April is the Month for Irritable Bowels

What do talk show and America’s Next Top Model host Tyra Banks and Real Housewife of Beverly Hills Camille Grammar have in common?  They have both spoken about their battles with Irritable Bowel Syndrome.  And they are not alone – in 2007, actress Cybill Shepherd was a spokeswoman for Zelnorm (a drug for IBS no longer on the market) which she used to treat her IBS. Wonder Woman Lynda Carter also became an advocate for IBS research after her mother was diagnosed with IBS after suffering for 30 years.  The severe abdominal pain suffered by Nirvana frontman Kurt Cobain was caused by IBS and may have even lead to his use of heroin to relieve that pain.

IBS is very common, affecting an estimated 9% to 23% of the world’s population.  In 1997, the International Foundation for Functional Gastrointestinal Disorders (IFFGD) designated April as IBS Awareness Month. Their mission is to focus attention on important health messages about IBS diagnosis, treatment, and quality of life issues.

What is irritable bowel syndrome (IBS)?

Irritable bowel syndrome (IBS) is a group of symptoms, the most common symptoms of which are abdominal pain or discomfort (often reported as cramping), bloating, gas, diarrhea, and/or constipation. IBS affects the colon, or large bowel, which is the part of the digestive tract that stores stool. IBS a functional disorder, meaning that the bowel doesn’t work, or function, correctly.

What causes IBS?

Doctors are not sure what causes IBS. The nerves and muscles in the bowel appear to be extra sensitive in people with IBS. Muscles may contract too much when you eat. These contractions can cause cramping and diarrhea during or shortly after a meal. Or the nerves may react when the bowel stretches, causing cramping or pain. BS can be painful. But it does not damage the colon or other parts of the digestive system. IBS does not lead to other health problems.

What are the symptoms of IBS?

The main symptoms of IBS are:

  • abdominal pain or discomfort in the abdomen, often relieved by or associated with a bowel movement
  • chronic diarrhea, constipation, or a combination of both

Other symptoms include:

  • whitish mucus in the stool
  • a swollen or bloated abdomen
  • the feeling that you have not finished a bowel movement

Women with IBS often have more symptoms during their menstrual periods.

How is IBS diagnosed?

The doctor may suspect that you have IBS because of your symptoms. Specific symptoms, called the Rome criteria, can be used to more accurately make this diagnosis. Medical tests may also be done to make sure you don’t have any other health problems that cause the same symptoms.

In addition to a physical exam and blood tests, the following tests might be done to diagnose IBS:

Lower gastrointestinal (GI) series. This test uses x rays to diagnose problems in the large intestine. It is also called a barium enema x ray. Before you have the x ray, the doctor will put barium into your large intestine through the anus—the opening where stool leaves the body. Barium is a thick liquid that makes your intestines show up better on the x ray.

Colonoscopy. For this test the doctor inserts a long, thin tube, called a colonoscope, into your anus and up into your colon. The tube has a light and tiny lens on the end. The doctor can view the inside of your colon on a big television screen. In some cases, a shorter tube, called a flexible sigmoidoscope, is used to look at just the lower portion of the colon.

How is IBS treated?

IBS has no cure, but you can do things to relieve symptoms. Treatment may involve

  • diet changes
  • medicine
  • stress relief

You may have to try a few things to see what works best for you. Your doctor can help you find the right treatment plan.
Diet Changes

Some foods and drinks make IBS worse:

  • fatty foods, like french fries
  • milk products, like cheese or ice cream
  • chocolate
  • alcohol
  • caffeinated drinks, like coffee and some sodas
  • carbonated drinks, like soda

To find out which foods are a problem, keeping a food diary may be helpful.

Some foods  seem to make IBS better:

  • Fiber may reduce the constipation associated with IBS because it makes stool soft and easier to pass. However, some people with IBS who have more sensitive nerves may feel a bit more abdominal discomfort after adding more fiber to their diet. Fiber is found in foods such as breads, cereals, beans, fruits, and vegetables.Add foods with fiber to your diet a little at a time to let your body get used to them. Too much fiber at once can cause gas, which can trigger symptoms in a person with IBS.
  • Eat small meals. Large meals can cause cramping and diarrhea in people with IBS. If this happens to you, try eating four or five small meals a day instead of less-frequent big meals.

Medicine

The doctor may give you medicine to help with symptoms.

  • Laxatives treat constipation. Many kinds of laxatives are available. Your doctor can help you find the laxative that is right for you.
  • Antispasmodics control spasms in the colon and help ease abdominal pain.
  • Antidepressants, even in lower doses than are used for treating depression, can help people with IBS. They can help reduce the abdominal discomfort or pain associated with IBS and, depending on the type chosen, may help the diarrhea or constipation.
  • Another drug is sometimes prescribed for the treatment of IBS. Alosetron hydrochloride (Lotronex) is for women with severe IBS whose main symptom is diarrhea. Because it can cause serious side effects, Lotronex is only used if other medicines do not work.
  • Does stress cause IBS?

    Emotional stress does not cause IBS. But people with IBS may have their bowels react more to stress. So, if you already have IBS, stress can make your symptoms worse.

    Learning to reduce stress can help with IBS. With less stress, you may find you have less cramping and pain. You may also find it easier to manage your symptoms. Meditation, exercise, hypnosis, and counseling may help. You may need to try different activities to see what works best for you.

    Source: NIDDK

    Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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