Irritable Bowel Syndrome

Up to 20% of the U.S. population suffers with Irritable Bowel Syndrome, including a large number of my patients.
Irritable bowel syndrome (IBS) is characterized by abdominal pain and altered bowel habits. The altered bowel habits include diarrhea and/or constipation — sometimes alternating. Also commonly present are abdominal pain and distention, as well as bloating, gas, and mucous in the stool.

For most people, IBS is a chronic condition, although there will likely be times when the signs and symptoms are worse and times when they improve or even disappear completely.
It's not known exactly what causes irritable bowel syndrome, but a variety of factors play a role. The walls of the intestines are lined with layers of muscle that contract and relax in a coordinated rhythm as they move food from your stomach through your intestinal tract to your rectum. If you have irritable bowel syndrome, the contractions may be stronger and last longer than normal, causing gas, bloating and diarrhea. Or the opposite may occur, with weak intestinal contractions slowing food passage and leading to hard, dry stools.
Episodes of IBS can be triggered by a number of factors. Although these triggers vary from person to person, common ones include:
• Foods. Many people have more severe symptoms when they eat certain things. A wide range of foods has been implicated, including: chocolate, alcohol, caffeinated beverages such as coffee and tea, sodas, dairy products, sugar-free sweeteners such as sorbitol or mannitol, spices, fats, fruits, beans, cabbage, cauliflower, and broccoli.
• Stress. Most people with IBS find that their signs and symptoms are worse or more frequent during periods of increased stress, such as finals week, the first weeks on a new job, or perhaps family issues and conflicts. It should be noted, however, that while stress may aggravate symptoms, it doesn't cause them.
• Hormones. Because women are twice as likely to have IBS, researchers believe that hormonal changes play a role in this condition. Many women find that signs and symptoms are worse during or around their menstrual periods.
• Other illnesses. Sometimes another illness, such as an acute episode of infectious diarrhea (gastroenteritis) or too many bacteria in the intestines (bacterial overgrowth), can trigger IBS.
If you suffer with IBS, here are some things you can try:
• Acupuncture. This has been very useful for a number of my patients, especially when combined with Osteopathic manipulation. Current research has proven that acupuncture helps improve symptoms for people with IBS.

• Experiment with fiber. When you have irritable bowel syndrome, fiber can be a mixed blessing. Although it helps reduce constipation, it can also make gas and cramping worse. The best approach is to slowly increase the amount of fiber in your diet over a period of weeks. Examples of foods that contain fiber are whole grains, fruits, vegetables and beans.
Some people do better limiting dietary fiber and instead take a fiber supplement that causes less gas and bloating. If you take a fiber supplement, such as Metamucil or Citrucel, be sure to introduce it slowly and drink plenty of water every day to reduce gas, bloating and constipation. If you find that taking fiber helps your IBS, use it on a regular basis for best results.

• Avoid problem foods. If certain foods make your signs and symptoms worse, don't eat them. (Refer to the list above for common offenders.) If gas is a problem for you, the specific foods that often make symptoms worse include beans, cabbage, cauliflower and broccoli. Fatty foods also may be a problem for some people. Chewing gum or drinking through a straw can lead to swallowing air, causing more gas.

• Eat at regular times. Don't skip meals, and try to eat about the same time each day to help regulate bowel function. If you have diarrhea, you may find that eating small, frequent meals makes you feel better. But if you're constipated, eating larger amounts of high-fiber foods may help move food through your intestines.

• Try Probiotics. Probiotics are "good" bacteria that normally live in your intestines and are found in certain foods, such as yogurt, and in dietary supplements. Adding probiotics to your diet may help ease your symptoms, such as abdominal pain, bloating, and diarrhea.

• Take care with dairy products. If you're lactose intolerant, try substituting yogurt for milk. Or use an enzyme product to help break down lactose. Consuming small amounts of milk products or combining them with other foods also may help. In some cases, though, you may need to stop eating dairy foods completely. If so, be sure to get enough protein, calcium and B vitamins from other sources.

• Drink plenty of liquids. Try to drink plenty of fluids every day. Water is best. Limit alcohol and beverages that contain caffeine, as these can stimulate your intestines and worsen diarrhea. Carbonated drinks can produce gas.

• Exercise regularly. Core strengthening, walking, and yoga can all help to stimulate normal contractions of your intestines, as well as helping to relieve stress.

• Use anti-diarrheal medications and laxatives with caution. If you try over-the-counter anti-diarrheal medications, such as Imodium or Kaopectate, use the lowest dose that helps. Imodium may be helpful if taken 20 to 30 minutes before eating, especially if you know that the food planned for your meal is likely to cause diarrhea. Use these as infrequently as possible-in the long run, these medications can cause problems if you don't use them correctly. The same is true of laxatives. If you have any questions about them, check with your doctor or pharmacist.
For most people, IBS will present a long term challenge, but it can almost always be controlled with some combination of the above strategies!

About the Author

Dr. Teitelbaum practices Osteopathic manipulation, prolotherapy, spinal decompression, acupuncture, and Chinese herbal medicine in the Dallas/Ft. Worth metroplex. For over 25 years, he has provided conservative, natural treatment for sports injuries, back pain, neck pain, headaches, posture problems, overuse injuries, and joint pain. Commonly treated conditions include muscle, tendon and ligament damage of the neck, low back, tailbone, shoulder, elbow, wrist, hand, hip, knee, ankle and foot.