Dear anonymous03:

Welcome back. I re-read much of our previous communication so to be better prepared to answer your new thread, a new thread on an old topic, and an unfortunate one: your IBS-C, which stands for constipation-predominant irritable bowel syndrome, a subtype of irritable bowel syndrome, a condition characterized by chronic constipation with associated abdominal pain.

The following is information you can find in Wikipedia on the topic of IBS, I will include quotes and paraphrase some of the information: IBS is one of the Functional Gastrointestinal Disorders (FGID), also  known as disorders of gut-brain interaction, or axis. There are two major kinds of FGID: (1) dyspepsia, also known as indigestion, and (2) IBS.

These are idiopathic disorders, that is, they are of unknown cause or mechanism, but what is known is that there are nerve cells (neurons) that are located in the walls of the stomach and the intestines, neurons called nociceptors, that are pain receptors. I will now focus on what happens specifically in the walls of the large intestines: the nociceptors “are highly sensitive to distension (stretch)”. They sense the stretching of the intestinal walls due to feces (solid/ semisolid waste matter) and gas stretching those walls. The nociceptors perceive this stretching as “damaging or potentially damaging stimuli”. Next, they send “‘possible threat’ signals to the spinal cord and the brain”. Next, “if the brain perceives the threat as credible, it creates the sensation of pain to direct attention to the body part, so the threat can hopefully be mitigated”. Sometimes the pain is “accompanied by symptoms such as nausea, vomiting, changes in vital signs as well as emotional manifestations”.

Wikipedia reads in its entry on IBS under Cause: “childhood physical and psychological abuse is often associated with the development of IBS. It is believed that psychological stress may trigger IBS in predisposed individuals”.

Last you shared, April 2020, you were living with your mother who inflicted on you severe stress since the time you were a very young child, all your life, practically. It so happens that there are a lot of parallels between your mother and mine, and it so happens that the two of us significantly suffer from, and have been diagnosed with IBS-C.

This is my understanding of how it happened, these are my words, simplifying the matter much, I am sure. I will be referring to myself but suggesting that some of the same is true to you too:

The intense and repeated distress that I experienced as a child living with my mother overwhelmed my nerve cells (neurons), repeatedly overly exciting, for so long, that they ended up being overly-sensitive/ overly reactive to stimuli. The light from the sun bothered me too much, noise from neighbors troubled me, the feel of sweat on my skin and the feel of tight clothing made me feel very, very uncomfortable, and the sensations in my intestines, from one point on,  also made me feel very, very uncomfortable.

Other people with calmer neurons are way less bothered by external (light, noise, sweat, etc.) and internal (sensations inside internal organs) stimuli. For them, it would take a whole lot of sunlight and noise and intestinal distress to get their attention, but for me, it took way lesser amounts of sunlight and noise and intestinal distress to get my attention and to cause me much distress.

The discomfort and distress that I feel in regard to my large intestines is due to the stretching of the intestinal walls caused by waste material and gas being there. The nociceptors in the walls of my large intestines sense the stretching and proceed to send alarm signals to my brain, the alarm signals are interpreted in my brain as danger, and the result: anxiety and great discomfort, my attention is on my intestines, my muscles almost everywhere contract, including the muscles responsible for my breathing and I take in less oxygen. In other words, my IBS was caused by distress/ anxiety and it continues to generate distress/ anxiety: it’s a loop.

I don’t remember suffering from IBS at an early age. What I read today indicates that a stressor later in life, such as an intestinal infection, can start the IBS. This makes sense to me because I know that anxiety is like wildfire, it starts someplace and then it spreads. So, let’s say my anxiety was not focused on my intestines, but following a painful intestinal infection, my anxiety spread into my intestines, a new location.

Like you, I saw a doctor for my IBS-C, a reputable clinic where I was diagnosed. I was given probiotics as well and it helped a lot, for a while, but not for long. Later on I changed my diet to include less vegetables of the gas causing type, and that helped, but it didn’t cure my IBS. The reason probiotics and other measures partly work for a while is (this is again, my understanding) is that those intestinal neurons are overly sensitive/ overly reactive, so the lesser stimuli to overly-react to, the less the discomfort. It is similar to a person being bothered by sunlight, the person wears sunglasses and feels a great relief. Over time, as his eyes get adjusted to the sunglasses, he then gets distressed again and needs darker sun glasses.

Like you, I feel a relief “when something presses onto my belly”, the relief happens because the pressure applied to the intestines from the outside of the body distracts from the pressure in the insides of the intestines (that stretching from the inside).

“You asked, “What should I do?”. My suggestions at this point:

1) Consider sleeping on your belly or side having a baseball or such item under your belly, to create that external pressure on your intestines while in bed, so to distract you from the internal pressure/ stretching.

2) Repeatedly throughout the day, pause and relax your muscles, including your diaphragm, so to allow natural, easier breathing. Lessen your daily anxiety in other ways, such as having a daily aerobic exercise routine.

3) No longer living with your mother will help long-term, if you leave her and then embark on the long, difficult healing process, healing from what she did to you.

anita

Dear anoymous03:

You are welcome and thank you for your kind words and good wishes!

In the following I will focus on the intestines and not on the stomach because your IBS history includes the intestines and my experience is strictly about the intestines. I have no doubt that there is a physical dysfunction in the operation of my intestines and in yours, after all, constipation is a dysfunction. As we age, our bodied function less and less effectively, and that is one reason why, as far as I know, almost every elderly person is constipated.

IBS-C is about over-sensitivity to the physical sensations that accompany constipation= the bloating, which constitutes the stretching and expansion of the walls of the intestines,  and the felt-movement of the waste material and gas within the walls of the intestines. A doctor in 2019 diagnosed you with “visceral hypersensitivity”- which is an over-sensitivity to sensations of the viscera= internal organs, intestines included.

The pregnant look makes it worse, and so does the feel of tight clothing against the distended belly, but even when not distended (pregnant looking), the physical sensations I mentioned above are still very distressing to a person suffering from IBS-C.

In other words, a person suffering from constipation suffers, a person suffering from constipation and IBS-C suffers a whole lot more.

Here is what I suggest:

1) Improve your nutrition so that your body receives the nutrients it needs, including oil such as in olive oil and avocado, and keep a food diary and avoid foods that disagree with you. Regarding certain healthful foods that disagreed with you in the past (“I have cut out certain foods, but it is affecting my health”), you may want to re-introduce those healthful foods in small amounts because they may  not disagree with you in smaller amounts or when eaten not in combination with certain other foods, or it may be that you incorrectly assumed in the past that this or that healthful food was the cause of your discomfort. Regarding portions: eat adequate portions even though you feel full and bloated- the sensations of fullness in the intestines do not indicate that you ate enough or too much (“I eat smaller portions.. because I get full really fast and my belly already is s heavy”).

2) In your mind, separate these two items: item # 1, constipation, item # 2,  IBS, and focus on treating the constipation. There is a lot of online literature on the topic and when you visit a doctor next, you may want to bring up constipation as a separate issue that needs to be seriously addressed.

IBS-C in essence is an anxiety disorder that is attached to the constipation experience: the sensations in the intestines are sent to the brain and the brain interprets those sensations as DANGER. The result: anxiety every time we feel bloated, or every time we are think of becoming bloated again.

You wrote that the discomfort is there all the time, that you “haven’t had a relief in a year and half”- I am sure it feels like it, but I doubt that you didn’t have a moment or an hour here or there where you felt relief. I will share with you my personal experience of relief with some caution: red wine never failed to give me relief from IBS.

I read about your suffering, which I am familiar with personally. Here is my suggestion regarding how to deal with item #2 (in addition to doing all you can to resolve item # 1): accept IBS as it is now in your life: don’t wish it to be gone, don’t wait for it to be gone. Don’t put living on hold until that time you hope to not suffer IBS anymore.

“About your advice as to relaxing myself, I can’t seem to. I really don’t know how except for exercising”- focus then on other things- on your work, on whatever it is that will get your interest and curiosity going. IBS is about your focus being on your intestines. Once your focus is elsewhere– you will feel a relief from IBS.

Regarding your mother, you wrote: “I  may just be as guilty of psychologically abusing her”- no, you are not. You are not guilty of abusing her. In the context of you and your mother, she has been 100% your victimizer, and you have been 100% her victim.

I don’t know anything about your father, but any man would want to get away from a woman like your mother ASAP. He got away from her because he was able to, being an adult, and left you with her, knowing that you were not able to get away from her.

anita

Dear anonymous03:

You are welcome. I read your correction: your father passed away of a sudden heart attack when you were 14. I am sorry to read this.

Regarding your mother, I imagine that you are not interested in the following input (not anything I didn’t mention before), but I will give it to you anyway because it is very relevant to your state of anxiety which predates and accompanies your IBS. You are welcome to not respond to it, and if you don’t- I will abandon the topic of your mother and your relationship with her altogether (and will be fine with it):

If what you shared about her is factually true (“I always got the full force of her anger. I was terrified of her.. she screams a lot…I’d score a 95/100. but she’d say ‘I thought you’d get a 97’… She comments on my body, how I am too skinny… brings me down… I have different hobbies than she does. When I pursue one of them, it literally was hell… She’d also give me the cold shoulder treatment.. look at me with absolute hatred, if she would talk to me, it would be to yell at me. I didn’t even understand what I had done wrong… she treats me like her emotional punchbag” and much more, April 2020),

then for as long as your empathy is with her and not with you; for as long as you minimize her abuse of you and make believe that her abuse of you was her best efforts (“I know I make my mom sound like some monster. She’s not… Life’s been rough for her.. she tries her best”, Jan 19, 2021),

then you will continue to feel that you are the one who is bad and guilty of anything and everything (“I am always nervous and on edge and full of guilt… I’m such a horrible person… I felt extremely guilty… I think I am a horrible person… I must be a terrible person…. I feel guilty about almost everything… I multiple times have felt everything is my fault… I believe everything that goes wrong is my fault… I shouldn’t have done that… I never meant to… I had no right to”. and  much more).

* You wrote in April last year: “I wasn’t really an easy kid to her… I always got yelled at”-

– it’s the other way around: you got yelled at not because you were not really an easy kid to her, but because she was not really an easy mother to you, to put it very mildly.

anita

Dear anonymous03:

First thing this morning I read your reply on the other thread and was very impressed by how well you expressed your intelligence, insight, honesty and compassion, and that’s before you mentioned me in the last paragraph, thank you for the support. I appreciate you.

Regarding your post here: again I am amazed by how much we have in common, in terms of (1) our mothers, (2) our anxiety and guilty core belief, (3) IBS-C, (4) body dysmorphia, possibly.

When you described these behaviors on the part of your mother, you also described my mother’s behaviors to a T: “I did get scolded a lot, sometimes for doing things that weren’t even wrong… She seemed to be mad at me for something or the other… After getting mad at me, she would give me the cold treatment, not talking to me for days on end and acting like I don’t exist or as if I have done her a terrible wrong… I was her emotional punchbag: She would return from work after having a bad day and immediately start scolding me… after she vented, she would calm down.. feels better. She has read my diaries and breached my privacy and trust in other ways too… Her behaviour towards my cousins and others was always pretty pleasant”.

And as a result, I too was “terrified of my mother and was afraid of her scolds. As a child, I obviously thought I was a naughty/ bad kid and caused her anxiety and trouble… So I would always wonder what I did wrong for her to hate me so”.

Following are my 1-6 comments regarding the mother part of your recent post. Please take your time reading what follows, allowing different parts to settle in a bit before moving on. Following these comments, if you don’t bring up the topic of your mother-yourself, neither will I:

1. “In the lockdown, both of us have been at home all day everyday, and I can’t help but lash out”- I was too afraid to lash out at my mother, but I did twice: once when at 20 or 21, she ran toward me with her arms extended toward me, so to hit me- I caught her hands in mine and forcefully pushed her arms down. The result: she never tried to hit me again. Another time, I grabbed a kitchen knife (yes, I did) and pointed it at her from a distance. The result: I heard that she told someone that she is afraid of me.

My points in telling these stories are that a. It is almost impossible for a victim to be.. a perfect victim, to never lash out; it is almost not-human to accept abuse without resistance at all times, for years.

b.  The mother is abusive to her child because she views the child as weak and dependent, and there is no one the child can turn to for help (there was no father/ no other adult but my mother when I was a child). She doesn’t abuse the cousins because they might tell their parents who are adults, adults who are not weak and dependent on her. Once the child is old enough and she/ he asserts herself convincingly and consistently, the mother will back down because her child.. is no longer weak and dependent.

The rules of parental abuse are the same rules that are practiced by predators in nature: they attack the Weak, not the Strong. When a mountain lion, for example, does not attack a Strong buck (male deer),  it is not because the mountain lion has changed, or has compassion for the buck: it’s because the mountain lion is afraid to be hurt by the buck.

2. “I told her my heart starts beating really fast when she yells and that I get anxious… she herself must have gone through some real crap in her childhood for her to be so anxious all the time”- she did go through some real crap in her childhood, no doubt, and her heart beat very fast too. Therefore, she knew all along that your heart beat really fast and that you felt very badly when she yelled at you.

3. “I set some boundaries and told her I will not respond to her if she yells..  she.. has been trying to change her behaviours”- she will stop yelling at you for good only if and when she fully understands that she can lose you, or that her life will be very uncomfortable if she yells at you again. “I’m all she has”, you wrote, and she knows it. Please be consistent and show her that you are undeniably Strong. If she yells at you- make her life very uncomfortable, every time she yells or gives you crap otherwise.

4. “she has had a massive impact on my mental health.. I probably would not have been such an anxious person.. had she not been the way that she is. I realize that I was never a bad or even difficult child (I have relatives who told me I was too stubborn)”- notice this: as an adult, you rationally understand that you were not a bad or difficult child, but as a child- you believed that you were a bad and difficult child. A childhood strong belief, aka core belief, does not disappear when an adult forms a rational understanding. The parenthesis you used in the quote above is evident of this:  you stated that you realize that you were never a bad or difficult child, but a thought arose from that core belief, saying: yes, you were a difficult child, relatives said so!- you placed that thought in parenthesis.

To change this core belief that you were and are a bad, difficult person who is at fault for anything and everything, it takes emotional healing that surpasses rational understanding. Such emotional healing takes persistent intent, work, perseverance and courage over a long period of time.

5. “While I understand how she has affected me, being mad at her doesn’t help me or us at all. I’m all she has, and vice versa too”- if she does not completely stop yelling at you, you will have to at least convince her that if she yells again, she will lose you. If you don’t feel anger at her, then sound and look angry, so that she will be afraid to lose you and, and/ or to make her life very uncomfortable as a consequence of her yelling.

She has been venting and yelling all along because it made her feel better (“after she had vented, she would calm down and there would be a massive change in her behaviour, and I realized that after she vents out she feels better”). Feeling better is her emotional payoff which keeps fueling her abusive behavior. The only way to stop her from abusing you is to replace her emotional payoff with a different consequence: make her life very uncomfortable each and every time she abuses you.

6. “I kind of not like it if someone spoke ill of her. I am protective that way”- yes, a lot of society (=parents) conveniently encourages this strong message: you have to obey and worship your parents forever more, no matter what they say and do! This message is not about love, it is about maintaining power: the abusing parents maintain their power at the expense of the abused children.

Regarding the second topic of your recent post, IBS: the treatment for the physical aspect of IBS is the treatment of various real ailments and dysfunctions of the digestive tract, most common: bacterial overgrowth, and a motility disorders.

Wikipedia has an entry on a motility disorder called Intestinal pseudo- obstruction, which is “caused by severe impairment in the ability of the intestines to push food through.. In primary chronic intestinal pseudo-obstruction (the majority of chronic cases), the condition may be caused by an injury to the smooth muscles (myopathic) or the nervous system (neuropathic) of the gastrointestinal tract… Clinical features of intestinal pseudo-obstruction can include abdominal pain, nausea, severe distension, vomiting.. constipation, depending upon the part of the gastrointestinal tract involved…

“There is no cure for primary chronic intestinal pseudo-obstruction. It is important that nutrition and hydration is maintained… Nutritional deficiencies are treated by encouraging patients to avoid food high in fat and fibre, which are harder to digest and increase abdominal distention and discomfort, and have small, frequent meals (5-6 per day)”-

– in my case, I suffer from primary, chronic intestinal pseudo-obstruction, which means that on X-rays, you will not see a growth or an object that is obstructing the movement of waste material in the large intestines, but the symptoms are the same: waste material gets stuck there, gas builds up and the belly gets bigger and bigger, resulting in that pregnant look (which has nothing to do with body weight. I used to be underweight and still look very pregnant). The reason for this obstruction is that at some point, repetitive, ongoing and irreversible damage was done to the  smooth muscles that make up the walls of my large intestines, and/ or to the nerve cells in the walls of my large intestines. This damage could have been a result of my years-long habit of over-eating and years long use of laxatives.

I personally experienced significant improvement in the distension aspect after no longer eating raw or undercooked cruciferous vegetables (cauliflower, cabbage, broccoli, etc.), and after no longer consuming wheat bran or psyllium husks (used to treat constipation). Also, eating a smaller portion at any one time is helpful.

This is a disorder and a condition that I have to live with best possible. As to the anxiety loop which is what IBS is about, as I see it: when I feel the sensations involved in the stretching/ expanding of the intestinal walls, I say to myself: this is not danger, this did not kill me before, and it will not kill me now, and I try to relax my muscles best I can.

In regard to red wine/ alcohol: I hate the taste of all kinds of alcohol, some more than others. The way I came to drinking red wine was in an afternoon party a few years ago where red wine was served with slices of orange. There I discovered this particular combination. I further experimented and discovered that the combination of red wine+ squeezed and added orange slices (or added orange juice) + stevia (a natural sweetener) tastes very good, to me. The diluting aspect of the orange juice makes a unit of alcohol volume less potent. I further discovered that for as long as I don’t drink too much (and feel  badly as a result), the drinking of this combination makes me not notice at all any and all intestinal discomfort during and for hours following the drinking. It is as if.. the problem does not exist, and I cherish this temporary relief.

As far as alcohol being frowned upon in your culture and in your home, by your mother: if you decide to “sneak it in and give it a go”, and your mother complains, telling you that she frowns upon alcohol, tell her that you frown upon yelling. (Maybe a deal can be made with her: no yelling= no alcohol in the home).

Regarding you being conscious of your belly, and having noticed that other girls’/ women’s are flat and yours never has been- same here, I am at awe at the idea of having a truly flat belly. I wonder: in the past, before experiencing these intestinal problems, did you overeat and/ or use laxatives?

anita