Irritable bowel syndrome (IBS) is one of the most common gastrointestinal illnesses known. With the usual onset in the teens or twenties, it continues to worsen with age in many individuals, frequently leading to significant alterations in social and working lives. The exact cause of this syndrome is not known although there are numerous theories. What seen certain though, is that once IBS develops, it is worsened by a multitude of other factors, including digestive disturbances. Indeed, most patients are aware of specific foods that seem to aggravate their condition.
In addition, because a sub conscious control exists between the mind and colon, certain individuals may have significant bowel symptoms even with normal psychological stress, initiating a cycle in which stress may eventually seem to be the major source of symptoms. Fortunately, only a small minority of patients with IBS manifest any true psychiatric disorder. In fact, studies indicate that many (or most) persons who manifest IBS suffer from an inherited disorder of bowel function, in which the normal nervous control of the colon is somehow indirectly connected with specific emotions causing the bowel related symptoms when these emotions are displayed. These emotions especially include anger and anxiety.
Therefore, IBS can be seen as a disorder of unknown cause, markedly altered by physical and emotional stress, even at levels that would not adversely affect individuals without IBS. In addition, other factors such as foods, medications and other agents additionally aggravate some patients.
The classic symptoms of IBS include:
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Abdominal distention (bloating) |
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Pain relief with bowel movement |
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Mucus in stool |
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Looser stools at onset of pain |
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More frequent stools at pain onset |
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Sensation of incomplete emptying of colon after bowel movement |
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Further symptoms include alternating diarrhea and constipation, pencil-thin or pellet-sized stools, immediate need to have a bowel movement during or within 30 minutes of eating |
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Night pain that awakens the subject from sleep |
IBS treatment is based on the understanding that this syndrome is a medical disorder that has a psychologic component that may be associated with anxiety/pain disorders. Stress, even normal amounts, can cause these marked physical alterations that are often seen by the subject as "loosing control" of ones own bodily functions, thoughts, etc. In addition, digestive disorders can further modify the severity of anxiety and panic disorders. Other than prescription medications, the following guidelines may be followed in an attempt to determine what effect, if any, exists between specific foods and IBS.
Avoid:
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Coffee/tea - caffeine stimulates the GI tract |
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Milk products - many people have intolerance to milk sugar (lactose intolerance) |
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Sorbitol - an artificial sweetener added to diet products |
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Fructose or "fruit sugar" - this includes fresh fruit or fructose added to sweeten pastries, etc. |
In select patients, the above listed avoidance measures may improve symptoms. If no improvement is seen within 2 weeks, it is unlikely that these substances contribute to their problem and continued avoidance is unnecessary. If initial improvement is noted, the potentially offending substance should be re-introduced into the diet again, to assure you that the initial relief was not coincidental.
A combination of dietary precautions and specific recommendations designed to reduce stress (even "normal" amounts) seems to be the best approach for long-term improvement.
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