30 years a pilot with IBS -- using Codeine Phosphate

I first developed symptoms in my mid teens. A definite need to visit the bathroom twice every morning before my 90 minute journey to school was required to avoid any embarassment. At this time I also developed the occasional but severe abdominal pain and urgent need for a bowel movement about 5 minutes after finishing eating. Very difficult if eating out with no toilets in the vicinity. I have miserable memories of a Sunday School village trip to Aberwystwyth in the early 60's when I spent the whole day walking back and fore between the beach and the public toilets half a mile away! These symptoms continued throughout my time at university and actually got worse with long periods of diarrhoea which on one occasion lasted months. Not good for an active social life. I got little help from the university doctor who after negative results from stool tests was adament that it was just a case of exam worry! I don't think that many medical people at this time had heard of IBS. I do remember at the time of self medicating with the bottles of Kaolin and Morph as mentioned by one of the other posters. It did work but I was always questioned at the chemists when buying it. On one occasion I was prescribed some small white tablets for diarrhoea and I remember them well as they had DF 118 stamped on them. They worked well and I tried save them for important occasions.

About this time I joined the University Air Squadron and had a full RAF medical during which I did not make any mention of my symptoms for fear of not passing. The medics were more worried about me having a possible heart murmur but I passed the medical and was allowed to join the Squadron as an engineer and get the occasional flight to keep me interested. My symptoms remained but with careful management of a couple of trips to the bathroom before doing anything that may last more than an hour, coupled with not eating anything much unless being in close proximity to a toilet I managed. In 1971 I joined the RAF full time as a pilot, and managed to get through the 3 years of training to get to the front line as a Lightning pilot. This was not easy as it required a constant regime of working around my symptoms. This usually meant getting up earlier than most others so I could get breakfast early (one has to eat before flying). This allowed plenty of time after eating for bowel movements, before going to work. I did use the kaolin mixture quite a bit but this was unofficial as I'm not sure it was cleared for flying use. I also avoided eating much during my working day. I was fortunate to get through on to fighters, only 2 of my course of 15 avoided the 'chop' on to bombers or transport. I am sure if this had happened to me then my IBS would have posed a real problem but, with fighter flights lasting rarely longer then 90 minutes I was able, as before to manage the situation. A good job really as when out over the North Sea I was sometimes more than 200 miles from the nearest toilet!!!

I also found that the concentration required while flying did usually help put the IBS out of the mind most of the time. In 1974 however, things came to abrupt halt. I had another long bout of diarrhoea and had tried to keep going as best as possible. I had avoided eating much as everything was just going straight through me and this resulted in some not so clever flying, I managed to scrape the tail on my plane while doing a landing at too lower speed. This was not too unusual with the Lightning but my boss was not very happy. While waiting in the Medical centre for a couple of injections prior to our departure for a month in Cyprus I went flat on my back with a faint, much to the hilarity of all the rest of the guys. They all thought it was the sight of the needle but actually it was the culmination of the diarrhoea and my not eating for days. That was it , the cat was out of the bag, I stayed in the Medical centre for a few days and had to explain all to the 'doc'. I was grounded much to my annoyance pending investigation. A month later I spent 2 weeks in St Marks Hospital in London having every test under the sun from both ends of my digestion system. This was the first time that I heard the term IBS. The only bonus was that I managed to get them to let me out for one afternoon and I went to Wimbledon and managed to see Chrissie Evert who was, and still is a bit of a stunner!! I was given a variety of things to try one being Colovac fibre and a variety of tablets. The Colovac did not help at all and the problem with the tablets was finding something the Medics were happy for me to take while flying. The medical profession are very concerned with the secondary effects of drugs hence the warnings on most things these days ie do not drive or operate machinery, avoid alcohol !! Well a Lightning weighs nearly 30 tons and does Mach 2 and fighter pilots drink beer, so I guess they had to be careful. After much haggling they allowed me to take a low dose of Codeine Phosphate which for me made a fantastic difference. I only take a 15mg dose (this is very small), usually once a day, and it really helps to stabilise my bowel movements and it gives me confidence that I will not suddenly by rushing off to look for a toilet. I have continued to take this for 34 years with no side effects that I know of . The codeine is an opium derivative so people tend to be concerned that you can get addicted. I have not noticed this effect.

After leaving the Airforce I continued my flying career in the Middle East and I have a word of caution here. Most countries there have strict drug laws and codeine is a banned drug. I was fortunate that it was relativly easy for me to take in my own supply of codeine phosphate although it was done with my employer's knowledge and I always had letters in Arabic to explain what the drug was for. Things are different now and quite a few people have been arrested going in to Dubai for having readily available tablets such as 'Cocodamol' which contains codeine. Looking back the DF118 tablets I was given back in the 70's I now see are a dihydrocodeine.

I have now retired and I must admit that life is a lot easier now. The ability to have the option of staying home and not having to do anything on a BAD day is by far easier than having to go to work and hoping all will be well. I do feel that without taking the Codeine I would not have been able to have continued in what was an intense, demanding, stressful BUT fantastic job. Throughout my flying career I always felt a degree of envy of my fellow pilots who did not have to contend with similar IBS problems,and I do feel I had to work a lot harder to succeed. I am not sure that the use of Codeine Phosphate would be allowed for Civilian flying in the UK, all my flying was Military and the use of the drug was always approved by them. I now have the tables issued to me on a repeat prescription from my local health centre.

As a note my Father had an heart operation 4 years ago, some of his follow on drugs gave him diarrhea. Coincidentally he was given Codeine Phosphate tablets by his doctor to help his problem.

So if you have any of my symptoms i.e. the need for more than 1 bowel movement in the mornings, sudden gurgling in the abdomen with pain in the small of the back followed by the urgent unavoidable need to a bowel movement which is usually diarrhea, especially after eating a meal. Then maybe, Codeine Phosphate may be a help to you. I hope so!

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