Antibiotics are not for IPS. Besides antispasmodics, low dose tricyclic antidepressants are used, such as Elavil.

Jan

There is at least one study that shows that antibiotics do work for IPS. They had a very small sample size and I don't think there's been any other tests done but the one I found. Dr. Shen was one of the authors.

I was diagnosed having it once but think I had pouchitis all along. IPS is so hard to diagnosis. I had IBS along with my IBD and maybe I have IPS along with my pouchitis, I don't know.

I think if you are having just one run to the restroom after something upsets you and that it probably is stress or something like IPS. If you keep on needing to go, like I did, it's probably pouchitis or it's cousin inflammation. I say it's cousin inflammation as my j-pouch can get inflamed with a mild case of pouchitis going on inside.

Wondering if Elavil would help me....I might try to contact my PCP to see if I can get a prescription before losing my policy...thanks, Jan. If it works, I'm sure that it will be less money than Librax.

I just called one health care provider who gave me a figure of almost $700 for canasa suppositories for a three month supply...along with the Librax which is supposed to be almost $300 for a three month supply, I should be in the poor house by the end of the year. So discouraging....would rather take a vacation!

TE Marie, my running at times is definitely stress related. Since my husband is so ill, and is getting worse, my stomach has been a mess. Must have gotten out of bed at least 5 times during the night and who knows how many times all morning. I had such cramps by the end of the morning, I wanted to just scream. I'm "assuming" that's what IPS is....stress-related.

Yes, Elavil is cheap, as there's a generic available. Plus, it would be low dose. Lower than what is recomended for depression.

The thinking is that it alters your perception of gut activity, so that you are less aware of every twitch and grumble.

Jan

Mema1, I've given in on the antibiotics. I was afraid to use them so often that I'd become antibiotic dependent. I'm 58 years old and had a dim light bulb moment that I discussed with my GI at Mayo. He said that the antibiotic doses that we take for pouchitis and/or IPS are lower than what are prescribed for other uses. He has never seen a j-poucher need an antibiotic for some other reason have a problem because they had been taking antibiotics for chronic pouchitis.

The way I see it if antibiotics are going to do the trick for me and I don't need to go on a biologic, which is REALLY expensive and has side effect that scare me worse then what is my problem. I am not going to live another 50 years. I'm on the other side of the hill definitely sliding down....with 3 fantastic grandchildren. I'm doing much better with my inflammation/pouchitis/cuffitis and all with rotating antibiotics, probiotics twice a day, and canasa or anucort. I've found that since taking the antibiotics I can skip a few days with the suppository treatment.

That's what works for me. I don't know if it will help you or not. I said all of that to tell you that antibiotics are cheaper than Canasa and whatever with me. Maybe you should try a 2 week round and see how you feel. I can't take CIPRO as I got C-diff from it when I had my colon I'm alternating low doses of augmentin and flagyl. 2 weeks on one, one week off and 2 week on the other and all over again after a week. Others on here use Cipro and another antibiotic that starts with an X .

I hope this makes sense, ask me if it doesn't

Thanks, Jan, I'm going to try the Elavil. Right now I have stocked so much Librax that I have enough that will probably last me at least 6 months so I'll try it before my last bottle.

TE, I'm still a bit afraid of the antibiotics, and I continually get yeast infections if I stay on them too long. Forget flagyl, I just can't take it. I do have a script for anucort that's just coming in so I'll try that. I've been using the canasa for a month, and personally, I don't think that it's working.

I guess I had a bit of leakage during the night but slept through it because I'm so exhausted from lack of sleep. Anyway, the butt burn this morning is unreal, and the bleeding from the irritation was about the worse that I've had so far.

Think I'm getting to the end of my rope and perhaps the anti depressant is what I should be taking anyway....just overwhelmed by everything and ready to give up.

It is all what you are comfortable with I can't do Cipro and you can't do Flagyl. Many can't tolerate it. I use to get yeast infections too but don't now, maybe it's because I use so many probiotics and eat so much Greek yogurt. I never thought about that. I use to get them all the time when I had my colon and was on antibiotics.

Jan, any idea what the dose would be for the Elavil. I don't know for sure if my surgeon would know and would like to try to get a script soon.

TE Marie, did you ever find the PM I sent to you a few weeks back?

I use probiotics as well but can't eat yogurt. Wish I could because I love it, but boy does it ever give me the runs. As far as the yeast infections go, they started all of a sudden whenever I take an antibiotic and is a nuisance since I go around not knowing what end to scratch first.

Usually it is 25 or 50mg per day. I would suggest starting at 25 and moving on to 50 if you do not see positive results within a week.

Jan

Thanks so much Jan...

Jan, do you know what the difference between Elavil and Amitriptyline is, or are they one and the same? One of the posts that I saw said that Amitriptyline is the generic of Elavil, but can't find any other information on it.

Whoops, just googled it, and it said that Elavil was no longer available in the US, so it must be similar to Librax and most likely as expensive.

Amitriptyline is the generic of Elavil. Widely available in the US and should be cheap.

Not sure where you read it is not available. You don't need the brand name. What is expensive is when the brand name is the only version available.
http://www.goodrx.com/amitript...ity=30.0&qty-custom=


Jan

I think Jan's right because I just read someone's medical records who has an active prescription for amitriptyline. It's very commonly prescribed.

Thanks, so much.....I Googled it and that's what it said, "not available in the US"....dunno, but appreciate the information.

http://www.rxlist.com/elavil-drug.htm

Yes, the "brand" Elavil is not available in the US (brand name manufacturers frequently stop making the brand once several generics are available). However, cheap generics are definitely available.

The problem with Librax, I think, is that it is an old drug (actually a combo of a benzodiazepine and antispasmodic), and has largely been replaced by newer drugs. Generics no longer available, and I would not be surprised if they stopped making it completely at some point. So, now is a good time to find good alternatives. Amitriptyline and an antispasmodic may work for you.

My husband used to take Midrin for migraines, then they just stopped making it. Not enough people taking it to make it worth their while. He had to figure out something else.

Jan

That's why I'm so thankful that you had suggested Elavil. If they do stop making the generic Librax, at least I'll have an alternative to try. So thanks again.

Now I just have to figure out what to do about this narrowing and the cramps that I continually get because of it. I had beef for dinner last night and am still feeling like I have a slight blockage, which I know that I don't have. It just doesn't give up.

While it's fine to try amitryptyline, and it might work well for you, it's really nothing like Librax at all. Librax is chiefly used as an antispasmodic. If you like the effect of Librax and want to consider alternatives that might work similarly, some options to consider would be bentyl, donnatal, and levsin.

My new Neurologist, at Mayo, changed my medication over to amitriptyline for chronic migraine treatment. It is a serotonin and norepinephrine acting agent see the following:

http://www.drugs.com/drug-clas...antidepressants.html

Notice one of the problems it helps is IBS, which I think of as the same as IPS. It is an older medication and therefore generic and less expensive. We are all different Mema1. I have chronic migraines, fibromyalgia and j-pouch that shows traits of IPS and definitely has pouchitis problems. I don't think you have all of these complicating factors. But you might benefit from a smaller dose and as pointed out it is a cheap drug. I hope you find something that helps you feel better.

That is correct Scott. It is a combination drug, and that is why I suggested using an antispasmodic with the amitriptyline. Unfortunately, the antispasmodic in Librax, clidinium bromide, is not available separately. It has been replaced with other antispasmodics.

The benzodiazepine component is available though- chlordiazepoxide, even in combination with amytriptyline. It is OLD. Older than Valium. http://www.goodrx.com/amitript...ity=30.0&qty-custom=

Super old drugs that are not used much anymore become orphan drugs.

Jan

I've tried the Bentyl and the Lesin, Scott, and they didn't do a thing for me. Haven't tried the Donnatol, but would think that since it's the weakest of the drugs, doubt if it would do anything for me.

As I said before, I'm not even sure that it's IPS that I'm treating. I just know that whenever I have any kind of stress whether it be good or bad stress my stomach starts to groan and growl so everyone in the room can hear and the gas pains start...if that's IPS, then that's what I've got. The Librax so far is the only thing that takes care of it and even then there are times when the pains come and go.

Donnatal is milder than Bentyl and Levsin but it's designed to treat the exact symptoms you are complaining of. I used it to treat spasmodic bowel/pouch and found it to be effective. My issues were triggered by eating, the act of which would trigger excessive peristalsis. Your issues seem more related to anxiety and stress and therefore an anti-depressant might work better, but Donnatal is worth a shot. Good luck.

Thanks everyone for being so helpful with your advice. So much appreciated!!

Now I just have to figure out what to do about the narrowing and the cramps that I'm getting from it.