The constant pain, gas, bloating, disturbed defecation and uncertainty that plagues people with IBS is deeply disabling. The unpredictable course of the disease makes people with IBS expert bathroom-mappers, constantly on the lookout in case the urge comes suddenly.
Irritable bowel syndrome is considered a gastrointestinal functional disorder, meaning that the natural rhythmic movement of the gut is flawed. It is the most common syndrome seen by gastroenterologists and keeps more people holed-up at home then the common cold.
It is a puzzling syndrome with no clear-cut mechanical defect or biochemical cause that explains symptoms. Many theories abound. One proposes that the nerve cells in the large intestines are hypersensitive. Another suggests that the gut is overreacting to stress hormones, inflammation and serotonin, a brain chemical that is also abundant in the intestine. Serotonin plays a role in depression making the gut-brain theory a popular one. Without a distinct cause doctors and patients need to rely on a careful history of symptoms to make a diagnosis. It sometimes takes years before a correct diagnosis is made.
So how do you know if what you are experiencing is IBS or some other GI disorder?
The road to a diagnosis can be an arduous journey. Doctors will want to rule out other GI disorders such as parasites, gluten sensitivity, small intestine diseases and lactose intolerance. A diagnosis is made when people experience:
- At least 3 months of abdominal pain or cramping that is present at least 25% of the time
- A noticeable difference in consistency and frequency of stool that can be hard, loose watery or poorly formed
- A feeling of incomplete evacuation or the need to strain
- A sense of urgency
- Mucous in stool
- Bloating or a feeling of abdominal distention.
There is no single treatment that works for everyone and much of what will work depends on your own physiology. It is a constant process of trial and error.
Here are some measures that can help tame an ill-tempered bowel.
Pay close attention to dietary triggers and excesses. People with diarrhea as the predominant symptom may find they are sensitive to lactose, too much fruit and sorbitol, a type of sugar.
Eating soluble fiber found in psyllium seed husks, whole grains, fruits, and vegetables is good because it forms a gel in the gut that can slow gut movement and decrease pressure. Insoluble fiber can also slow the gut by retaining water by bulking up stool.
If you have bloating or gas you may do better limiting beans and vegetables in the cabbage family. If you want to increase movement of the gut, try caffeinated coffee or dark chocolate. Take a pass on animal fats which tend to intensify gut sensations. Also try eating many small meals spread out over the day instead of 3 large ones.
Peppermint has been the mainstay of an upset stomach and may work in IBS by relaxing the smooth muscle lining the gut. A few capsules of peppermint oil may calm cramps.
This strategy has been a very promising treatment. Foods and supplements containing live bacteria cultures of Lactobacillus and Bifidobacterium not only keep the natural gut flora in balance, but they may also reduce inflammation, a factor that might increase gut sensitivity. Look for yogurt containing live cultures and fermented foods such as tempeh and Korean kimchi also contain probiotics.
The brain-gut connection makes IBS particularly amenable to mind-body therapies. In fact many patients who have IBS also suffer from depression and other psychiatric disorders. Psychotherapy, hypnotherapy and cognitive behavior therapy such as biofeedback, progressive muscle relaxation and stress management can help settle the gut.
A well-controlled study of a standard and individualized Chinese herbal formulations offered symptom improvement to some patients with IBS.
Acupuncture can influence gastric emptying and acid secretion to settle an active gut.
Nothing gets the gut moving like a good fast walk.