Text by Henrylito D. Tacio
Joan (not her real name) is not your typical woman in her early fifties. She has had recurrent diarrhea for as long as she can remember. When she gets the urge to go, she has to move fast. After she is through, nature often calls again in an hour or two. Sometimes, it turns out to be only gas, but she never knows for sure – beforehand. Diarrhea may stop three to four days, only to be followed by constipation, so that when she does finally “go,” she eliminates only a few “tiny hard pellets.” She almost always has a crampy pain in the left lower part of her belly.
Joan knows more doctors than do most of us – name it, and she has seen them. She has been examined from head to toe, and her stool has been repeatedly cultured for every parasite and bacterium are known to man and looked at under the microscope; she has undergone countless biopsies, barium enemas, skin tests, colonoscopies, CT scans, and psychological evaluations – all of which were invariably reported as “normal.” Almost every specialist she consulted has given her the same “good news,” that she has “nothing more than an irritable bowel” to which she simply must “adjust.”
Joan’s dilemma is shared by hundreds of thousands of individuals. “The irritable bowel syndrome (IBS), also known as nervous bowel or spastic colon, is twice as common in females as in males,” writes Dr. Isadore Rosenfeld, author of “The Best Treatment.” “It may begin as early as the teens, or not before midlife.
The clinical picture may vary – some days or weeks are better than others, but the individual with IBS never really feels good for any length of time. “If you’re looking for a weakness of medical science, then IBS is definitely one,” explains Dr. Willie T. Ong, an internist-cardiologist who has written several health books. “Just imagine, there is no laboratory test to confirm the disease.”
“I happen to believe that, despite all the ‘negative’ tests, the irritable bowel is a real disorder whose causes we simply do not yet understand,” Dr. Rosenfeld points out. “Those affected do not lose weight, they’re rarely anemic, they don’t often have blood in their stool, and they never have fever – but they are sick and miserable themselves!”
According to the Mayo Clinic, only a small number of people with irritable bowel syndrome have severe signs and symptoms. “The signs and symptoms of irritable bowel syndrome can vary widely from person to person and often resemble those of other diseases,” it says.
Among the most common are: abdominal pain or cramping, a bloated feeling, gas, diarrhea or constipation (sometimes alternating bouts of constipation and diarrhea), and mucus in the stool. “For most people, IBS is a chronic condition, although there will likely be times when the signs and symptoms are worse and times when they improve or even disappear completely,” the Mayo Clinic says.
Until now, it isn’t clear what causes IBS. The cause may be different for different people. In addition, triggers vary from person to person. “Stimuli that don’t bother other people can trigger symptoms in people with IBS — but not all people with the condition react to the same stimuli,” the Mayo Clinic claims. Common triggers include:
Foods. The role of food allergy or intolerance in irritable bowel syndrome is not yet clearly understood, but many people have more severe symptoms when they eat certain things. A wide range of foods has been implicated — chocolate, spices, fats, fruits, beans, cabbage, cauliflower, broccoli, milk, carbonated beverages, and alcohol, to name a few.
Stress. Most people with IBS find that their signs and symptoms are worse or more frequent during periods of increased stress, such as finals week or the first weeks on a new job. But while stress may aggravate symptoms, it doesn’t cause them.
Hormones. Because women are twice as likely to have IBS, researchers believe that hormonal changes play a role in this condition. Many women find that signs and symptoms are worse during or around their menstrual periods.
Other illnesses. Sometimes another illness, such as an acute episode of infectious diarrhea (gastroenteritis) or too many bacteria in the intestines (bacterial overgrowth), can trigger IBS.
At the moment, there is no “best” treatment for IBS, but the good news is that IBS is not fatal and doesn’t lead to more serious medical complications like ulcerative colitis or cancer. Doctors claim there are plenty of things you can do to take some of the irritability out of your bowels.
The editors of “Prevention” magazine health books asked several experts on the subject and gathered all their answers in “The Doctors Book of Home Remedies” and its sequel. Philip Goldberg also shared some tips in his book, “Pain Remedies.” Below are the remedies that doctors themselves use at home and in their offices:
Take the news in stride. “There’s a very good connection between stress and an irritable bowel,” says Dr. Douglas Drossman, a gastroenterologist, and psychiatrist. What you don’t want to do is get stressed because you have irritable bowel, and thereby create a “vicious cycle,” he says. Especially during flare-ups of abdominal pain, it is important to “take a deep breath. Think about what’s happening. Recognize that it’s happened before and it will pass. Know that you’re not going to die – because people don’t die from an irritable bowel,” he explains.
Become a relaxed person. Anything you can do to help yourself unwind should help to alleviate your symptoms, says Dr. Drossman. You may benefit from relaxation techniques, such as meditation, self-hypnosis, or biofeedback. If the stress in your life is particularly problematic, you may want to consider psychological counseling. The key is to find what works for you.
Keep a stress diary. Persons with irritable bowel have an intestinal system that overreacts to food, stress, and hormonal changes. “Think of your irritable bowel as a built-in barometer, and use it to help you determine what things in your life are most stressful,” says Dr. Drossman. If, for instance, you have stomach pain every time you talk to your boss, see it as a sign that you need to work on that relationship (perhaps by talking it over with your boss, a friend or family member, or a therapist).
Log in your food and beverage intake, too. Certain foods and beverages, just like stress, can activate an irritable bowel, so it’s also helpful to record in your diary of foods and beverages that give you the most trouble, says Dr. Drossman. Although there are some things that are likely to disturb most people, everyone is different.
Add fiber to your diet. Many people with IBS do much better simply by adding fiber to their diets, says Dr. James Rhodes, a professor of medicine at the University of Kansas Medical Center. “Fiber increases stool production and reduces pressure in the intestines, which is good for both constipation and diarrhea,” says Dr. Stephen Hanauer, professor of medicine in the Section of Gastroenterology at the University of Chicago Medical Center. “It also allows for more regular bowel movements.” The best fiber to add to your diet is the non-soluble type – found in bran, whole grains, fruits, and vegetables. Here’s a word of warning about bran: add it slowly to give your body time to adjust.
Drink lots of fluid. To keep your bowels moving smoothly, you need not only fiber but fluids as well. You’ll need more on hot days spent playing tennis than on rainy days spent at the movies, but in general, “you should drink between six and eight glasses of fluid a day,” says Dr. Rhodes.
Be wary of dairy products. Many people develop twitchy bowels because they can’t digest lactose, the sugar in milk, explains Dr. Melvyn Werbach, author of “Healing with Food.” Your doctor can test you for lactose intolerance, or you can give up dairy products for a couple of days and see how you do. In either case, you may find this one dietary change can clear up all your problems.
Cut out the fat. There are lots of good reasons to eat a low-fat diet – and now you have one more. “Fat is a major stimulus to colonic contractions,” says Dr. William Snape, Jr., director of the Inflammatory Bowel Disease Center at the Harbor-UCLA Medical Center. In other words, it can worsen your IBS. A good place to begin to cut fat out of your diet is by eliminating heavy sauces, fried foods, and salad oils; he points out. Instead, fill your diet with complex carbohydrates such as pasta, rice, fruits, and vegetables.
Know the foods you’re sensitive to. Some people with IBS are particularly sensitive to gas-producing foods, says Dr. Rhodes. If you fall into this group, you may find relief by avoiding such flatulence champs as beans, cabbage, Brussels sprouts, broccoli, cauliflower, and onions. Acidic foods tend to bother some people with IBS. Here, you may wish to experiment by laying off such things as oranges, tomatoes, and vinegary salad dressings for a while, to see if things get better. What about spicy foods? Try eating a lot of spicy foods for one week and a lot of bland foods the next week, and note if your condition changes, Dr. Rhodes suggests.
Avoid caffeine and nicotine. Caffeine can be found in coffee, tea, and cola, while nicotine is common in cigarettes. Caffeine and nicotine have been observed to irritate your bowel and aggravate IBS symptoms, says Dr. Marvin Schuster, former director of the division of digestive diseases at Johns Hopkins Bayview Medical Center.
Don’t be too sweet on sweets. Controlling your sweet tooth is one of the best ways to put the bite on IBS-triggered diarrhea. “You have to be careful with sugars if you have IBS, especially fructose and the artificial sweetener,” says Dr. Hanauer. That’s because sugars, which are not easily digested, are a leading cause of the runs.
Mind your dining. Another often-overlooked factor of IBS is how and where you eat. “You should eat slowly and in as relaxed an environment as possible,” suggests Dr. Arvey Rogers, professor of medicine at the University of Miami School of Medicine. The idea is to focus on your eating. “If your attention is drawn to something besides your food, you can develop indigestion, gas, bloating, and cramping,” warns Dr. Brian Rees, medical director of the Maharishi Ayur-Veda Medical Center in California.
Go for a jog. “Good body tone, good bowel tone,” says Dr. Rhodes. Exercise strengthens the body (of which the bowel is a part). It helps relieve stress. And it releases endorphins that help you control pain. All in all, regular exercise will more than likely calm your irritable bowel. Be careful, however, not to overdo it. Too much exercise can lead to diarrhea.
Try a painkiller. Hormonal changes can sometimes pique an irritable bowel. For this reason, women often get attacks during their periods, says Dr. Drossman. Ibuprofen medications may help to inhibit some of the hormonal releases that are the root of the problem. For the rest of us, these pills can help with the pain.
Call a hot-water bottle to the rescue. If you’re experiencing an attack of abdominal pain, the best thing to do is to sit or lie down, take a deep breath, and try to relax. Some people also find it helpful to put a hot-water bottle or a heating pad on the tummy, says Dr. Snape.
Unknowingly, Dr. Ong also suffers from IBS. Aside from those mentioned above, another solution to the problem is prayer. “I know you might think it’s silly, but prayers have really helped me with my irritable bowel,” he admits. “When the bowels act up, usually there is stress involved, and knowing this helps me accept the problem.
“Some people will get turned off when I say that most ailments can be cured by having a peaceful mind and a positive attitude,” he continues. “But I sincerely believe it will help patients in the long run. Soon you will get the hang of it. Don’t despair, living with IBS is easier than you think.”