DOCTOR IS IN: Understanding Irritable Bowel Syndrome

By JENNIFER A. CHRISTIE, MD

Assistant professor of medicine and director of Gastrointestinal Motility in the Emory University School of Medicine, Division of Digestive Diseases. Specializes in the diagnosis and treatment of colon cancer and digestive disorders in women.

Do you have bellyaches, and either diarrhea or constipation, or both off and on? If so, you may have irritable bowel syndrome (IBS). This problem can be a real annoyance and can affect your health.

About 15 percent to 30 percent of the U.S. population has IBS, a bowel disorder with a complex of abdominal pain and stool alterations. It is not in your head, it is a real diagnosis defined as chronic, recurrent abdominal pain with relief after a bowel movement.

Symptoms of IBS can include:

•    loose stools at pain onset
•    increased frequency of bowel movements with pain
•    abdominal distension or bloating
•    mucous in the stool and
•    constipation or a feeling of incomplete evacuation of stools

Doctors believe that there are several causes of IBS, which include abnormal, spontaneous intestinal movement causing constipation or diarrhea, as well as heightened sensory perception, which can cause belly discomfort. These are thought to be largely due to an imbalance of serotonin. Serotonin functions as a neurotransmitter in nerve systems, which regulate bowel function.

Other proposed causes include dietary triggers, bacterial interaction with the gut immune system, and stress and anxiety on brain-gut interaction, all of which may alter gut function.

Symptoms can vary for people with IBS. It is recognized by experts that diarrhea can be a key factor or that constipation can be the greatest problem, or a combination of the two can be present.

In addition, symptoms vary in terms of severity. If you have mild IBS symptoms, you can usually be treated with “bulking” agents such as fiber, modifying your diet and regular exercise. However, if you have severe symptoms that are affecting your ability to eat a healthy diet, go the school or work, go out with friends or on a date, and just enjoy life, there are medications that your doctor can prescribe to treat specific symptoms.

Treatment of IBS must include dietary and lifestyle modifications and multi-disciplinary care. So, if you have an aching belly, quit suffering, go see your doctor for help. If necessary, he or she may refer you to a specialist (gastroenterologist) for additional care.

More about Dr. Christie

Additional web sites for IBS information

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19 comments Add your comment

Lori

July 27th, 2009
9:20 pm

You didn’t mention that IBS sufferers often suffer from chronic heartburn as well, and that some heartburn treatments (prevacid, prilosec) also seem to lessen the IBS symptoms.

Elena

July 28th, 2009
1:06 pm

If you suffer from these symptoms, I would also recommend exploring the foods you are eating. I was diagnosed with IBS and went to several gastros who prescribed drugs and fiber. It took my internist and my own internet searching to find that it was a combo of h. pylori (treated by antibiotics) and fructose malabsorption disorder. Feeling great now and not on drugs!

CT

July 28th, 2009
6:20 pm

Also be aware of possible gluten intolerance / celiac disease. It is easily controlled by diet but a LOT of people with IBS are misdiagnosed. It is a simple blood test for gluten allergy.

Kathy

July 29th, 2009
9:10 am

Been a suffer for years. Stress pays BIG part. I have just started Gluten free diet just to see how my body reacts. There is a difference. All this talk about fiber, well if I eat too much, I get diarrhea, heart burn etc. I am trying to strike some kind of balance in my diet. It is not easy. Trial and error.

Dolores

July 29th, 2009
9:50 am

I wonder if you are aware that there are 20 years of clinical research that shows that hypnosis reduces IBS symptoms by 70%. A new study released in July by gastroenterologist Dr. Whorwell reports that hypnosis not only reduces the symptoms but also positively affects the quality of life issues that many IBS sufferers experience. FYI the Mayo clinic published a review of the effectiveness of hypnosis that includes some of the studies that were completed regarding IBS.

Ashley

July 29th, 2009
10:55 am

I agree about the chronic heartburn and the stress. My IBS has been terrible the last few weeks, AND I had shingles, both of which are caused/aggravated by stress. I have noticed that Beano helps some with the bloating. My doctor said that gas-x and things like that don’t usually work in the intestines, but Beano is an enzyme and will work a lot better. I was also advised to eat more fiber, and I kept running to the bathroom over and over, and I finally found a physician who told me to stop eating so much fiber, and take 1/2 tablet of immodium twice per day, and it has helped so much. People with IBS-C might benefit from additional fiber, but people with IBS-D may find themselves running to the bathroom even more!

janecorson

July 29th, 2009
11:54 am

thank u ,for the all the helpful sugggestions. my dr has none….i have ibs/d and have tryed a lot of things,,,fiber, imodeum, ,and now trying probiotics….nothing really last ..but thanks for beano …

Maria

July 29th, 2009
1:45 pm

I been studying myself for 3 yrs. I have the constipation (ibs side) It is definetly all stress and lack of fiber. I been going to theraphy and i realized that my thoughts were controling my stomache. Once i relax symptons vanish. My diet improved but its not the best. i practice yoga and exercise regularly for yrs so this was not a real solution. When I was little i had panic attacks. My ibs attacks are quite similar to panic attacks. its all related.basically we are not digestine our thoughts, our lifes, accepting our present….i’ve learned to talk to my stomache and i only get attacks 3 a yr when I eat the wrong foods (like red sauce or meat). Before I accepted that it was my anxiety and worry my ibs attacks were 3 times a month. Th esmall intestine is attached to your nervous system (as clear as water) so, don’t worry, love yourself and tell urself that you’ll find a way and it will cease.

Michelle

July 29th, 2009
3:02 pm

I have suffered for years with IBS and have found great success using probiotics. But you have to make sure you find the kind that work for you – I take Natural Factors Acidophilus & Bifidus., and that you take enough of them. I take 10 billion cfu each night on an empty stomach. I also take digestive enzymes after each meal. The combination of the two have changed my life, and I can eat what I want again. I still have the off day of course, but nowhere near what I used to deal with.

Jan

July 29th, 2009
6:01 pm

I’ve had IBS for 20 plus years. Stress and anxiety made it worse. I tried everything – diet, exercise, probiotics. My doctor put me on Cymbalta. It has worked wonders for me.

Peg Johnson

July 29th, 2009
6:08 pm

I have had IBS constipation type for many years. I have been to many Gastro Doctors, they tell me to take laxatives. They also have told me that I will always be very bloated. They have also given me every test possible.

Lisa K.

July 31st, 2009
9:39 am

i have had ibs for many years. combo of diarreah & constipation.my gastro dr. suggested ‘MIRALAX” AND IT HAS WORKED MIRACLES!! BEST OF COURSE FOR CONSTIPATION. I REALLY BELIEVE IT IS THE “MIRACLE DRUG” FOR ME. ASK YOUR DOCTOR! I ACTUALLY TAKE IT EVERY DAY, BUT SOMEONE ELSE MIGHT ONLY NEED IT OCCASSIONALLY.

Lisa K.

July 31st, 2009
9:44 am

I JUST MADE A COMMENT ABOVE THIS, BUT I FORGOT TO ADD I ALSO DRINK A LOT OF WATER AND WALK!!
GOOD LUCK. I ALSO HAVE ACID REFLUX AND TAKE ACIPHEX.
I ALSO NEEDED SOMETHING TO HELP RELAX MY TENSE STOMACH MUSCLES AND IT TAKE THE EQUIVELENT TO LEVSIN SL (CANT REMEMBER THE EXACT NAME). THAT HELPS TOO. I ONLY TAKE IT BEFORE I GO TO BED BUT IT SAYS I CAN TAKE IT UP TO 4 X DAY. NEED A GOOD GASTRO DOCTOR – GO SEE DR. DAVID FISHKIN IN MARTINSBURG, WEST VIRGINIA. HE REALLY CARES ABOUT HIS PATIENTS.

Dee

July 31st, 2009
11:22 am

I have had IBS all my life (45yrs) and it stinks, literally. The bloating is the worst. I have had 2 bowel obstructions and what my drs call a nervous stomach. I know it for IBS, but the bloating is bad. I too had the eat more fiber talk and I tell ya it doesn’t work. I must have the IBS-D. A friend suggested taking colestid and I tell you it worked great for a couple of years. It is a med for colesterol but the side effect is it slows down your intestines. I would eat and not be half way through and have to go and then when we were done, go again. That stopped completely. I think my problem now is due to the surgeries. Has anyone else out there had this problem? One of my biggest fears now is that colon cancer runs in the family (Dad and granddad plus a couple of uncles) so I don’t have a good outlook. Also my mom passed away from ulcerative colitis, she perforated and bled to death. nt a good outlook.

Michel Beaudestin Perry

August 3rd, 2009
2:44 pm

I would like to congratulate Dr. Christie for such a balanced 1½ page article covering almost every symptom and treatment I have had for the last 20 years. I hope you can transmit my comments to her?
I have always known that there is a link in my IBS (which has been a combination of constipation, diarrhea and psychological depression due to some life dilemmas difficult to resolve. These dilemmas were causing me a lot of anxiety as wellas depression, which made me susceptible to IBS. All of these are different-anxiety leads to worry which leads to fear or flight pschological syndrome, which leads to a partial resolution of the dilemma, leaving you depressed and suffering from IBS. I had to get different treatments for each of these conditions from a gastroenterologist and a psychatrist. I also had to resolve the life’s problem dilemmas. Now at the age of 66, very soon 67, I have all these dilemmas resolved and all of the symptoms under control, but addicted to two antidepressers, one anti-anxiety medication, one IBS medication, two medications for diabetes, and one medication for lowering the bad cholesterol, one medication to control arthritis, a strict diet regime and a strict exercise regime, but surviving with an mysterious smile. As my gastroenterologist said 19 years ago, “your colon is your colon, we can give all we can, but we can’t give you another colon” Any sufferer from IBS wishing to get in touch me for guidance can do so by writing to: mbeaudestin@gmail.com

Chris B

August 4th, 2009
12:26 pm

In October 2008, I had a revision to my gastric bypass, which shorted the intestines even further from my stomach to my colon…very similar to short gut. Since then I have had horrible diarrhea. My bariatric surgeon has had no other patients with my symptoms. In April, I had a colonoscopy to rule out anything (everything okay). GI doc treating me as if I have IBS, but not officially diagnosed with it. No celiac disease. First we tried Imodium (8 pills a day–didn’t work), then Questran (didn’t work) and am now on nortryptoline (helps me sleep, but doesn’t seem to be slowing things down). I have diarrhea between 8-9 times a day…very violent, runny, smelly. Also very smelly gas…usually take Gas X but will try Beano based on above suggestion. Good news is that I’ve lost 70 lbs, but the side effects from the diarrhea—hemmoroids, anal fissures, just generally uncomfortable have been awful. I’m in the bathtub as hot as I can stand it, 3-4 times a day. Ughh.

[...] DOCTOR IS IN: Understanding Irritable Bowel Syndrome | Better Health [...]

tracy

August 31st, 2009
5:55 pm

i was wondering if anyone has ever tried probiotics. i take them everyday and do not have my problem anymore, as soon as i stop taking them for a week it flare’s back up so i just keep taking them and no more ibs.

Janet M

March 31st, 2010
2:47 pm

After over 20 years of suffering with autoimmune problems and Irritable Bowel Syndrome, I was finally diagnosed with Celiac disease a couple of years ago. The long-term damage to my system was so pronounced that I have also developed allergies to casein and nuts. Needless to say, I’ve been desperate to find something that will help me “normalize” my system (to the greatest extent it can be), and cleanse it as well.

The Dr Max Powers 15 Day Cleanse was EXACTLY what I was looking for. Excellent, effective, and allergen-free. Two-a-day along with an allergen-free diet and my IBS is a thing of the past. Best of all–no prescription medication needed now! The price is pretty great, too.