Irritable Bowel Syndrome
Irritable Bowel Syndrome
Pacify Digestive Turmoil
Sometimes it's called the angry gut. That's because if you have irritable bowel syndrome (IBS), your insides often stir up a fuss. Your digestive tract roils, rumbles and rolls out gas. You may suffer from frequent diarrhea, diarrhea alternating with constipation or just constipation. Usually, you have abdominal pain. And it's also likely that you'll experience flatulence and bloating.
An irritable bowel episode can ruin your day, keeping you in the bathroom when you would rather be out and about or when you have an important meeting to attend. In fact, an irritable bowel can make you an expert on where to find all the public bathrooms in town.
IBS tends to be a chronic, long-lasting problem. No one knows what causes it, though diet and stress are known to aggravate symptoms.
SOOTHING THE RUMBLES
Thankfully, women doctors say that making some simple changes in your diet and daily habits may help you turn your angry gut into a laid-back bowel.
Use laxatives sparingly. If you wake up with painful constipation or diarrhea, and you're about to get on a plane or attend an important event, it's okay to take a chemically based laxative or anti-diarrheal medication, says Ernestine Hambrick, M.D., a colon and rectal surgeon at Michael Reese Hospital in Chicago. Just don't make it a habit.
"You end up with a yo-yo effect that doesn't touch the underlying syndrome," says Dr. Hambrick. You'll go from constipation to diarrhea and back and perhaps even develop a lazy colon that no longer works on its own.
For long-term relief, you're better off relying on natural solutions, say women doctors.
What Women Doctors Do
More Fiber, Slowly but Surely
Dietary fiber, say women doctors, plays a big role in the relief of irritable bowel syndrome (IBS). Jacqueline Wolf, M.D., a gastroenterologist, assistant professor of medicine at Harvard Medical School and co-director of the Inflammatory Bowel Disease Center at Brigham and Women's Hospital in Boston, and the nutritionists at the center, offer these suggestions.
* Increase your intake of dietary fiber slowly to allow your body adequate time to adjust. Start with 8 grams a day (the amount in one-third cup of Bran Buds cereal or two pears) and increase your intake by 3 to 4 grams a day until you reach 30 grams daily.
* If you experience excessive gas, bloating or diarrhea, add fiber more slowly (two grams a day instead of four).
* Eat fiber-rich foods before trying supplements, which are more expensive than food.
* Choose fresh rather than canned fruits and vegetables whenever you can.
* Sprinkle bran over hot and cold cereals, applesauce and yogurt.
* Toss in bran when you're cooking meat loaf.
* Add bran when baking homemade bread or buy 100 percent whole-grain breads.
* Plan meals around legumes, such as pinto or lima beans, instead of meat.
* Snack on high-fiber cereals and nuts instead of sugary sweets.
* Drink at least eight eight-ounce glasses of water daily to help form softer, bulkier stools.
Irritable Bowel Syndrome
Eat a lot of fiber. Fiber is key to stabilizing IBS, because it bulks up and softens stool, helping your irritable bowel become regular, says Ann Ouyang, M.B., B.S. (the British equivalent of an M.D.), professor of medicine and chief of the Division of Gastroenterology at the Milton S. Hershey Medical Center of the Pennsylvania State University College of Medicine in Hershey. So if you're constipated, fiber will help you go more often, and if you have diarrhea, it helps make the bowel movements more solid.
A sample day's worth of fiber might include a bran-based cereal for breakfast, a sandwich on whole-wheat bread for lunch, and a baked potato, a half-cup of peas and a cup of strawberries for dinner, says
Jacqueline Wolf, M.D., a gastroenterologist, assistant professor of medicine at Harvard Medical School and co-director of the Inflammatory Bowel Disease Center at Brigham and Women's Hospital in Boston.
When To See A Doctor
Like clockwork, you have always gone once a day. Gradually, you pass stool only every three days. Or vice versa. Or you have alternating constipation and diarrhea. These changes, or any other changes in bowel movements, especially when accompanied by abdominal pain aggravated in stressful situations and relieved by passing stools, are the cardinal signs of irritable bowel syndrome, says Ann Ouyang, M.B., B.S. (the British equivalent of an M.D.), professor of medicine and chief of the Division of Gastroenterology at the Milton S. Hershey Medical Center of the Pennsylvania State University College of Medicine in Hershey.
Other symptoms may indicate a more serious condition. See your doctor if you have:
* Blood in your stool
* Unexplained weight loss
* Diarrhea that causes you to wake up at night
* Constipation, diarrhea, abdominal pain or any combination of the three so severe that you can't work for several days or engage in social activities
Sample a supplement. The downside of fiber-filled foods is that while you're incorporating them into your diet, they can make you feel really bloated and gassy. If you're not used to a lot of fiber, women doctors suggest that you try a natural fiber supplement, such as Fibercon, Metamucil or Citrucel. Of these, Citrucel usually leads to the least gas formation, says Dr. Hambrick.
Supplements soften hard, dry stools and bulk up watery, loose stools, so they are effective whether your chief complaint is constipation or diarrhea.
Supplements are available in supermarkets and drugstores in granular or wafer form, so you can choose the type most palatable to you. They all require drinking extra fluid throughout the day, however, for them to function properly. A good way to do this is to drink something every other hour, suggests Dr. Hambrick.
Pick up some pectin. Pectin, another source of high fiber, is found in fruits such as papayas, oranges and grapefruit or in apple pectin--a granular natural supplement found in most health food stores, says Dr. Wolf. You can sprinkle apple pectin on your food or dissolve it in liquid.
Order water--and make it a double. "Water helps food move through your system smoothly and bulks up your stool," says Dr. Wolf. Try to down six to eight eight-ounce glasses a day.
Decaffeinate your life. "Caffeine is a major bowel stimulant; it makes material move through the bowel too soon," says Dr. Hambrick. But just cutting out coffee isn't enough. Chocolate, tea and soda also contain caffeine, so eliminate them from your diet, too.
Keep a diet diary. If you can't figure out what specific foods bother you, keep a diary to track your symptoms. One caveat: "The food that you just ate might not be causing your symptoms," says Dr Wolf. Delayed reactions to certain foods may kick in hours after you eat, so even a diary isn't foolproof. But it can provide useful clues.
Steer clear of wheat and dairy products. Many people with IBS are sensitive to wheat as well as milk and milk products, says Dr. Wolf. If you have this sensitivity and eat prepared foods, you may not realize that wheat or dairy products are among the ingredients unless you read the label. So read before you ingest. (For practical ways to cope with lactose intolerance, which can contribute to IBS, see page 336.)
Eat at home. For some, dining out is often a culprit regardless of what they eat, says Sheila Crowe, M.D., gastroenterologist and assistant professor of medicine in the Department of Internal Medicine in the Division of Gastroenterology at the University of Texas Medical Branch at Galveston. Even in the nicest, cleanest restaurants, people with IBS sometimes find that a lovely meal leads to problems. The reaction may be caused by rich or spicy foods or food additives.
Shake your bootie. "Exercise contributes mightily to the normal function of the colon; it moves things along," says Dr. Hambrick. Do whatever you like--swim, run, walk--any kind of aerobic exercise, at least three times a week, and four or five times if you can.
De-stress. Stress aggravates the symptoms of IBS. To calm down your colon, try to find a relaxation method that works for you, whether it's listening to a relaxation tape, meditating, or just taking time for yourself, says Robyn Karlstadt, M.D., a gastroenterologist at Graduate Hospital in Philadelphia. "Unplug yourself for 20 minutes a day."
One hint: Be a realist, Dr. Karlstadt says. Maybe you can't take time out when the kids get home from school. But what about while they're upstairs doing their homework? Think through all your options.