April is irritable bowel syndrome (IBS) Awareness Month. IBS is a chronic functional bowel disorder characterized by symptoms of abdominal pain and altered bowel habits (constipation and diarrhea), in the absence of structural or biochemical abnormalities that are detectable with the current routine diagnostic tools. IBS is the most common condition diagnosed by gastroenterologists and is one of the most frequently seen conditions by PCPs. IBS affects both men and women of all ages. It is thought only a fraction of individuals with symptoms of IBS seek medical attention. Most individuals will initially consult PCPs for their symptoms, and the factors that drive this consultation are symptom severity, especially pain, and concerns that symptoms might indicate an underlying severe disease, such as cancer.
Relax to Find Relief
Many individuals with IBS find symptom relief and an improved sense of well-being when they incorporate relaxation techniques into their daily lives.
Better Sleep, Less Pain
If your abdominal pain is affecting your sleep, you might want to improve your sleep hygiene. This may include lifestyle changes such as having a regular relaxation period before getting into bed, keeping a consistent wake-up time, using the bed only for sleep, avoiding caffeine for at least 4 hours before bed, or not staying in bed awake for longer than 20 minutes. Improving your sleep can benefit your ability to cope with pain.
Breakfast is Important to help Bowel Movements
If you suffer from constipation, be sure to have breakfast. This is the meal that is most likely to stimulate the colon and give you a bowel movement.
Help for Children with IBS
Children with IBS need reassurance to know that bowel problems happen to virtually everyone now and then. Help them make healthy choices. Talk reassuringly and in a matter-of-fact way about bowel habits. Importantly, recognize the developmental stage of your child and, if necessary, be sure to work with your child’s physician to plan treatment that takes into account the child’s point of view.
Probiotics and IBS
Probiotics may be helpful to some who suffer from IBS. Probiotics work by adding helpful bacteria back into the gut in an attempt to replace harmful gut bacteria. Studies have shown a particular strain of bacteria, Bifidobacterium infantis 35624, to be superior to a placebo in relieving the main symptoms of IBS.
Medications That Worsen Pain?
Opioid-based pain medications such as morphine or oxycodone are prescribed to relieve pain. However, they should not be used for pain in IBS and other functional GI disorders. Under some circumstances and with some individuals, the use of narcotics can cause pain. If you are on one of these drugs for IBS pain and your pain seems to be getting worse, talk to your doctor about switching to a non-narcotic substitute.
Keep Things Moving
Regular exercise improves bowel functions, including the common IBS symptom of bloating. Daily movement is important to keep bloating from worsening. Take breaks from sitting to stretch your legs (and abdomen).
Pregnancy and IBS
Changes in bowel function are common during pregnancy. If you are experiencing excessive abdominal discomfort during your pregnancy, try reducing gas-producing foods such as beans, cabbage, legumes, cauliflower, broccoli, lentils, and brussels sprouts.
Is Fiber Right for You?
Dietary fiber can affect symptoms in IBS – for better or for worse. For some, it may help to add fiber, and for others, it may help to reduce fiber. It is likely that many persons with IBS will benefit from some adjustment in their fiber intake.
Conventional medications not completely controlling your symptoms? Give other strategies a try, including cognitive therapy and hypnosis. Such therapies have been shown to produce major improvements that can last for years.
The 4-12 Elimination Diet to Identify Problem Foods
Each person responds to food differently, and something that causes symptoms in you may not for someone else. Try this simple 4 step, 12-week elimination diet to identify the foods which may intensify your symptoms.
Keep a Symptom Diary
Keeping a diary for one to two weeks may help identify factors that bring on symptoms or make your condition worse.
Menstruation and IBS
Women with IBS more frequently report painful menstruation and PMS compared to those without IBS. If you experience painful menstrual symptoms, be sure to tell your doctor.
Is IBS affecting your sex life?
Sexual difficulty is reported by a disproportionally high number of IBS patients, both men, and women. This ranges from decreased sexual drive; the most common symptom reported painful intercourse.
Be open with your partner if you are having these difficulties and explain the reasons why – like pain and discomfort. This will help to avoid misunderstandings and foster support. Or speak with your health care provider if this is an issue for you.
Remember that no medicine is completely safe
When using medicine – prescription, over-the-counter (OTC), or supplements (including herbs and vitamins) – remember that no medicine is completely safe.
Here are some things you can do to help reduce the risks of using medicines and to get the most benefit:
- Take an active role in your own healthcare – evaluate your treatment choices
- Let your doctor or pharmacist know all the medicines and treatments you use
- Ask about risks or possible unwanted effects
- Know what to do if unwanted effects occur
- Read the label and follow the directions
Prescription and OTC medicines don’t always mix well with each other. Dietary supplements (like vitamins and herbals) and some foods and drinks can cause problems with your medicines too. Ask the pharmacist or your doctor if you have questions.
Source: U.S. Department of Health and Human Services, Food and Drug Administration
Eat consistent, small meals before large events
Before a big event, eat small meals throughout the day to avoid symptoms later. Often in a misguided attempt to prevent the onset of symptoms, IBS sufferers will avoid food before a big event. The problem with this strategy is that your body may over-react when food is finally introduced, especially if it is in a large quantity.
Peppermint Oil may relieve symptoms
Peppermint oil, taken before meals, has been shown to relieve symptoms in the short term better than placebo in IBS patients experiencing abdominal discomfort. It works by decreasing muscle spasms in the GI tract. Peppermint oil can be purchased over the counter. Remember, it can cause severe heartburn, so take it in capsule form.
While traveling, be sure to divide your medications into two containers – keep one in your hotel room and one with you at all times. Also, bring your physician’s contact information with you so that you can reach them at a moment’s notice.
Yoga for IBS
Meditation & movement therapies, such as yoga and tai chi, may help lessen symptoms of abdominal pain, bloating, flatulence, and diarrhea. Such therapies have little potential concerning side effects and may be helpful for symptoms outside of the GI tract, as well as promoting general stress reduction.
Four common food offenders
Four common food offenders for IBS are:
By taking a systematic approach, you may be able to sort out which, if any, affects your symptoms. Make a list and, one at a time; eliminate a food from your diet for about 12 weeks to see if you notice improvement. If you do not notice improvement after 12 weeks, begin eating that food again and try eliminating the next food on your list.