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Post Info TOPIC: IBS-D and cirrhosis


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RE: IBS-D and cirrhosis
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Interesting list of possibles. Thanks, now I am really glad I am going to be treated!



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Lamont Cranston "Only the Shadow knows."

70 years old, retired IT Network support 33 years continuous sobriety in AA, ,DX'd in '99 with MS, DX'd with HCV 2, 2b , F0-F1 3/17/2017 VL 5.7m Started EPCLUSA 7/28/17

No Virus Detected on November 20, 2017 3 months after EOT

Tig


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Mabuhay Gardens, lol! I think I got trashed there a time or two!

I agree totally with your doctor. The more I read, the more confusing and interwoven everything is. Human biology is incredibly complicated, but interesting. My nephew is a biologist with the CDC and my brain starts swimming when he starts explaining things! 



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Tig

66 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 8+ years!

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Tig56 wrote:

If you consider that HCV attacks the largest organ in your body and is connected in every facet of digestion one way or another, it makes sense that your bowel function may be impacted by it.

Here's a list that describes many of the extra hepatic manifestations caused by HCV. It's a staggering number of things.

Extra Hepatic Manifestations


 Great band name! Now appearing at the Mabuhay Gardens,The  Extra Hepatic Manifestations

OK, time to do some reading. I hate to say it though, it seems like the more I read and seem to know about human biology, the more I am baffled by it's complexity! My gastro even admitted to me that he reads 20-40 hours a week on various gastro research, and that it just creates more questions than answers.



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Lamont Cranston "Only the Shadow knows."

70 years old, retired IT Network support 33 years continuous sobriety in AA, ,DX'd in '99 with MS, DX'd with HCV 2, 2b , F0-F1 3/17/2017 VL 5.7m Started EPCLUSA 7/28/17

No Virus Detected on November 20, 2017 3 months after EOT

Tig


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If you consider that HCV attacks the largest organ in your body and is connected in every facet of digestion one way or another, it makes sense that your bowel function may be impacted by it.

Here's a list that describes many of the extra hepatic manifestations caused by HCV. It's a staggering number of things.

Extra Hepatic Manifestations



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Tig

66 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 8+ years!

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Is there any theory on whether Hep C causes either loose or constipated digestive issues?

 

By the way, gallons of water and fiber haven't been effective. In fact, I'd say that additional fiber really makes constipation worse for me.

I have made a science of this issue, as I find it very distressing to not be regular, the way I was until about 2 or so years ago. I am praying that once I am past the Epclusa treatment, my body will be more normal.



-- Edited by LamontCranston on Sunday 23rd of April 2017 04:55:53 PM



-- Edited by LamontCranston on Sunday 23rd of April 2017 05:00:20 PM

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Lamont Cranston "Only the Shadow knows."

70 years old, retired IT Network support 33 years continuous sobriety in AA, ,DX'd in '99 with MS, DX'd with HCV 2, 2b , F0-F1 3/17/2017 VL 5.7m Started EPCLUSA 7/28/17

No Virus Detected on November 20, 2017 3 months after EOT



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Lamont,

Me too!, I think poo is a very interesting topic!! heehee (Jaggles too)! She and I (and many others) have shared conversations all about what we experience or can do, about the "do" situ's.

I should not make light of a very seriously-disturbing condition/affliction/symptom/or manifestation of a disease process going on ... us poor folk who suffer through either ends (forgive the pun) of this GI spectrum, from discomfort, to diarrhea to constipation who dearly wish to be boringly "normal".

Perhaps with cure, you will find further "relief" (more pun). In the meanwhile I commiserate with you.

I myself have long been at the chronically constipated end of the scale, no real mystery there tho, as (1) I suddenly discovered I had been packing an unknown HCV most of my life, and (2) being my own worse enemy ... all my life I allowed myself to be a mostly chronically dehydrated person, even tho I very much KNEW better, and just because i managed all my life to get away with it, or, so I thought. (I am endlessly surprized at my epiphanies, of which, I am most impressed and appropriately humbled with the degree of ignorance I live in!)

It was really only the last decades that I made much effort at all to improving to my water intake, and it was pretty lame, lip service mostly. It was not until the HCV was finally diagnosed and I was on treatment did i make any real sustained or valiant efforts to drink more water (even on treatment, I was still reluctant to drink enough, and paid for it).

Now that it is all waaaay too late, I have become a firm believer that water is one of THEE most important things I can do, not only for my chronic constipation, but for my health/kidneys ... period. I HAVE turned a new leaf, it started ON treatment and I now continue to make concerted efforts to get that all-important water in.

I HAVE (finally) learned I CAN have better control of my constipation, just with water intake alone, plus, i too have a regular (sorry, another pun) minor probiotic regime. My diet and fibre intake is now improved and adequate as well. It all helps, big time (half pun) - but the water intake, especially so.

I too tweeked with interest (out of warped bunged-up desperation) about possibly looking forward to a "bit" of diarrhea on epclusa. But, as it turns out, "diarrhea" IS NOT any big "side" of epclusa. Rather, in epclusa, of the largest reported "side" (of which there are few), is more limited to "fatigue/headache" (as high as in the 10's to 20%), and the frquency of those vary somewhat between the different new double (NS5A/NS5B) DAA regimes. There are some other possibe sides (in all these new DAA doubles), but the incidence of those are far, far less seen, (often less than 2 %). Just the regular, plain ole fatigue/headache are the most common experienced. Now, mind you, I was on epclusa plus VOX. The vox triple when laid out side by side, compared to the epclusa double alone, the triple DID have a slight bit more emphasis on the "possibility" of GI "disturbances", like diarrhea, but alas that "side" was not seen in me, even on VOX! NS3/4A's like VOX may hold some of their own slightly differing sides, as compared to the NS5A's and NS5B's commonly found in new DAA's doubles like epclusa.

Tig verifies, you have indeed made a valid connection between your "systemic" HCV and how it may affect the rest of your GI tract (and all your other systems for that matter). On the other hand, causation is a very hard thing to suss sometimes, due to so many variables that can be in play, from general health and diet to other disease process influences. 

Our livers are mind-boggling, amazing things, as is the whole of our gi systems, and every other system we posess which is what makes us. Equally amazing is HCV, it's effects and the "counter" effects our systems muster in response to this virus!

Try really pounding down the water and fibre (the old 1,2 - hee hee) for your constipation, as well doing your probiotics like you are, lots of fruits and veggies. I try to never to let the constipation get ahead of me and I will still dose with small amounts of psyllium to help when necessary. C.



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 64 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

 

(SEE UPDATES IN BIO)

Tig


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There is a relationship between the two. Anytime there is a digestive disease, it's likely to cause issues some of the time at the very least. I experienced trouble with my gall bladder in 2002. Lots of pain and the big D on a constant basis. Removed the GB but the goose moved in to stay.... 

Here are some links to info:

IBS-D

IBS-D 2 



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Tig

66 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 8+ years!

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Interesting topic, for me.

I just turned 65, yes, it is difficult to understand how I could have lived so long, and was wondering if anyone else had Hep c connected digestive issues. It has occurred to me that it is possible to have both at the same time, sort of independent of each other, but not likely. 

I was the loose caboose guy most of my life, until about 18 months ago, when I developed chronic constipation, and "you name it" after meals. In fact Ive convinced myself that my hepc is connected to it.

Of course I have no evidence that they are related, but I want it to be over once I am treated. 

I have had a lot of other tests, Endo, Colon, scopes, cat scan, Mri ....But wasn't dxd with hepc until a couple of weeks ago. 

When someone mentioned that Epclusa can cause diarrhea, well, that sounded ok to me. After all I've had the opposite problem for a while now. The only thing that has improved this condition is Phillips ColonHealth probiotics. Trust me, I have tried everything to sort this out, but that one actually works. 

Always look on the bright side.

 

 



-- Edited by LamontCranston on Monday 3rd of April 2017 11:34:54 AM



-- Edited by LamontCranston on Monday 3rd of April 2017 11:37:40 AM

__________________

Lamont Cranston "Only the Shadow knows."

70 years old, retired IT Network support 33 years continuous sobriety in AA, ,DX'd in '99 with MS, DX'd with HCV 2, 2b , F0-F1 3/17/2017 VL 5.7m Started EPCLUSA 7/28/17

No Virus Detected on November 20, 2017 3 months after EOT



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Another good addition for these types of issues is a good probiotic. 



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Wendy 53 y/o, DX 1994, geno 1A F1

1999 TX 1 - Inter -non responder 2001 TX 2 - Peg + Riba - viral load tripled and taken off

T3:  Harvoni 12 weeks Sept. 19, 2015 ALT 41 AST 30 VL 541800 UND at EOT and SVR 24 ALT 18 AST 26 platelets 223

 



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Hi Vet,

I also suffered from IBS and found psyllium helpful but it didn't completely cure it. Eventually I discovered I had developed food sensitivities that were messing with my digestion, so that might be an avenue for you to explore if you don't get it figured out.

 

Cheddy and Jade, it's important to use ground or cracked pepper with tummeric. The one difficulty with tummeric is the "bioavailability" but black pepper contains an enzyme (or property of some sort) that boosts the bioavailability of the tummeric. = you absorb instead of just metabolizing.

A



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61 y/o, Infected via transfusion Oct'83, GT-1a, F-4 cirrhotic,
tx Holkira pak/moderiba 12 weeks

4 years.... successful dragon slayer 



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Hey Vet.  What better place to discuss such detail than in an anonymous group of loving strangers.  All safe here. There's a children's book called "All Animals Poop" that dispels our goofiness around the subject. So does med school, according to my doctors. Takes longer.

Anyway, digestive issues were a major symptom of my former HepC virus.  Things got better after.

As for tumeric, Jaded, it does help with all things inflammatory.  That helps with all kind of aches and pains.  I don't take a lot of herbs, but I like this one, personally.

I'm going to go enjoy the lights in winter. Happy Holidays to all.

 

 



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GT2a, VL 681,500, Less than F1, Treatment Naive

12 wks Sovaldi/Ribavirin, SOT 2/25/16, EOT 5/17/16

UND at 2,4,8 and 12 wks during treatment but ribavirin crazy.

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SVR12 8/13/2016!!!!!!!!!  I WON!!

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VetwithC wrote:

Not a fun thing to experience or share, but I was wondering if any others out there have similar experiences?

My bowels have always been on the loose side, but manageable with psyllium to slow things down. It has been just a nuisance going on for decades, but cleared up to almost constipation for a couple of weeks during Harvoni Tx a year ago, but in the last couple of months it has returned to IBS-D again with a vengeance.  So much so that I have to take a swig or 2 of pepto bismol and sometimes immodium if I have a long trip to town.  A couple of embarrassing events has taught me to slow the flow down if I'm going to be in public for a few hrs and I always carry Pepto and/or immodium with me, as I hate public toilets and I don't like to take these meds for more than a day so it keeps me on a short leash if I want to avoid public toilets.

 As I mentioned it has been a little over a year post Tx and still have no viral load, but my liver has degraded to cirrhosis..........could that be the cause?

Trying to schedule a colonoscopy as well as an ultrasound to check on my 8 mm stone.  Yellow, watery, mucousy stools has prompted me to pursue that.

Just wondering if others have experienced same or have any suggestions.............

Thanks in advance and bah humbug to these holidays and the delays in dealing with life.

  


 I've started taking a couple of teaspoons of turmeric daily 2 months ago because I had read on this site that it was helpful for cirrhosis. I have had many different types of overall improvements almost immediately and I see that it is also good for IBS. It costs me a bout $3 for 400grams at my grocery store (powdered form). It reduces inflammation as well and lowered my blood pressure.

 

Here's a link on IBS and turmeric...I'd give it a try.

http://www.turmericforhealth.com/turmeric-benefits/turmeric-and-irritable-bowel-syndrome-ibs

I take a gram of magnesium daily and that loosens you up...but noticed that turmeric had a counter effect on that so I think it's worth a try. 



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64 year old EOT 10-28-15,SVR24 April 21 2016  ALT-12/AST-23 June '19 - fibroscan 6.9 F-0 July '19



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Hey Tig, 

I was writing my last post to Canuk and noticed yours when I submitted reply to him.

I was hoping you would pipe up with your often helpful advise.

I think I answered most of your issues in my reply to Canuk, but yes I am tired of the long waits and BS with the VA and now have an appointment with a civilian Dr. 

Yeah, it's a gall stone and like I said, I am a bit concerned, especially after observing some yellowness in my stools. That's on my list of questions for the Dr.

 

Will check out the links you provided, 

Thanks, 

Harry



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DXed in year 1999 with geno 1a, went with a wait and see approach while my viral load increased from 240,000 to 3 mil and contacted VA when Harvoni came out and now have harvoni and starting TX on Monday.


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Canuck, 

Thanks for your reply.

To make a few things clear, I did have a colostomy done in Thailand 7 years ago and they found no polyps, but did observe that I had diverticulitis and with the Dr's limited English and my foggy mind from the anesthesia all I remember  him saying was to avoid popcorn and nuts with hard seeds that can get lodged in the pockets of the intestines.

 

re: psyllium..........it's a wonderful substance that can either soften your bowels or firm them up as i remember when I was a teenager and had constipation, it was Rx'd to soften and it worked great. Now, I use it to bulk up my watery stools and it does so by absorbing the liquids. I did a quick Google 'psyllium and diverticulitis'  after reading your post  and the Mayo site even suggests it in a diet for diverticulitis.

Some cramping pains after a severe bout with too much pushing to empty myself and will feel more physically drained than I do normally with my cirrhotic fatigue.  

 

re: my 8mm gall stone..........the drs have been aware of it for a decade, but most tell me not to worry about it, as it's too big to pass thru my 5mm tube, but I do worry.

 

Since viral clearance, my liver and most other blood tests have returned to normal.

 

I might mention that all my HCV Tx & labs has been done by the Veterans Administration and I am thankful for that but have observed that they are way over burdened and often miss little details and are late in getting work done.  Their wait time for a colonostomy is 2 to 3 months out and same for an ultrasound So I have an appointment with a local civilian GI Dr, who was recommended by a close friend just to get a 2nd opinion.



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DXed in year 1999 with geno 1a, went with a wait and see approach while my viral load increased from 240,000 to 3 mil and contacted VA when Harvoni came out and now have harvoni and starting TX on Monday.
Tig


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Hey Harry,

Sorry you're having such a hard time with IBS. That's so difficult to live with and the embarrassing moments can't be avoided sometimes. You're being very proactive and I have a feeling you're going to find a way to both deal with it and reduce the issues inherent with it. I have had bouts on and off for years, but diet and understanding has provided the best results. I know a lot of people that have similar issues, so you're not alone. 

What is the plan going forward regarding the cirrhosis? Have they done a recent fibrosis staging? The degree of scarring needs to be determined, along with the rest of your liver function. It's all tied together and hopefully there is a key that unlocks the door to improvement.

I would want to know more about that 8mm stone you referred to. Kidney or gallstone?  If that's a gallstone and it's interfering with bile flow, you could have at least a partial answer to some of the abdominal pain. They yanked my gallbladder years ago, it was lazy and wouldn't squeeze properly. Left me in a lot of pain and provided plenty of weird bathroom stories to boot! It doesn't take much to upset the GI tract and can very often only involve some simple fixes to resolve them. Lets hope anyway.

I'm sure you've looked for information on this, but I thought I'd throw a few more articles at you. I think diet is a BIG deal with IBS. There are some biologics (Rx) they are using with some success, but it always discovering the right diet and the things that trigger it. Yes Canuck, the use of psyllium and the like are often used to "glue the poo" together, in addition to adding dietary fiber. Fiber is useful for all kinds of fun things!

IBS-D Diet Sheet

Fiber Supplements for Diarrhea

IBS Supplements 



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Tig

66 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 8+ years!

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Greetings.

I have NO Medical background.

That said here is what I am drawing towards. You system sounds to be highly acidic which can be brought under control but only if you know.

https://labtestsonline.org/understanding/analytes/gastrin/tab/test

 

Read up on Gastrin and then maybe you will want to ask you Doctor to test your levels. wink

 

JimmyK



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Hi again Vet with C,

Sorry to hear of your bowel troubles, IBS is stuff I am not too familair with, I have a tendancy the other way! There are folk here who have experienced (I am sure) bowel issues similar to you, I am hoping they will pipe up. Tig too (I am sure) with have knowledge on IBS. Let's see what they think.

Off the top of my head, I would wonder if you have been WELL-followed (for these symptoms and bowel problems) as you indicate they have been ongoing for some time. Did your doc not do any colonoscopy, or any bowel work-up, prior?? Do they know, fully, the extent of your complaints and how bad your diarrhea can be? Did your doc(s) condone/recommend use of pepto-bismal/immodium/psyllium? If they are aware then I would assume you have received some counsel about diet and what to avoid that can make things worse?

I am a bit confused about your psyllium use tho - (forgive my ignorance) - I too have relied on it in the past (plus diet and water) to help combat constipation, but I have not heard of psyllium being used (directly) to combat diarrhea, per say. (I have heard of folk with early diverticulitis/diverticulosis having to be very careful with diet and incorporationg use of psyllium/and other dietary fiber, with care, to help keep things running more smoothly to try to prevent exacerbations), but I am not familiar with use of psyllium so much when having diarrrhea alone. Is the psyllium use because you alternate between having both, periods of constipation, that are followed by an exacerbation of diarrhea I wonder?? Do you get terrible bowel cramping /pains? 

8mm stone!!?? A gall stone I assume?? Now, there is a consideration as well! Yesserie, by all means, get yourself some follow-up for that (and for all you are going through)! Yes to a doctor's visit - I assume your doc would want you to have a colonoscopy?, and yes to an U/S (or more) regarding your stone. Geeze, I hope you have been well-followed for this stone thing as well. Do you get any back/rib/side/shoulder pain/gas/indigestion/worse with fatty intake? How are you bloods doing, ALP, ALT's, AST's, bili's??

Sorry for your discomforts, but keep slogging at it, to find out what you may be able to fix, improve. (I'm not much of a xmasy person either, but, was really tickled watching the real wee ones doing santa's knee the other day at the mall - just too cute and funny, poor santa, such a trooper!)  smile C.

 



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 64 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

 

(SEE UPDATES IN BIO)



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Not a fun thing to experience or share, but I was wondering if any others out there have similar experiences?

My bowels have always been on the loose side, but manageable with psyllium to slow things down. It has been just a nuisance going on for decades, but cleared up to almost constipation for a couple of weeks during Harvoni Tx a year ago, but in the last couple of months it has returned to IBS-D again with a vengeance.  So much so that I have to take a swig or 2 of pepto bismol and sometimes immodium if I have a long trip to town.  A couple of embarrassing events has taught me to slow the flow down if I'm going to be in public for a few hrs and I always carry Pepto and/or immodium with me, as I hate public toilets and I don't like to take these meds for more than a day so it keeps me on a short leash if I want to avoid public toilets.

 As I mentioned it has been a little over a year post Tx and still have no viral load, but my liver has degraded to cirrhosis..........could that be the cause?

Trying to schedule a colonoscopy as well as an ultrasound to check on my 8 mm stone.  Yellow, watery, mucousy stools has prompted me to pursue that.

Just wondering if others have experienced same or have any suggestions.............

Thanks in advance and bah humbug to these holidays and the delays in dealing with life.

  



__________________
DXed in year 1999 with geno 1a, went with a wait and see approach while my viral load increased from 240,000 to 3 mil and contacted VA when Harvoni came out and now have harvoni and starting TX on Monday.
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