Real Talk About IBS-D: Irritable Bowel Syndrome with Diarrhea

This is a sponsored post. Salix Pharmaceuticals compensated me for this post. All opinions are my own. Certain product information has been included to meet regulations.

April is Irritable Bowel Syndrome (IBS) Awareness Month, and while it’s not as pretty as other months – say “National Chocolate Month” – it’s just as important. See, most folks don’t know how to talk about their bowels. But, if you’ve been following me for any length of time, you know that I’m more than comfortable talking about that. I’d like to share my story this April about irritable bowel syndrome with diarrhea (IBS-D). 

My Journey to Diagnosis

My first bout of really bad IBS-D happened in Portland at a blogger retreat. We were in a rented house with limited bathrooms, and of course the worst happened. We were in Portland for only five days, and the first night, I started to have abdominal pain and then felt unwell. It seems like all of a sudden, I knew I had to run to the bathroom. I was trapped in the bathroom (one of the two bathrooms for 10 people), and I couldn’t leave. I was doubled over in pain. It was cramping like a period cramp, but somehow I could tell it was coming from somewhere else. Were these intestinal spasms? I was having really bad cramping, and sometimes I had diarrhea. After 20 minutes and my legs starting to go numb, I thought I could return to life outside the small bathroom. I was wrong. I ran back and forth to the bathroom that first day. I just sat and cried and cried.

What was I going to do? I had five days of jam-packed appointments. I went back and forth about going to the hospital, but I was unfamiliar with the area. I spent the next bout on the toilet looking for urgent care centers. Ultimately, I didn’t go, and by the morning, things were better. However, I knew that I had a long car ride to one of our first appointments. I considered stopping at a drug store and buying adult diapers. While purchasing adult diapers is not something I would normally ever think to pick up at a store, desperate times called for desperate measures. I was afraid to eat at most meals, and always had to know where the bathrooms were along the way to each restaurant. It was scary, and it caused me to distrust my own body. Thankfully, I made it on the (thankfully short) plane ride home without accidents.

As soon as I got home, I booked an appointment with a gastroenterologist (GI). Sadly, this isn’t what most people do. In a survey from the American Gastroenterological Association (AGA), over 60% of  patients wait more than a year after symptoms to talk to their doctor. 

My new GI had no idea what was going on, but she suspected a Crohn’s disease or ulcerative colitis flare up. However, I didn’t have the classic family history or blood in my stool. I spent weeks under the assumption that I had developed another serious autoimmune disease and couldn’t wait for the colonoscopy to confirm. However, the colonoscopy (and following genetic testing) showed nothing – a perfect scope. Don’t get me wrong, I was so thankful that it wasn’t one of the diseases that can cause irreversible damage to my insides. But I also didn’t understand what was wrong with me. The only other answer was IBS-D. That diagnosis wasn’t surprising. IBS-D is sometimes diagnosed after doctors exclude other diseases.

Struggles with IBS-D

IBS-D can be difficult to live with. Nerves in the bowel may be more sensitive, so it’s not only embarrassing, but also painful. I was always afraid of situations where I wouldn’t be near a bathroom. Or where I was around people that would notice if I went to the bathroom two or three times in the span of an hour. I would evaluate restaurants based on their bathrooms. One stall? Forget about it! Two stalls, okay, let’s go. No bathroom for customers? It’s not even on my list. Life shouldn’t be about where you can find the nearest restroom, or where you can sit down if you’re having intense intestinal cramping. 

But why? Why IBS-D? Why now? I asked that question a lot, on the toilet. “Why is this happening to me? What have I done to my body to make it treat me like this?” The exact cause of IBS-D is unknown, but it is believed that an imbalance of gut bacteria may be one of the potential causes of IBS-D symptoms. Stress and immunity can also contribute to this – it’s not known how exactly – through possible increased mucosal permeability or psychosocial factors. Check mark! I knew I had a lot to figure out with this diagnosis, and thankfully there are a lot of resources available for IBS-D. 

Facing IBS-D Head On

Eventually, I was put on XIFAXAN® (rifaximin), and went on a low-FODMAP diet and focused on the probiotics I was taking to help repopulate my gut with friendly bacteria. It was a rough go, but I had big relief from that protocol. While I know that this protocol may not last forever, and that IBS-D might return, I do know that I can repeat XIFAXAN up to two times, if necessary. I also know what changes I’ve made in my life to help manage stress, which can contribute to IBS-D symptoms.

INDICATIONS

• XIFAXAN® (rifaximin) 550 mg tablets are indicated for the treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults.

IMPORTANT SAFETY INFORMATION 

• XIFAXAN is not for everyone. Do not take XIFAXAN if you have a known hypersensitivity to rifaximin, any of the rifamycin antimicrobial agents, or any of the components in XIFAXAN.

(See additional Important Safety Information below and click here for full Prescribing Information for XIFAXAN®.)

Thankfully, I’ve met with the Salix Pharmaceuticals team at Digestive Disease Week in the past, when I was an editor for a magazine, and got to know the medication even better. Unlike other vendors, I approached my visit with the team more from a personal level. I wanted to thank the team for providing a drug to help with IBS-D, as an actual patient. Also, I really wanted a photo with Gut Guy!

Learn More About IBS-D and XIFAXAN

If you’d like to know more about XIFAXAN, here are more details about XIFAXAN for the treatment of IBS-D. 

• XIFAXAN is a prescription antibiotic that works mainly in the digestive tract
• XIFAXAN is the only FDA-approved 2-week treatment for IBS-D in adults
• XIFAXAN is taken every day for 2 weeks and can provide up to 6 months of relief from IBS-D symptoms. In a clinical trial, relief from IBS-D symptoms ranged from 6 to 24 weeks, with an average of 10 weeks.
• You can be retreated with XIFAXAN up to two times if symptoms come back
• XIFAXAN is a short-term treatment, not something you take indefinitely
• XIFAXAN is the only FDA-approved treatment that alters the bacteria in your gut in IBS-D
• Visit www.xifaxan.com for more information and learn how you can talk to your prescriber about your IBS-D

IMPORTANT SAFETY INFORMATION

• If you take antibiotics, like XIFAXAN, there is a chance you could experience diarrhea caused by an overgrowth of bacteria (C. difficile). This can cause symptoms ranging in severity from mild diarrhea to life-threatening colitis. Contact your healthcare provider if your diarrhea does not improve or worsens.
• Talk to your healthcare provider before taking XIFAXAN if you have severe hepatic (liver) impairment, as this may cause increased effects of the medicine.”

If you want to learn even more about IBS, check out IFFGD – the International Foundation for Gastrointestinal Disorders, a non-profit for education and research. They’re a great team, filled with the latest research. 

Please, take a look at your digestive tract symptoms. Don’t let IBS-D take your life, your happiness, and your freedom away from you. If you are dealing with IBS-D, please talk with your gastroenterologist and don’t be afraid to share your story! While you may not love chatting about digestive issues like I do, you can at least be open and honest with your doctor.

INDICATION

XIFAXAN® (rifaximin) 550 mg tablets are indicated for the treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults.

IMPORTANT SAFETY INFORMATION

• XIFAXAN is not for everyone. Do not take XIFAXAN if you have a known hypersensitivity to rifaximin, any of the rifamycin antimicrobial agents, or any of the components in XIFAXAN.
• If you take antibiotics, like XIFAXAN, there is a chance you could experience diarrhea caused by an overgrowth of bacteria (C. difficile). This can cause symptoms ranging in severity from mild diarrhea to life-threatening colitis. Contact your healthcare provider if your diarrhea does not improve or worsens.
• Talk to your healthcare provider before taking XIFAXAN if you have severe hepatic (liver) impairment, as this may cause increased effects of the medicine.
• Tell your healthcare provider if you are taking drugs called P-glycoprotein and/or OATPs inhibitors (such as cyclosporine) because using these drugs with XIFAXAN may lead to an increase in the amount of XIFAXAN absorbed by your body.
• In clinical studies, the most common side effects of XIFAXAN in IBS-D were nausea (feeling sick to your stomach) and an increase in liver enzymes.
• XIFAXAN may affect warfarin activity when taken together. Tell your healthcare provider if you are taking warfarin because the dose of warfarin may need to be adjusted to maintain proper blood-thinning effect.
• If you are pregnant, planning to become pregnant, or nursing, talk to your healthcare provider before taking XIFAXAN because XIFAXAN may cause harm to an unborn baby or nursing infant.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch/ or call 1-800-FDA-1088.

For product information, adverse event reports, and product complaint reports, please contact:

Salix Product Information Call Center

Phone: 1-800-321-4576

Fax: 1-510-595-8183

Email: salixmc@dlss.com

Please click here for full Prescribing Information.