About one in seven adults in Australia and New Zealand suffer from this painful (and often inconvenient) digestive ailment. Even though there's no certified cure, IBS is definitely treatable--often with just diet and exercise.
The intestinal distress associated with irritable bowel syndrome (IBS) is responsible for one in every ten GP visits annually. Only the common cold results in more missed days of work. While no-one is exactly sure what causes this mysterious, misery-making complaint, doctors now admit that it is definitely not'all in your head'.
They also will tell you it's not a life-threatening condition and will confirm that it won't develop into a more serious illness such as inflammatory bowel disease (see on previous) or colon cancer (see on previous).
The alternating bouts of diarrhoea and conspitation associated with IBS typically develop in the late teens or early 20s, primarily in women. Many people are never diagnosed, however, because medical tests routinely show nothing out of the ordinary. For this reason, doctors have established a specific set of criteria to help identify the condition. If you don't have a definite diagnosis of IBS, it's worth looking at the criteria to see if they apply to you. And even if you these key IBS symptoms, the underlying source of the problem remains elusive.
To better comprehend IBS, it helps to understand how it compares to normal digestion. Usually, when partially digested food leaves your stomach, it is moved through your intestines by the gentle, wavelike contraction and relaxation of the intestinal wall muscles--a process known as persistalsis. When you have IBS, the muscles in your colon (which is part of your large intestine) go into spasm, contracting either too quickly and forcefully (causing dirarrhoea) or too slowly and weakly (resulting in constipation).
There's plenty of speculation about why the colon misfires. Some suggest that hormonal problems play a role (women with IBS screen to have more symptoms on premenstrual days) or that a chemical imbalance in the brain may be at fault. Specific foods seem to trigger IBS flare-ups in some people, as does the inability to digest lactose (see Taking Control, below). Overuse of antibiotics could be another cause, as can a bacterial, viral or parasitic infection. Another newly popular hypothesis is that people with IBS have extrasensitive pain sensors in their guts. The overactive nerves could cause the muscle spasms underlying this ailment. Finally, stress appears to be key factor. Even a healthy person experiencing the natural 'fight or flight' response that occurs in a stressful situation will have spasms of the intensines and sometimes an involunatary empyting of the bowels. But for some reason, people susceptible to IBS feel this intestinal response to stress to an excessive degree.
LIKELY FIRST STEPS
While irritable bowel sydrome (IBS) can be very painful and the associated symptoms are often distressing and disruptive, they are not a sign of serious underlying illness. However, some of the symptoms can also occur in more serious conditions. Therefore it is imporant to visit your doctor for a diagnosis. This is particularly necessary if;
LIFESTYLE CHANGES
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Dietary changes Avoid trigger foods, smaller meals more often.
----------------------------------------------------------------------------------------------------------------------------------------------
Exercise To improve digestion and reduce stress.
MEDICATIONS
------------------------------------------------------------------------------------------------------------------------------------------
Antidiarrhoeals To prevent spasming.
------------------------------------------------------------------------------------------------------------------------------------------
Laxatives Don't use longer than two weeks.
-------------------------------------------------------------------------------------------------------------------------------------------
Antispasmodics To relax the muscles and relieve pain.
-------------------------------------------------------------------------------------------------------------------------------------------
Antidepressants Low-dose tricyclics and SSRIs help spasming.
--------------------------------------------------------------------------------------------------------------------------------------------
Tegaserod For constipation symptoms in IBS.
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Stress reduction Try biofeedback or hyponsis to relax colon.
NATURAL METHODS
-----------------------------------------------------------------------------------------------------------------------------------------------
Peppermint oil To relieve pain, bloating and diahorrea.
To be on the safe side, your doctor will probably with tests to rule out more serious intestinal ailments, such as Crohn's disease, ulcerative colitis, diverculitis and colon cancer. Once these are out of the way, your treament plan for IBS will depend on your predominant symptoms--diarrhoea, constipation and/or abdominal pain and bloating. If you have a mild case (which two-thirds of patients, do), your doctor will likely recommended that you start with self-care measures --including diet changes, stress reduction and exercise. Drug therapy is usually reserved for those with severe symptoms that do not respond to lifestyle measures.
Lifestyle changes
What is happening
The intestinal distress associated with irritable bowel syndrome (IBS) is responsible for one in every ten GP visits annually. Only the common cold results in more missed days of work. While no-one is exactly sure what causes this mysterious, misery-making complaint, doctors now admit that it is definitely not'all in your head'.
They also will tell you it's not a life-threatening condition and will confirm that it won't develop into a more serious illness such as inflammatory bowel disease (see on previous) or colon cancer (see on previous).
The alternating bouts of diarrhoea and conspitation associated with IBS typically develop in the late teens or early 20s, primarily in women. Many people are never diagnosed, however, because medical tests routinely show nothing out of the ordinary. For this reason, doctors have established a specific set of criteria to help identify the condition. If you don't have a definite diagnosis of IBS, it's worth looking at the criteria to see if they apply to you. And even if you these key IBS symptoms, the underlying source of the problem remains elusive.
To better comprehend IBS, it helps to understand how it compares to normal digestion. Usually, when partially digested food leaves your stomach, it is moved through your intestines by the gentle, wavelike contraction and relaxation of the intestinal wall muscles--a process known as persistalsis. When you have IBS, the muscles in your colon (which is part of your large intestine) go into spasm, contracting either too quickly and forcefully (causing dirarrhoea) or too slowly and weakly (resulting in constipation).
There's plenty of speculation about why the colon misfires. Some suggest that hormonal problems play a role (women with IBS screen to have more symptoms on premenstrual days) or that a chemical imbalance in the brain may be at fault. Specific foods seem to trigger IBS flare-ups in some people, as does the inability to digest lactose (see Taking Control, below). Overuse of antibiotics could be another cause, as can a bacterial, viral or parasitic infection. Another newly popular hypothesis is that people with IBS have extrasensitive pain sensors in their guts. The overactive nerves could cause the muscle spasms underlying this ailment. Finally, stress appears to be key factor. Even a healthy person experiencing the natural 'fight or flight' response that occurs in a stressful situation will have spasms of the intensines and sometimes an involunatary empyting of the bowels. But for some reason, people susceptible to IBS feel this intestinal response to stress to an excessive degree.
- Identify possible trigger foods and cut back or eliminate them from your diet.
- If you suffer from constipation boost soluble fibre and exercise more.
- Consider medication to treat specific symptoms.
- Practise some relaxation techniques to ease stress.
While irritable bowel sydrome (IBS) can be very painful and the associated symptoms are often distressing and disruptive, they are not a sign of serious underlying illness. However, some of the symptoms can also occur in more serious conditions. Therefore it is imporant to visit your doctor for a diagnosis. This is particularly necessary if;
- you have blood in your bowel motions.
- you are over age 40 and your symptoms have come on recently
- you've lost weight
- you have a family history of bowel cancer.
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Dietary changes Avoid trigger foods, smaller meals more often.
----------------------------------------------------------------------------------------------------------------------------------------------
Exercise To improve digestion and reduce stress.
MEDICATIONS
------------------------------------------------------------------------------------------------------------------------------------------
Antidiarrhoeals To prevent spasming.
------------------------------------------------------------------------------------------------------------------------------------------
Laxatives Don't use longer than two weeks.
-------------------------------------------------------------------------------------------------------------------------------------------
Antispasmodics To relax the muscles and relieve pain.
-------------------------------------------------------------------------------------------------------------------------------------------
Antidepressants Low-dose tricyclics and SSRIs help spasming.
--------------------------------------------------------------------------------------------------------------------------------------------
Tegaserod For constipation symptoms in IBS.
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Stress reduction Try biofeedback or hyponsis to relax colon.
NATURAL METHODS
-----------------------------------------------------------------------------------------------------------------------------------------------
Peppermint oil To relieve pain, bloating and diahorrea.
QUESTIONS TO ASK
- Why aren't you testing me for colon cancer and other bowel diseases?
- Would I be a good candidate for a clinincal trial and if, so, what risks would I face?
- Do you think I'm anxious because of IBS or vice versa?
- Because there's no cure, will I feel this uncomfortable forever? What else can I do?
- Seek counselling. If you're feeling down because IBS has taken such a toll on your life, you may want to consider professional advice from a psychotherapist or behavioural counsellor.
- Try acupunture. This complementary therapy has been credited with offering signifi-credited with offering significant relief from chronic pain of any type, possibly because it encourages the brain to release endorphins and monoamines, chemicals that block pain signals.
- Find out whether you're lactose intolerant. For many people, symptoms of IBS can be indistinguishable from those of lactose intolerance. But don't simply stop eating dairy. Instead, try this quick test. Drink two glasses of nonfat milk on an empty stomach. If you experience symptoms (gas, bloating, diarrhoea) within four hours, repeat the test with lactase-treated milk, such as Zymil. If, after four hours, you are sympton free, you may very well be lactose intolerant.
Lifestyle changes
Many people feel much better simply by changing what they eat. Basically, you need to avoid foods that make your symptoms worse and stick with those that agree with your system. Keeping a food diary at first will help you track the relationship between symptoms and diet. By writing down what you eat, and noting which foods bring on what symptoms, you'll be better able to pinpoint offenders. You may, for instance, have trouble with dairy, wheat or corn products. Or you might find acidic or spicy foods to be the problem. Artificial sweetners, such as sorbitol and mannitol, as well as caffeine, alcohol and even chocolate, can also cause spasms.
Because eating too much at once may trigger intestinal contractions, you'll be advised to eat smaller, more frequent meals. You may also want to experiment with getting more fibre. Try gradually increasing the amount of soluble fibre in your diet over a period of weeks. This can be extremely beneficial in your primary IBS symptom is constipation or abdominal cramping.
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