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.

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.”

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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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