The Low-Down on Irritable Bowel Syndrome
This week, we ask experts at George Washington Medical Faculty Associates about the chronic gastrointestinal disease that often gets a bad rap.
By
Melissa Romero
Sometimes broccoli can trigger IBS symptoms. Photograph courtesy of Flickr user sk8geek.
Suffering from irritable bowel syndrome (IBS) can be extremely uncomfortable, but it’s not something you should be embarrassed about, says Dr. Antoinette Saddler.
As an assistant professor of medicine at George Washington University Medical Faculty Associates, Saddler says she sees hundreds of patients a week who suffer from IBS symptoms, which include recurrent stomach pain and discomfort, diarrhea, constipation, and cramping. “It’s not something patients should feel isolated about. Many people suffer from the symptoms, and [IBS] is very treatable once we understand what’s going on.”
Approximately 20 percent of Americans suffer from IBS symptoms, but many of them go undiagnosed. And even though it’s a common disorder, Saddler says experts are still trying to understand how or why it develops.
We spoke with Saddler and Claire LeBrun, a senior nutritionist at GW Medical Faculty Associates, to find out more about the disorder and how to treat it.
How do you know if you have IBS?
Saddler: “There are some real diagnostic criteria that patients have to meet, since it’s such a difficult thing to characterize. The symptoms can’t just have been going on for a few weeks—it has to be more long-standing and chronic, at least six months. We have to determine if there’s been a change in stool frequency or consistency. But patients should never allow themselves to be labeled without some sort of diagnostic evaluation from a doctor.”
LeBrun: “Gastroenterologists usually have to rule out things like Celiac disease, bacterial overgrowth in the bowels, ulcers, and lactose intolerance before diagnosing someone with IBS.”
What can precipitate IBS symptoms?
Saddler: “The most common things are stress and some dietary triggers. But I’m careful when I say that stress precipitates symptoms, because it’s usually more complex than that.”
LeBrun: “Stress may cause IBS to flare up, and a lot of women have said it’s worse around their [menstrual] cycle.”
Are there certain foods that can trigger symptoms, too?
LeBrun: “There are common foods that give people more gas in general, like vegetables such as broccoli and cauliflower, and onion and garlic. I’d also limit beans and legumes, soy, wheat, gluten, and dairy. But I don’t think there’s any food group that you can say across the board that if you give up these foods, your symptoms will go away.”
What about foods IBS patients should eat?
LeBrun: “The least likely culprits [of IBS] I put people on are chicken, turkey, lamb, and beef. Their diets should be whole foods, nothing processed, and ideally organic if they can afford it.”
So if the cause of IBS is unknown, how should patients treat it?
Saddler: “Since it’s not a life-threatening disease, there are certainly a lot of different strategies for preventing symptoms. But it’s the sort of thing that really has to be tailored to the individual. Once we’re very sure the patient doesn’t have another disease, we can treat it symptomatically with over-the-counter or prescription anti-diarrhea medications. Or if someone is suffering from constipation, we sometimes do fiber therapy.”
LeBrun: “I make sure my patients are being detectives and figuring out what is potentially bothering them. I think patients know more than anyone what they’re sensitive to, so they should keep a food diary and write down their symptoms when they occur.”
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Comments
For over thirty years I’ve dealt with IBS to the point it dictated what type of work environment I could or couldn’t work, as I may need to leave at a moments notice. I eliminated all the so called suspects in my diet including gluten, sugar, and sugar/sugar substitutes to see if the symptoms would disappear, with minimal results. Nothing seemed to work until my physician started me on Welchol to lower my cholesterol. This medication has a dual benefit or as the literature states a side effect called gastroparesis. Just what I needed. Within two doses my signs and symptoms disappeared. I agree with the comment posted above, "the IBS caused the stress, not the stress causing the IBS." Life is so different and less stressful when you aren’t controlled by this health condition.
Posted by: Kelly, Jan 16, 2012 06:00:19 PM
Thanks for the spotlight on IBS! I’ve had this disorder for 20 years, and it can be extremely difficult to deal with.
Many patients also date their symptoms back to a bout of food poisoning, and the term "post-infectious" IBS describes a recognized sub-group of IBS sufferers that is worth mentioning. I suffered from an awful food poisoning episode when I was 12, and it was as if my digestion never really recovered.
For anyone who’s interested there are more than 600 personal stories from IBS sufferers on my website IBS Tales at http://www.ibstales.com
I’ve also written a book about my IBS experiences, called Sophie’s Story: My 20-Year Battle with Irritable Bowel Syndrome. 60,000 words about my bowels! But I felt it needed to be written - there are many myths out there about IBS, and many people who are struggling.
Posted by: Sophie, Jan 11, 2012 04:51:05 PM
As an advocate, past IBS suffererer and patient support associate as well as a lifetime member of the International Foundation for Gastrointestional Disorders (IFFGD) I appreciate the fact that IBS is given some press space.
However I find like most gastroenterologists who treat this condition, a big emphasis is put on diet. I was down to crackers and water at one point, and admitted to the ER with IBS so severe, that ’everything’ triggered my condition.
While stress can certainly play a role in IBS, I find in speaking with patients all over the world, that usually the stress is a result of having the IBS, and not the other way around. A big part of the IBS condition is the brain-gut axis or connection, where the brain in the gut malfunctions with a miscommunication from the brain. A great deal of research has been done into this aspect of IBS. When other treatments of diet, medications, anti-spasmodics, etc fail, many people turn to IBS gut-specific clinical hypnotherapeutic protocols, which can be extremely effective and a recorded 100 day program helped my very severe IBS of over 20 years, when my gastroenterologist suggested I research other treatment methods. Since 1998, this method has been extremely helpful in severe refractory cases of IBS, where all hope of relief was lost. Also included in this protocol is a recording explaining the IBS condition to family members and associates, something that may prove difficult for the sufferer.
Posted by: Former IBS Sufferer and Advocate, Jan 11, 2012 04:17:49 PM
Thank you for spotlighting IBS, which is extremely common but often not discussed in public by those who are affected and often misunderstood by them and others.
It would be helpful to provide additional resources for readers, as it’s often difficult for people with more than mild IBS, their families, friends and medical providers
to sort through much information of widely varying accuracy and quality that exists for this condition. Here are a few reputable suggestions. I am a person with IBS involved in the IBS community.
The International Foundation for Functional Gastrointestinal Disorders (IFFGD), a 501c3 not for profit in Milwaukee, Wisconsin concerned with functional GI and GI motility disorders, of which IBS is the most common one. Major legislation on behalf of the FGIMD community is currently in Congress. Information on this and other topics can be found at http://www.iffgd.org
The University of North Carolina Center for Functional GI Disorders, one of the major research centers in the U.S. in this field and one that is very dedicated to education of affected people through downloadable materials and scheduled public online chats http://www.med.unc.edu/ibs
IBS Impact, a small grassroots group of people with IBS and supportive relatives and professionals specifically focused on greater public awareness and self-advocacy by people with IBS. There are many original resources and reputable links at http://www.ibsimpact.com and http://ibsimpact.wordpress.com with more to come soon.
Posted by: A reader, Jan 11, 2012 01:32:59 PM
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