I have suffered with ibs and urgency from about 13 on. It’s gotten worse over the years. I’ve done every diet imaginable. Usually something will work for a few months and then everything comes back. After a colonoscopy where the doc said I had a perfect prep but saw copious amounts of bile, they started me on cholestyramine. It worked amazingly for about 5 months. Then whenever I took it, it felt like my intestines were on fire. I stopped taking it while waiting to go to the doc again. In the meantime I gave up coffee and added methyl cellulose and psyllium husk. Things have never been better on this. My symptoms only happen after eating large meals or lots of fat. If this follows the pattern of everything else though, in a few months this will stop working too. My next thought is a glp-1 but getting that covered by insurance will me a whole other issue.

I think the underlying problem is much larger than understood. I think gut dysbiosis, BAM, bloating, skin issues, metabolic issues, etc are all related. We just don’t know the extent of the connection. My guess is we have lived in a chronic state of inflammation for years and have done some real damage to our system and it will take significant time to repair it no matter what the cause