Irritable Bowel Syndrome

Irritable Bowel Syndrome

Maybe it was the innocent ingestion of the "wrong" food that started your colon kvetching. Or perhaps your bowel complaint got started with stress, and all the everyday irritants only make your bowels more irritable. Doctors don't know all the "whys" of irritable bowel syndrome (IBS). What they do know is that some people have more or less constant problems with constipation, diarrhea, bloating, heartburn and nausea, singly or in combination, usually accompanied by abdominal pain.

If this describes your misery, you have good company. Some doctors believe that IBS may be nearly as widespread as the common cold. But naturally, people don't mention IBS as much. Doctors suspect that many people suffer in silent embarrassment and don't even tell their own physicians.

The good news is that IBS is not fatal and doesn't lead to more serious medical complications. (If your symptoms are accompanied by bleeding, fever or weight loss, doctors warn that you may have something more serious than IBS.)

But if you do have IBS, or if you suspect you have it, you should definitely tell your doctor. And meanwhile, there are plenty of things you can do to take some of the irritability out of your bowels.

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 sorbitol," says Stephen B. Hanauer, M.D., professor of medicine in the Section of Gastroenterology at the University of Chicago Medical Center. That's because sugars, which are not easily digested, are a leading cause of the runs. His advice: Avoid candy and gum, which contain these sweeteners, and read food labels on other products.

Munch when you're mellow. 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 Arvey I. Rogers, M.D., chief of the Gastroenterology Section at the Veterans Administration Medical Center in Miami and professor of medicine at the University of Miami School of Medicine. By eating relaxed, you avoid swallowing air, which can aggravate abdominal pain and other IBS symptoms. And you provide time for digestive juices to start flowing before the food passes by.

Get a juicer. Most store-bought juices contain high amounts of sorbitol--especially fortified apple, peach, pear and prune juices, adds Dr. Rogers. Since fruit juices are an excellent source of nutrients, you can make your own--with reduced sorbitol content--by using a commercial juicer that can be bought at most department stores.

Minimize milk. Milk isn't much better for people with IBS, since many may have lactose intolerance, which can mimic IBS. If in doubt, eliminate dairy products for a while and see if your condition improves. Generally, however, limit dairy products whether or not you are lactose-intolerant (unless they are being relied upon as a major source of calcium).

Bulk up. Eating a high-fiber diet--between 35 and 50 grams daily, compared with the average 11 grams most Americans eat--is perhaps the best way of taking the irritability out of your bowels. "Fiber increases stool production and reduces pressure in the intestines, which is good for both constipation and diarrhea," says Dr. Hanauer. "It also allows for more regular bowel movements."

Since increased fiber usually causes more gas and can temporarily worsen symptoms, the slow and steady route is strongly recommended. "I advise my patients to start with 1/2 cup of oat or wheat bran high-fiber cereal (or three tablespoons of pure bran) every day at breakfast. I suggest they have a green leaf salad with lunch and dinner and plenty of fresh fruits and vegetables throughout the day," advises Alex Aslan, M.D., a gastroenterologist and staff physician at North Bay Medical Center in Fairfield, California. "Continue to slowly add the bran over a six-week period until you have 1 to 1 1/2 cups each morning, while having two salads and lots of fruits and vegetables." Adequate fluid intake is also very important.

Meditate. Even when you're not eating, controlling the stresses in your life is a key factor in controlling IBS. "Being under stress will definitely make IBS worse," says Dr. Hanauer. "And not being under stress can help." You may benefit from relaxation techniques such as meditation, self-hypnosis, biofeedback, regular exercise or even keeping a "stress diary" to determine what's causing you (and your bowels) grief.

But don't medicate. You won't help yourself by relying on medicines to control diarrhea, constipation or other gastrointestinal problems. "Laxatives and antidiarrhea medications should be used only on a short-term basis--if at all," says Dr. Hanauer. The exceptions: Natural psyllium-based laxatives such as Metamucil or Citrucel can be taken daily to boost your fiber, and they actually cause less gas than bran.

Give pain the "heat-ho." For the abdominal pain of IBS, nothing beats a heating pad. Turn it on low heat and rest it on the painful area. Another warm-up strategy: Take a warm bath, says Dr. Rogers.

Don't be a coffee achiever. Coffee and other caffeinated drinks play a significant role in IBS--and it's not a beneficial one. "For one thing, caffeine, even in very small amounts, stimulates motility. And that's bad news if you're prone to diarrhea," says Dr. Aslan. "Even if you're not, there's an unknown chemical in >coffee that can cause cramping." His advice: Either cut back or cut out coffee and limit intake of tea, chocolate, cola and other caffeinated substances.