Got IBS? Check your meds.

photo (6)Statistics show that people with Irritable Bowel Syndrome are more likely to have a psychiatric diagnosis than the general population.   And of course that means pills.

The symptoms of IBS include abdominal pain and discomfort, bloating, and diarrhea (there is a form that includes constipation, but that’s not so relevant here).  The diarrhea can be so severe that a person could become housebound, or even incontinent.

Research also shows that people with IBS tend to be lactose intolerant-up to 80 to 90 percent, depending on the study you look at.

Enter the pills.  For some twisted reason, anhydrous LACTOSE is used as a filler in many pills.  I’ve even seen it on the labels of anti-diarrhea tablets!  Have you ever heard of anything more asinine?

So if you’re having tummy troubles, or know someone who is, check the “inactive ingredients” section on the patient handout that comes with your pills, or look your pill up on the internet, or ask your pharmacist.  Remember that each generic has a slightly different formulation, so you have to get the info on exactly the pill you’re taking.

What to do if you’re lactose intolerant and (previously) unknowingly ingesting lactose via your meds?

Take lactase enzyme with each dose.  How much lactase depends on how lactose sensitive you are.  I’m horribly lactose intolerant, and I take one super-strength Lactaid tablet for my morning pills and one for the evening pills, and that seems to do the trick, for me.

You can also request lactose-free pills, but they’re scarce as hen’s teeth, as lactose is very cheap and compresses very easily, making it a perfect pill filler.

I really think lactose should be banned as a component of pharmaceuticals, because in my opinion it’s a hidden cause of an illness that has become epidemic, as more and more people are taking multiple medicines.  Lactose is used in many kinds of pills, from blood pressure meds to antibiotics and, of course, neuropsychiatric meds.

© Laura P. Schulman, M.D., M.A. and A Canvas Of The Minds 2012. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Laura P. Schulman, M.D., M.A. and A Canvas Of The Minds with appropriate and specific direction to the original content.


4 thoughts on “Got IBS? Check your meds.

  1. Also, many people are just lactose-intolerant in general. And such medications probably aren’t vegan friendly, ha. I have a somewhat tangentially related question. How would someone know they have IBS versus just having some general difficulty? I’m just not sure when I should start to feel like there’s a problem that should get checked out.

    • Sorry for the delay in answering your question! Life got very hectic for a while.

      If you are having tummy troubles and wonder if it’s IBS, first take note of the diagnostic criteria for IBS:

      Abdominal pain or discomfort that is relieved after having a bowel movement;

      Abdominal bloating that can be visible at times;
      Change in consistency and/or frequency of stools;
      Not otherwise explained.
      In other words, it is a nonspecific, “garbage can” diagnosis for abdominal symptoms that haven’t been properly diagnosed yet. I don’t believe in it.

      You can check if you’re lactose intolerant by scrupulously reading labels and avoiding ingestion of lactose for two weeks. If your symptoms go away, voila, you have a diagnosis.
      If your pills contain lactose, then during this trial period you must take Lactaid tablets at the same time you take each dose of medicine. Two Lactaid Fast Act tablets should be enough, with each dose of meds even if you take multiple pills, like I do. Let me know how it goes!

  2. Laura, this is a great post. I’m so lucky not to have problems with lactose (I drink milk by the half-gallon), but I know that many people do.

    My problem actually is more with capsules (as opposed to tablets) that contain gelatin. I don’t have a digestive issue, mine is moral. I am a vegetarian, and I try very hard to eliminate any potential contamination from the things I ingest. But as you mentioned, different generics (and brands) have different ingredients, and I have found an enormous difference in medication that is supposed to be “identical.” So for a mood stabilizer I take Carbatrol, do not substitute. It does good things for me when nothing else has, so I just have to make my peace by asking the forgiveness of the animals slaughtered in its making.

    (I know, I’m rambling off topic.)

    • Re: different generics/brands with different ingredients…

      US FDA regulations allow generics to have between 80% – 120% of the active ingredient of the original. I can’t believe that level of variability is permitted, quite frankly. It seems utterly irresponsible.

      Imagine you’re taking a prescription for 100mg of lamotrigine, and your generic actually has 80mg, but then your pharmacy gives you a different brand and you’re suddenly getting 120mg – that’s a 50% increase in dosage at the “same” dose! And you have no way of knowing which pill has a higher or lower concentration of the active ingredients. How is that permissible?!?

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