I got stomach pain, and still do, if I don't eat with the mestinon. And I don't mean a couple of crackers, I have to EAT something substantial. It's a nuisance, I don't always want to eat when it's time for a pill, but I suffer if I don't. I eat first, then swallow the pill, or swallow then immediately eat a bunch. Worst case is to take the pill, then wait 20 minutes or so, then eat, that seems to be just deadly.

The other thing I discovered is a bit more obscure. I have lactose intolerance. Generally, I can cheat a bit if I eat the dairy-whatever with other food. Wanna take a guess what one of the fillers that they make the mestinon pills with is? Lactose!!! Now, a pill is not all that big, but it's not like eating a pill-sized piece of cheese, it's a little packet of lactose, and on an empty stomach it makes a wicked little bubble of gas in my guts that just hurts! I found that by eating a lact-aid or dairy-ease pill before swallowing the mestinon pill, I didn't get the gut cramps. Found I could get away with as little as 1/4 of the dairy ease tablet brand we get most of the time. You mention she has had IBS at times in the past, if it is at all lactose-related, this might just be a trick that could help. I don't know why they put lactose in their pills, knowing that it can be a problem for people, makes no sense to me. But for me, it then makes sense why I have to either eat a significant amount first, so the lactose in the pill is buffered by the other food, or do the lact-aid pill to handle it.