Handling the Stress of ISB

Your gut has been uncomfortable a long time, and you’ve had a lot of tests. Your doctor says it’s irritable bowel syndrome (IBS). What are your treatment options now?

On the one hand, that’s great: having IBS can mean you don’t have something much more serious, like cancer or ulcerative colitis. Your doctor is likely to say you have it after ruling out everything else. On the other hand, it can feel like a real letdown, like your doctor just got bored of looking and settled for the common disorder with no known cause.

Symptoms of IBS can include abdominal pain, diarrhea or constipation, stomach bloating and fatigue.For those who have it, it means years of making sure you are close to the right bathroom at the right time.

Women get IBS more often than men. It’s less common over age 50. Ten percent to 15% of Americans have IBS.

Doctors tend to treat the symptoms of IBS rather than the cause. If you have diarrhea-predominant disease (IBS-D), you are likely to be told to take Imodium or something else that stops diarrhea. If you have constipation-predominant disease (IBS-C), you may be told to take a fiber supplement or a laxative. (Those with a third version of IBS, called IBS-M, have alternating bouts of diarrhea and constipation.)

If your problem is more severe, your doctor may prescribe a medication.  Beyond medication, your doctor might tell you to exercise more and to eat more fiber. If your other medications are making IBS worse, your doctor might be able to change your prescriptions.

So, is IBS even worth worrying about? Yes. First, it’s a very uncomfortable condition. Second, poor gut health can affect your body in many ways. And studies increasingly show a connection between gut health and brain health. The microbes in the gut have even been shown to have a connection to risk of Alzheimer’s and Parkinson’s diseases.

Stress and anxiety can make the condition worse, as can hormonal changes and lack of sleep. Chronically being negative can set IBS off. Smoking won’t help, either. Even certain foods can trigger an IBS flare.

If you have IBS-D, having conditions like cancer, inflammatory bowel disease, hyperthyroidism or a gastrointestinal infection can make symptoms worse. But you can control some factors that cause flares:

  • Food sensitivities, like lactose intolerance
  • Food intolerances, like celiac disease
  • Drinking caffeine or alcohol
  • Medications, like antibiotics, proton pump inhibitors, NSAIDS, ACE inhibitors, or chemotherapy

If you have IBS-C, having Parkinson’s disease, diabetes, hypothyroidism, a spinal injury, bowel obstruction, multiple sclerosis, endometriosis or diverticulitis can make symptoms worse. With IBS-C there are less factors you might be able to control. Here are some of them:

  • Stress
  • Lack of fiber
  • Medications, especially opiates, calcium-channel blockers and antidepressants

Avoid them when possible to prevent your condition from flaring up.

Paying attention to what you eat can help. Some people are sensitive to the sugars in certain foods, called FODMAPs. Ask your doctor if going on a low-FODMAP diet might help you. This can involve getting rid of grains, dairy products and certain fruits and vegetables, but if your IBS is bad enough, it might be worth a try.

In some cases, bile acid diarrhea can be mistaken for IBS-D. This condition happens either when your intestines don’t absorb bile correctly or when the body overproduces bile. This speeds up you intestinal activity and leads to watery diarrhea. If your doctor decides you have bile acid diarrhea, you may be prescribed a bile acid sequestrant drug like Cholestyramine, which will stop the diarrhea. Having your gallbladder removed has been linked with bile acid diarrhea.

If you have IBS and some vegetables make you gassy (like, say broccoli), try going without them. Don’t give up on all vegetables, though. They add fiber and beneficial nutrients to your diet. Alcohol, dairy, and raw fruits and vegetables also can give you gas. If your body doesn’t tolerate grains well, they also can be a problem.

Each person’s gut is different; what helps one person with IBS won’t work for another. But managing stress and keeping track of when you get the worst symptoms can help. Keep trying new things to manage your symptoms, and don’t give up if a new treatment takes a while to work effectively.

One study from University of Ghent, Belgium, found that fecal transplants helped patients with IBS-D and IBS-M. Patients had less symptoms after they were given a donated stool sample (yep, poop) that was full of “good” gut bacteria. The patients then had less gas and pain and less urgent bowel movements and they had to “go” less often. The good effects wore off after about a year but came back once the patients were given a second sample.

Disclaimer: This article does not provide medical advice. Do not take action based solely on this article and always consult with an appropriate healthcare professional. This article is purely for informational purposes.

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