Irritable Bowel Syndrome (IBS)

by Michael Safdi, M.D., FACP, FACG of Cincinnati, OH

Do You Have IBS?

Irritable Bowel Syndrome (IBS) is a common problem. It affects over 40 million Americans. Although people under stress over long periods of time may be more likely to seek medical attention, IBS clearly is found among men and women of all ages and from all occupations. IBS usually begins before the age of 40 and become a chronic problem. The symtoms vary greatly in quality, frequency and intensity. IBS can interfere with your lifestyle, but will not require surgery, not lead to cancer no evolve into a life threatening problem.

Do You Feel Like This?

The primary symptoms of IBS include abdominal pain, diarrhea and constipation. Other common symptoms are indigestion, nausea, gas, and bloating. Generally speaking, the abdominal pain is in the lower abdomen and is characterized by a crampy feeling which comes and goes. It is often relieved by the passage of stool or gas. Diarrhea is usually associated with meals and frequently occurs early in the day. A strong sense of urgency may precede the passage of loose or watery stools. Constipation can be either the passage of small quantities of stool (often in small balls or narrow strands) or infrequent bowel movements (less than every third day). In many patients, diarrhea and constipation alternate. Gas can be characterize by a tight, bloated sensation, belching or excessive gas from the rectum. These symptoms are usually inter-mingles to varying extents so that every patient's symptoms are relatively unique to them. Unfortunately, the exact cause of this complex disease remains unknown.

How Serious is IBS?

Although IBS is not life threatening, your doctor plays a vital role in accurate diagnosis and subsequent treatment. This occaisionally requires referral to a specialist or intestinal disorders. Because of the complex nature of this disorder, your physician must get a thorough medical history including medications, other health problems, dietary habits, exercise patterns and home/work environments. The physical exam is occasionally very helpful in identifying painful areas. Almost everyone, particularly if a patient is older than 50, should have the lining of the rectum directly examined with a flexible lighted instrument called a sigmoidoscope on a regular basis. Sometimes an examination of the total colon (a colonoscopy or barium enema) is necessary. Anyone with blood in the stool definitely needs the most thorough of examinations such as a colonoscopy.

After performing these tests, your doctor can assure you with a great degree of certainty that you have no actual structural abnormaility, but that you do have a functional problem. The normal colon functions in a smooth orderly fashion to remove water and minerals from the watery waste coming from the small intestine, which has already digested the food and absorbed the nurtients. When the rhythm of the colon's orderly contractions is disrupted, either too much or too little fluid may be removed, leading to constipation or diarrhea, respectively. The colon has its own inborn basic rhythm, but it can be alerted by the nervous system. The brain can have a direct effect through the nervous system on bowel functions. It is crucial the patient understands that although IBS can have a dramatic effect on your lifestyle, it will not shorten your life or ruin your overall health. In our society, everyone is exposed to some stress. It is important to be able to handle this appropriately. Books, tapes or courses are available from the library or elsewhere to help with stress. Regular exercise will help your physical and emotional health. You should discuss the type of exercise with your doctor.

How Do You Get Rid of IBS?

The average American eats too much fat and only one-third the amount of fiber recommended by the National Cancer Institute. Fiber is a general term for food which is not absorbed into your system and which stays in the stool, thereby increasing the stool bulk.

High fiber foods include bran (unprocessed bran can be added to a great variety of foods and is inexpensive), fruits (grapes, oranges, plums, etc.), salads (spinach is best) and vegetables (broccoli, string beans, etc.). Foods high in protein and low in fat such as skinless chicken or turkey, fish, lean meat, skim milk or low fat cheese, are helpful and healthier. Many patients are aided by the regular ingestion of a supplement to increase stool bulk. Ideally, this should be low in sodium and sugar and have a least six grams of fiber per teaspoon. KONSYL® is the only bulking agent on the market meeting all of these criteria. Many physicians prescribe antispasmodics (drugs that decrease the intestinal muscle spasms). It is best to move your bowels when you feel the urge; in other words, try not to delay your bowel movement or strain to force your bowel movement.

REMEMBER, IBS is common, not life threatening and almost always controllable. While there is no cure, your doctor can help you "fine tune" the necessary changes in your diet and lifestyle to control or eliminate your IBS symptoms. Be sure to report any changes in your symptoms to your doctor.

NOTE: This information is provided in the interest of patient education by Konsyl Pharmaceuticals, Inc. Konsyl is available in all leading pharmacies without a prescription.