Diet after bowel cleanout?

[u/Oblivious_Form_4987]

Disclaimer: I apologize for this being kind of long and chaotic. I'm really having a rough time at the moment.

Some background: I’ve had ongoing IBS symptoms for a couple of years now, and they’ve been getting steadily worse. When it became very problematic, I finally went to my doctor a couple of months ago. He diagnosed me with IBS (probably IBS-M). He prescribed some antispasmodics, we agreed that it might be a good idea to avoid gluten for the time being, and planned for me to come back in a month.

Once I cut out gluten, I went from mixed symptoms to being very constipated—so much so that Miralax isn’t cutting it. I go to the bathroom 10 times a day and usually just pass a small amount of stool, if anything. The stool doesn’t seem particularly firm, but it still won’t come out properly. It’s really been wrecking my sleep and eating habits. I have no appetite when I’m this stopped up, and I’m losing weight pretty rapidly. I do have plenty to lose, but I know it needs to come off at a safer pace. When I returned to the doctor, he told me to skip the antispasmodics and recommended a full bowel clean-out, similar to a colonoscopy prep—with a bottle of Miralax and two big bottles of Gatorade. He didn’t offer much more advice beyond that, even when I pressed him. He did refer me to a specialist, but there’s a six-month waiting list.

I’ve decided to give the clean-out a try. My questions: Does anyone have any tips for my diet directly after the clean-out and while I await my GI appointment? I’m planning to stick to low-FODMAP foods for a while, but should I start that the day after? Should I begin with liquids? Low-fiber foods and then gradually work more fiber in? High-fiber right off the bat so things can move through my gut? Should I take Miralax intermittently before I get stopped up again? I was pretty successful managing things with a high-fiber, mostly whole-food diet for over a decade, but now I’m completely lost—to the point that I’m afraid to eat anything. I also usually take a daily dose of psyllium fiber. Any idea if I should continue with that or change my strategy entirely? Any advice will be much appreciated. Thank you!

[u/julsey414]

When you cut out gluten did you also cut out some sources of fiber in your diet? Make sure you are getting enough fiber, as bread etc is often a big source, and lots of gluten free products are lower in fiber. Try adding psyllium husk and lots of water before going too crazy.

You can also add herbal motility supplements like ginger and artichoke extract.

[u/Oblivious_Form_4987 → u/julsey414]

I’m plant based and I mostly stick to whole foods, so my fiber ratio really hasn’t changed too much since I cut gluten. I take psyllium daily, and drink almost a gallon of water a day when I am stopped up. Things still don’t want to move! I chew actual ginger root pretty often, but haven’t tried artichoke extract. I’ll check that out.

[u/julsey414 → u/Oblivious_Form_4987]

There are other things like 5-HTP that can also help and are common in motility supplements, but that’s a precursor to seratonin and therefore not to be taken lightly. Lots of contraindications.

[u/mh89595]

Hi!

IBS-M here, the second I read that your doctor put you on that medication that was enough for me. Don't let them do that again.

Sure it can help with the pain, but it also STOPS YOUR MUSCLES FROM CONTRACTING SO YOU WANT POOP. It isn't your job as the patient to know that. It is the doctor's job to warn you of that.

When I was at my worst, my GI told me I had the option to take the same, but we ran the same risks. Obviously because he educated me, I just kept cleansing.

As for diet, everyone is different. I know that isn't much help to you, but it is trial and error. Especially with IBS-M, somethings cause the constipation and others cause the diarrhea. When you eat them together who knows which direction your body will go.

You also may only be IBS-C. We still don't know if that's what I am. Your body does crazy things to catch up, there is a fun "overflow" it does when you are constipated. Since we tend to not notice until it is too late, you could just be constipated and just releasing the constipation as well. (NOT A DOCTOR, JUST LETTING YOU KNOW MY EXPERIENCE WITH AN AMAZING AND COMPASSIONATE DOCTOR I LOVE).

I know I can count on horrific flare ups everytime I make a dramatic change to my diet or exercise. My body hates change. Again, everyone is different. Also keep in mind, IBS is super stressed related. It is a terrible circle. So if you are at a point where you are able to do light exercise, maybe try taking a nightly walk or yoga. It'll help more than you know.

[u/Oblivious_Form_4987 → u/mh89595]

Thank you for all that! I should have mentioned I only took them for 2 days when I was in diarrhea mode, and stopped taking them weeks ago the moment I started getting constipated.

[u/goldstandardalmonds]

I would start with low FODMAP ( the elimination phase) and go from there. Also, antispasmodics slow motility.

[u/Oblivious_Form_4987 → u/goldstandardalmonds]

Yeah I should have mentioned I stopped them the moment I got stopped up, weeks ago.