tugging" around my belly button (adhesions?). I have terrible gas and gas pains in the evening, and the loudest rumbling and gurgling from my guts. Go to sleep, repeat cycle.

I have looked into SCD, Paleo, and low FODMAP diets as they are all recommended to help control symptoms of SIBO. Even though I wasn't tested or anything, my GI believed that's what it was (textbook symptoms). I know I have been craving carbs, especially super sugary sweets. I want to be super positive, but even going on the least restrictive of these diets will be a huge hurdle for me.

So just today I started having a new "symptom" or whatever, I got really nauseated suddenly, completely out of the blue. I really felt like I was going to throw up. Went back to the bathroom, but instead of throwing up, I had violent diarrhea with small, gloppy bits of mucous and long, stringy, tissue-y strings of mucous. After I emptied, the nausea was gone. Happened twice this evening. Is this common with SIBO? Or anything else? Just another weird manifestation of my Crohn's? I'm happy not to throw up, even though my hemorrhoids are not loving the constant diarrhea.

 

[tots]

Maybe the pain is making you feelike you are going to throw up. an internal symptom of extreme pain? Does your doc treat the pain?

 

[Jennifer]

My GI suggested that I had bacteria overgrowth back when I had similar symptoms (except my main problem was mucus) but all he suggested was probiotics. My GI is a dip though. That whole wanting to vomit while having diarrhea though I know all to well. What causes it? I honestly have no idea (neither does my GI, dip remember? He had never even heard of it happening to people before). It doesn't seem like its caused from straining as the nausea starts when you gotta go and doesn't tend to go away until you're just about done but you're never really done on the days that this happens. When the nausea and diarrhea happen at the same time for me, it happens at least twice but usually 3-4 times a day. Seems to me that the bowels aren't completely emptying for some reason. I also don't recall having this issue before my resection so I know I have a slight narrowing at my resection sight. Do you also have a stricture of sorts?

Sorry that didn't seem all that helpful.

 

[SarahAnne]

No, Crabby that actually was helpful. I just had my second resection in October and my body just seems to be doing weird (weirder?) things lately. I have lots of scar tissue and adhesions, this last surgery was to remove a stricture. I asked my GI about all of the diarrhea issues and he said that my body is "mechanically different now," it's going to take some time for it to go back to normal.

That's funny about the probiotics, my GI never mentioned them to me. When he mentioned SIBO and put me on Flagyl & Cipro, my husband asked about taking probiotics. My GI said the only one that really worked even a little bit was Florastor. He seemed very skeptical about them. It seems the doctors either put lots of faith in them, or they think it's placebo crap.

Do you know what was the cause of all your mucus? I have a lot, every BM, and I am starting to worry a bit. It doesn't seem to matter what I eat, it's always bad. My latest inflammatory markers are down quite a bit, so my GI pretty much dismissed it, but we all know how the blood work goes. I always thought mucus was from inflammation, and this is a LOT of mucus.

 

[Jennifer]

That's what I've always been taught too, that mucus is caused by inflammation yet my inflammation markers are low as well. So why do we see mucus? I have no idea. My GI said it was from a buildup of bacteria in the gut. Bacteria that's getting trapped or caught in places caused by a resection etc. (basically something foreign in the intestines making them less streamline than they were before). This excess bacteria is what's causing the mucus (or perhaps is the mucus, my GI didn't explain it very well). Problem with me though is that I've been taking antibiotics quite often lately yet I still see mucus off and on. So in my opinion, it must be something else. I haven't figured it out though.

My fiance gets the same way as you to where its A LOT of mucus and he feels nauseous when he has it too. Yet he doesn't have an IBD or any related diagnosis and has never had a resection. Maybe its the intestinal lining shedding or something for some reason.

Possible anal fissure or bowel obstruction is what one site said. Or maybe we all also have IBS, I dunno. http://ibdcrohns.about.com/od/relatedconditions/f/mucusstool.htm

 

[SarahAnne]

This is no fun, just when I felt like I was getting better. :frown:

Woke up yesterday morning with pain in my LRQ. The pain is what woke me up, I have a high tolerance for pain and I wouldn't say it was severe, somewhere in between moderate and severe.
I got up and walked bent over to the bathroom, because I couldn't stand up straight. Immediately had D, it was terrible, SO PAINFUL! I haven't had much pain since surgery, mostly just uncomfortable distension.
I couldn't bear down at all. The pain got intense every time I tried to bear down, cough, blow my nose, etc. After I finished, the pain wasn't as bad, but it never went away.

Last night, I was lying down and pressing on my abdomen trying to find the exact spot. The pain was low first thing in the morning, but when I press down on mid-section, the tenderness about 2 inches to the right of my belly button.
Site of both resections. When I pressed down, I could hear and feel gas moving around.

Tried to eat something around 9:30, had severe pain & ran to the bathroom. This time I actually did throw up, it was pretty violent.
Woke up this morning with the same pain, only worse. I feel sore and tender, like I was kicked in the abdomen.
I'm not running a fever, never do. I went to the ER the end of January for very similar pain. The ER doc was convinced I was pregnant (maybe b/c I was so distended?), and it didn't matter what I told him. When the test came back negative, he looked at my chart and my abdomen and saw all my surgery scars. Only then did he listen to me about having Crohn's! :voodoo:

I had x-rays which showed nothing, he seemed reluctant to do a CT so I didn't press the issue. When I went to my GI less than a month later, he seemed pretty focused on the SIBO thing and didn't really address the issues I had in the ER.

My head is spinning right now. This is exactly what I went through with my stricture, I'm not saying it wasn't SIBO but I wasn't tested for it.
I've got to call my GI tomorrow, maybe I will ask for a stool culture and blood work. I have no idea what's going on and I'm tired of waking up in so much pain.

 

[LindaS]

SarahAnne, have you done the breath test to see if you have SIBO? The test is drinking a very sweet solution, then doing the breath test. The sweet liquid isn't the best for diarrhea, but at least then you'll know if you're treating the correct thing. I won't let my GI treat SIBO without testing first, since it seems to be a kind of "catch all" when the GI doesn't know what is wrong.

I hope you feel better soon.

 

[Sybil Vane]

I would go to the ER. Do you have another ER you can go to? That ER doc sounds like an idiot. They should be giving you CT scans to check for abscesses or obstructions. I've had surgery for strictures, too, and when I have a flair, my last site gets all inflamed. You probably need an IV and bowel rest. I'm keeping my fingers crossed that you get a break from all of this pain.

 

[Jennifer]

Is to the right of the belly button where your resection site would be if you have part of your TI and colon removed? Mine has been hurting off and on there too and when I press. Sometimes I do have really sharp pain that goes away after a few throbs. Maybe it is all just scar tissue messing us up.

You on the other hand are actually throwing up so I hope your GI orders tests that would show a stricture rather than check for bacteria first.

Edit: Mine god man it is the same area! Crap! Now I have to call my stupid dip of a GI too...

 

[SarahAnne]

Linda ~ No, my GI never did the breath test. He said he "suspected" it was SIBO and put me on Flagyl & Cipro. TBH, I didn't even know what it was!
I had seen it before on the forum, but I didn't pay any attention to what it was cause I never had a doctor mention it. I thought it was similar to C. Diff. I took the script for the meds and when I got home, I researched it here and on the internet. That's when I found out there was actually a test for it!

Sybil ~ There are 2 hospitals here, I usually go to the same ER cause it's easier, they have all my info on file. I never get the same ER doc, about 50% of the time they are very helpful. The other half of the time, I feel like I get the jerk doctors that don't want to hear anything about Crohn's. They always want to believe it's female problems. It's not like I go in there diagnosing myself and asking for pain meds. I make sure they know I have Crohn's b/c any pain I do have is almost always related to it.

Crabby ~ Bingo. I had my TI removed along with some SB & part of colon back in 1996. Latest surgery this past October was for multiple strictures in same area due to scar tissue. When I press down it is sore and tender, I can feel the scar tissue and adhesions, the area isn't as pliable as the other areas of my abdomen (does that make sense?).

My old GI dilated my stricture during scopes for 3 years, Humira failed, and I started Remicade too late to have any affect on it. The sudden pain and vomiting worries me b/c that is where I started going downhill last year and lost a lot of weight really fast. I just got up to 100 lbs!

I know it's bad, but I haven't eaten anything today b/c I just can't go to the bathroom anymore. I started crying this morning when I had to get out of bed the second time to go, I knew how much it was going to hurt. Also, my hubby is working tonight so I just can't afford to be very ill when I have the kids by myself. However, if the pain gets worse or I start vomiting again, I'll call my mom & have her watch the kids.

I don't want to be a drama queen and go to the ER if it's not anything serious, but I'm terrified of there being something wrong that I don't know about. I've read enough on here about perforations, abscesses and emergency surgeries, I certainly don't want to go down that path.

 

[LindaS]

I don't want to be a drama queen and go to the ER if it's not anything serious, but I'm terrified of there being something wrong that I don't know about. I've read enough on here about perforations, abscesses and emergency surgeries, I certainly don't want to go down that path.

If you feel there is something really wrong, you need to go. Better to find out it is nothing after going to the ER than not to go and have it be something really bad.

I hope you feel better.

 

[Jennifer]

You've learned on this very forum that when in doubt, go to the ER and get checked out. Even if that ER doc is a dip (can't always be the same guy there), that ER visit will get you a quicker visit with your GI which it sounds like you need. Be careful.

I've yet to do any vomiting but nausea and mucus came yet again for me tonight so I will try to make an appointment with my GI tomorrow (hopefully I wont have to wait 10 years to be seen). Let us know when your appointment is (I'm hoping/assuming you will set one up tomorrow as well?).

 

[SarahAnne]

Called the GI's office about my symptoms, waiting for a call back. My GI is out of state, 5 hours away. It makes me very nervous at times, I have to plan ahead for appointments and I can't just get "worked in" if I'm feeling very poorly. So I have no problems going to the ER if I feel I have to.

I haven't had any more vomiting, I didn't eat much at all yesterday I was just too scared to. I had a couple of bites of cantaloupe this morning, hope it doesn't come back to bite me in the ass when I'm at the vet's office later with my 70 lb Golden Retriever.

I'm very anxious, my kids are on spring break and my hubby took a vacation day for tomorrow. We are supposed to take our new canoe out for an all day paddle, and I just don't know what to do. Not eat all day long? I know I'd pass out. Guess I'll have to bring a roll of toilet paper in a large ziploc bag. I hate the thought of defiling nature with my explosive diarrhea. But I really want to go!!!

 

[Jennifer]

Hope you get to see yours soon still though. Nothing inside getting backed up is probably why you don't feel as bad yet that in itself isn't good (gotta have nutrients but you know that).

I'm having pain at my resection site this morning and called and made an appointment with my GI on April 12th but I apparently have to get another referral form my GP just to see my GI. Apparently with my insurance the referral only lasts for so long. How am I supposed to know that? This sucks. I do have an appointment with a GP (not mine cause they are still out of town) this week on the 15th so hopefully I'll get it sorted then. Sucks cause I wanted to ask for a referral to a new GI cause I don't like this one but I bet they are gonna tell me I can't ask for 2 referrals for the same type of doctor. Lame!

 

[Chrismac]

I've never had an operation, everything inside is as it always has been but I usually get nauseous and sick for two reasons. The first is because I work long hours I sometimes hold it in (with big effort) for long periods of time. I wonder if this causes it to back up or something, but it makes me feel incredibly nauseous and it only passes once I've been.

The most common one I get is nausea AFTER I've had a BM. I'm not 100% sure but I think it is when my stomach has not completely emptied, even if nothing is coming out at that time, and so my body protests. But I will continue feeling like that until I have another BM and everything has gone.


Recently I've been getting it all day, everyday. Ugh. I hate the feeling of being sick.

I'm sorry you are going through it, I really hope it is something that can be fixed soon for you.

 

[SarahAnne]

That sucks Crabby, I wouldn't want to be stuck with an idiot doctor - main reason why I drive 5 hours now!

GI nurse called me back this morning, they have called in Xifaxin 550mg, twice daily for 14 days. I'm unfamiliar with this antibiotic, anyone been on it before? I read up a little on the side effects and it said on WebMd that it may (rarely) cause C. Diff. Oh, yay.

Thankfully, I haven't had anymore nausea or vomiting. I'm still sore and tender, but it's more annoying than anything else. We went canoeing and I was okay. There was a bathroom by the campground where we ate lunch, it's the only time I had to go all day. I was a bit naughty and took immodium so I wouldn't have to worry too much. I had a turkey sandwich and it didn't come back to haunt me! I won't get into the habit of taking it though, I used to take it every day, several times a day. My GI gave me a big scolding!

I'm really glad I got to go, we had a great time! I really feel okay too, Tommy was really worried I was paddling too much and might pull something or make my sore area worse. I'm tired now, but a good tired, being on the water all day in the sun. At least I got some natural Vitamin D!

Chrismac - I know that feeling, I don't work now but I used to work at Starbucks. I was an Assistant mgr so I worked 8+ hours a day, 5 days a week. On my feet the entire time, and when it was busy I couldn't always pop away to the bathroom. I was horrible about trying to hold it, I later learned this is NOT good as it can lead to problems with control later on. So sorry you've been so nauseated constantly, it is a feeling I absolutely hate. Do you have anything you can take for it, like zofran or phenergan? They tend to make me really sleepy, but that's better than the constant nausea.

 

[Chrismac]

I don't dare to take immodium now I read all about toxic megacolon. Although I think the name is hilarious (sounds like a weird superhero) I don't want to risk it! My doctor told me off too.

I'm glad you were able to go canoeing, it's so much fun and just great being able to be outdoors and in the water. I'm glad you could go and not have to worry. Always good when you are in sight of a bathroom too!

Tell me about it! I work in a nursing home, 12 hour shifts, so it's not always possible to go if I'm with a resident. I haven't looked at anything to take yet but I saw my doctor today and they are booking me in to see my consultant so hopefully whatever is going on will sort out soon.

 

[wolfem]

Wow. I can sort of relate to all of this. I'm in remission, but what the heck is going on here? Nobody has checked me for SIBO either and I get bloated and extreme hunger pains on and off. I was getting nauseated really badly but now I'm on ranitidine, it never happens. Something just doesn't seem right. I mentioned in other posts that I had a SBFT because I was having trouble with my esophagus. The radiologist said everything is fine--even my stomach, but she was a little troubled by my surgical site (terminal ilieum resection) and she wouldn't tell me why. She pushed on it and asked me if it hurt. It does hurt still. What the heck?

I'm still losing weight but no real inflammation.

Sorry to carry on about myself!

Hope your symptoms resolve!

 

[Jennifer]

Carrying on about ourselves is what helps us all learn. We didn't hijack this thread at all. Whoever gets an answer first, please post so we can have our GIs take a look see.

 

[SarahAnne]

Wolfem ~ No need to apologize about carrying on, that's what this forum is all about!! If I can learn a little something about someone's else's experiences, and vice versa, it helps tremendously. Sorry if this is a little personal or TMI, but are your stools normal? I usually have D, but it has gotten way worse, and sometimes is very foul smelling. Based on the color and smell, I don't doubt that I have some sort of infection but I haven't officially been tested.

The antibiotics I was on helped the awful smell and the severe bloating, but I was nauseated and vomiting the entire time I was on the Flagyl, I don't get on well with that drug at all. Symptoms came back rather quickly, and now I am back at square one. If it is SIBO, I'm afraid I'm going to have to radically change my diet.

Chrismac ~ Let us know what the consultant says, I am very curious.

Crabby ~ Are you still having pain too?

 

[Jennifer]

I have pain off and on. Had a little today at the resections site. When I have pain it stabs for a few seconds then goes away (doesn't happen everyday either). So to me something must just be passing through the scar tissue from the surgery. I get to see a doctor tomorrow to try and get that GI referral through so I can actually go to my GI appointment and see if my dip of a GI doc wants to do anything about it.

 

[wolfem]

Gosh. That really stinks. My stools almost never look normal and sometimes my stool does smell strange. They just look like undigested food. Crazy. Its not like I have severe pain either. I just get bloated and then nauseated. Ugh. Anyhow, I just recently made a huge mistake. I went off of saccharomyces boulardii and now I'm back to being bloated and hungry. I'm back on S.B. but I don't know if its going to start working again. It does help a little. I think the very high dose probiotics work well. This is so awful. I only weigh 105 now. I lost 5 lbs in a month. I know it could be a lot worse but I have never been able to reach 112 even eating so much food. I always look pale too.

-Crabby I get those very tiny sharp pains too. For me, they only last a few seconds and they only come every so often. My inflammation markers are low too.

The bacteria backs up into the small intestine and grows there. I wonder if certain foods could keep the harmful bacteria from taking over? I wonder if certain foods could help with gut motility--hence, preventing bacteria from backing up. I know the FODMAP diet is supposed to starve them.

 

[Jennifer]

I believe replacing it with good bacteria is supposed to help like from yogurt but you get more good bacteria from the probiotics. Either way, I'd prefer to be tested for too much bacteria rather than shelling out a bunch of money each month for something that isn't the problem.

 

[wolfem]

You mean you would rather be diagnosed with it first before buying expensive probiotics? That's very reasonable. I'm not going to start the FODMAP diet until my doctor confirms SIBO first. I'm not even sure my insurance would cover a dietitian:shifty:

Hope you're feeling better, SarahAnne.

 

[SarahAnne]

I considered going on a low FODMAP as well, but I have to start slowly. I can't go cold turkey and give up everything I like, even if I know it doesn't do me many favors. I have already completely given up soda, that was harder than when I quit smoking cigarettes several years ago!

Yogurt seems to be very easy on me, I used to hate it but have developed a liking for it now. Had a chicken salad sandwich at a local deli when I was out with my mom yesterday, big mistake. My guts were spasming and cramping for about 30 min. last night before I had a violent D episode. Got horribly nauseated but didn't throw up.

My next Remicade infusion is Monday 3/19. I'm hoping it helps, but if most of this is SIBO related I don't think the Remi will do much for it. The pharmacy had to order my antibiotic, I have to start on it today.

Wolfem ~ how long did it take before you felt a difference on the probiotics? I have tried them, and didn't feel like they did anything. Do you have to take them for a certain period of time before they are fully effective? I would definitely take them if I knew they helped, but I also don't want to fork over a bunch of money for more pills that don't really do anything.

 

[Jennifer]

I tried them for two months before I quit using them cause they didn't seem to do anything for me either. My GI later tried Entocort for a few months and things got better even though my inflammation markers are in the single digits. :/ Months after stopping the Entocort, its come back.

 

[wolfem]

I considered going on a low FODMAP as well, but I have to start slowly. I can't go cold turkey and give up everything I like, even if I know it doesn't do me many favors. I have already completely given up soda, that was harder than when I quit smoking cigarettes several years ago!

Yogurt seems to be very easy on me, I used to hate it but have developed a liking for it now. Had a chicken salad sandwich at a local deli when I was out with my mom yesterday, big mistake. My guts were spasming and cramping for about 30 min. last night before I had a violent D episode. Got horribly nauseated but didn't throw up.

My next Remicade infusion is Monday 3/19. I'm hoping it helps, but if most of this is SIBO related I don't think the Remi will do much for it. The pharmacy had to order my antibiotic, I have to start on it today.

Wolfem ~ how long did it take before you felt a difference on the probiotics? I have tried them, and didn't feel like they did anything. Do you have to take them for a certain period of time before they are fully effective? I would definitely take them if I knew they helped, but I also don't want to fork over a bunch of money for more pills that don't really do anything.

SarahAnne,

I can't go cold turkey either. My diet probably is too restricted now but that is because I'm allergic to tons of foods. Stinks!!! I want pizza so badly. LOL. The diet and eliminating foods has helped me tremendously keep flares at bay (I know it doesn't work for everyone). However, I just can't imagine eliminating more for the FODMAP diet. As far as the probiotics, I've shelled out lots of money to find the right ones and the reason why I've done this is because I can't go on antibiotics. I had a severe C. diff infection in the past and doctors do not want me on antibiotics at all. My doctor wouldn't put me on antibiotics for my sinus infection so I'm pretty much out of luck. I guess the only time they would put me on antibiotics would be for sepsis (of course). The regular probiotics people take don't work for me. The ones I take have around 12 different strains with over 25+billion organisms. It works great but I ran out so now I'm having issues. Anyhow, they're expensive but they work for me so its worth it. It took about 2 weeks to work. Maybe even a month. It takes awhile for bacteria to colonize and compete.

Another thing that I typically do is add spices such as tumeric to my food. Some spices have bacteriostatic properties to they may help keep everything in check. Rosemary is another one but I can't stand the taste. lol. I would eat more garlic but I'm allergic.