We all have occasional upset stomach, constipation or diarrhea. But for people with Irritable Bowel Syndrome (IBS), the discomfort and chronic pain can dominate their whole life. Cramping, bloating and the immediate need to be near the bathroom can lean many people to give up or put off activities they enjoy because of their unpredictable symptoms. And because symptoms don’t “show” on the outside, it can be difficult for family and friends to understand what’s happening – and that in many cases, that it’s out of your control.
Understanding the Symptoms
An estimated one in six Americans – and twice as many women as men – has IBS. According to the International Foundation for Functional Gastrointestinal Disorders, people with the condition routinely experience bloating, gas, constipation, alternating bouts of constipation and diarrhea, bowel movements that are difficult to pass or feel uncomfortably urgent, or include a clear or white mucus in the stool. Many people who have these symptoms also experience nausea, heartburn, or acid reflux; anxiety; depression; discomfort or loss of appetite; and relief from symptoms that usually occurs after using the bathroom normally for several days.
IBS symptoms vary a lot from person to person and tend to come and go with stress and other lifestyle changes. Each person’s experience with IBS is a bit different, and certain symptoms often seem to be stronger or more frequent than others. That’s why it’s important to keep a food and symptom journal – to help you identify when symptoms flare up and what could be the root cause.
What is Causing this Pain?
People living with IBS are generally more sensitive to what’s happening in their gut, and feel pain from gas and other movements that might not bother others. It’s a functional disorder, meaning there’s a problem in the way a normal bodily function is carried out – not caused from something foreign in your body, like a virus. IBS isn’t contagious, cancerous or inherited, and symptoms begin before the age of 35 in half of all cases. It occurs when the muscles in your colon used to squeeze and push stool through don’t function properly. Muscles can contract too quickly (leading to diarrhea), or too slowly (causing constipation).
There are several suspected causes of IBS, although the direct cause of the condition is unknown. A course of antibiotics, emotional distress, or another GI illness can lead to IBS, and it’s suggested that IBS can develop after episodes of gastroenteritis. Food sensitivities or dietary allergies are also potential causes, although this hasn’t been proven. Many people find that symptoms worsen with stress or during menstruation.
Getting a Diagnosis
IBS is a difficult condition to identify because there are many overlapping symptoms that are also indicative of other stomach issues. From a doctor’s standpoint, IBS is diagnosed when a cluster of symptoms occurs together and last for at least several months. When looking for IBS, your doctor will likely perform tests to rule out other medical problems, including x-rays of the small intestine, a CT scan, an endoscopy or a colonoscopy. These tests, combined with your medical history and a physical exam are used to make a diagnosis. Unfortunately, there’s no definitive study that can confirm it.
Self-Care and Therapy: Managing Symptoms
Some people can control their symptoms by managing diet, lifestyle, and stress. Others will need medication and counseling. Here are few ways you can manage symptoms.
What you eat matters. One way to promote a healthy digestive tract is to add fiber to your diet. It promotes regular bowel movements, which reduces constipation. Be careful to add fiber slowly, because it could initially worsen symptoms until your body adjusts. Foods with soluble fiber that what’s found in oats, beans, barley, apples, carrots, peas and citrus fruits are good choices. Certain foods can aggravate IBS symptoms, including caffeinated drinks, alcohol, artificial sweeteners, processed foods such as chips and crackers, and cruciferous vegetables such as broccoli, cauliflower and cabbage. Lactose intolerance is often mistaken for IBS, so you can also try cutting out all dairy for 2 weeks to see if symptoms improve.
Control your stressors. Stress doesn’t actually cause IBS, but it can make symptoms worse. Anxiety and stress may make the mind more aware of spasms in the colon, or be triggered by the immune system which is also affected by stress. Deep breathing, meditation, yoga, getting adequate rest, as well as relaxation therapy, mindfulness training and cognitive behavioral therapy are all great ways to help keep stress at bay.
Get moving. It may seem like exercise is the prescription for many health conditions, and it is! Regular aerobic exercise – like biking or jogging – could reduce your symptoms of IBS and help you stay at a healthy weight. Exercise has been shown to make the muscles in the colon work better and help gas move through your gut faster – leading to less frequent symptoms.
If symptoms persist after you’ve made these lifestyle changes, your doctor may prescribe one or a combination of these drugs to provide relief:
- diarrhea medications to reduce frequency and urgency of bowel movements
- gut antispasmodic medicines to reduce muscle contractions and slow the movement of food in your intestines
- laxatives to loosen stools to relieve constipation
- nerve pain medications to block pain caused by damaged nerves
- antibiotics to stop or kill growing bacteria
If you suspect you have Irritable Bowel Syndrome, don’t self-diagnose. It's also important to remember that blood in the stool, weight loss, fever and constant pain are not symptoms of IBS. If you’re experiencing these symptoms, talk to your doctor right away.