Ten Steps to an Improved Quality of Life with Irritable Bowel Syndrome

2012-04-17 10:23
The Essential IBS Book, Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) affects almost 20% of the population, many of who struggle to enjoy the basic pleasures of life due to their symptoms. Although there isn’t a cure for the condition, there are several steps you can take to improve your personal quality of life.

IBS is a disorder that leads to abdominal pain and cramping, changes in bowel movements (diarrhea and constipation), and other symptoms. But unfortunately, there is no anatomical or biochemical abnormality to explain the symptoms and no two patients are exactly alike. However, there does seem to be some common factors which, when modified, can help relief the discomfort.

Dr. Alvin Newman MD FRCPC FACP FACG, an adjunct professor of Medicine at the University of Toronto, offers some wise advice in “The Essential IBS Book: Understanding and Managing Irritable Bowel Syndrome and Functional Dyspepsia.”

1. Take control of your own case.
Because no two patients are alike, it may take some detective work to find out the best treatments for your own case. But the first step is to understand that you have the ability to take control of your disorder rather than your disorder taking control of you. There will be times of discomfort with IBS, but recognize that things will get better if you take the time to understand your disorder and take steps to improve the things you can change while accepting the things you can’t.

2. Become an un-patient
A caring relationship between you and your doctor is critical, so find one that will empathize with your condition and work with you to take the steps to improve it. But don’t depend upon your doctor to do it all. An “un-patient” or “non-patient” is one who accepts his or her part in the treatment plan. Your doctor will take care of your pharmaceutical needs, should there be any, but you should ensure that you work on nonpharmaceutical lifestyle changes as well.

3. Eliminate, reduce or avoid aggravating foods as recommended by a dietitian
Dietary changes can be helpful for IBS patients, but again realize that no one specific diet is recommended because no two cases are alike. It may be helpful to keep a diet journal to identify those foods that aggravate your IBS. However, there are some foods that tend to be more irritating such as caffeine, lactose-containing dairy foods (milk, cheese), fructose-containing foods (ex: high fructose corn syrup), and saturated fats. Avoiding larger meals and instead eating more frequent smaller meals may also help. Once you find a diet that works for you, stick with the plan.

4. Take medications as prescribed by your doctor.
Some of the types of medications that may be prescribed are antidiarrheals (Lomotil, Immodium), laxatives (Miralax, Senna), antispasmodics (Bentylol, Buscopan, tranquilizers (Valium, Xanax), and antidepressants. The last two are used for two purposes. One, stress and anxiety can increase IBS symptoms so antianxiety/antidepressant medications may be helpful. Two, there is a small amount of serotonin, a neurotransmitter, in the gut and this is an area of investigation to ultimately find an underlying cause for IBS. Many antidepressants on the market today are SSRI’s or selective serotonin reuptake inhibitors.

5. Reduce stress in your life – at home and at work.
As mentioned, stress plays a role in the development of IBS. Research continues to better understand how hormones affect the bowel and how this can be treated. Until then, stress management techniques should be employed to help minimize symptoms. Exercise is a proven stress reliever, and it is recommended that IBS patients aim for 30 minutes of aerobic, strength, and stretching exercise at least three times a week. Yoga and meditation may also be helpful. Learning improved time management skills and ensuring that you take time out of each day for your self is also important.

6. Try not to somatize your symptoms into something more serious.
IBS can be a miserable situation, but it is not fatal. IBS is not colon cancer, celiac disease or Crohn’s disease. If you have been adequately tested for a more serious condition, and nothing is found, take comfort in the fact that your IBS is not causing permanent harm to your body.

7. Refuse narcotics.
Despite the pain you may be feeling, narcotics are not recommended for the treatment of IBS. Instead, try heat, relaxation, and time.

8. Avoid untested herbal remedies.
So far, there aren’t any vitamins or herbal therapies proven to be effective in the treatment of IBS. One exception may be Vitamin D, because milk – the most common source of the vitamin in the American diet – is often avoided by IBS patients, so many are deficient. Have your doctor test for a vitamin D deficiency before purchasing supplements. Probiotics may be helpful, but research is continuing.

9. Beware of excessive testing and screening procedures.
Yes, you should receive enough testing to ensure an accurate diagnosis of your condition. However, studies indicate that many patients needlessly exposed to considerable amounts of radiation for unnecessary tests. Have an open conversation with your doctor before agreeing to tests.

10. Be Positive.
Patients need to reach a point where they have a positive attitude toward their condition. Obviously, this is a gradual process and not every day will be sunshine and roses. But the goal should be to develop effective coping strategies to help you live your best, as-normal-as-possible life.

Note: The author was provided a copy of “The Essential IBS Book” from the publisher, Robert Rose Inc. at no cost for this review.

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Comments

Peppermint oil capsules have been repeatedly shown to help IBS pain, spasms, and urgency in both children and adults. There are numerous research studies on this available. Soluble fiber supplements have also been shown to be helpful for both IBS constipation and diarrhea. Again, these are not new studies, and I'm surprised the author is oblivious to these treatments. What is the source for this book's claim that people with IBS are more likely to be deficient in vitamin D? I have never seen any studies at all to support this, nor does it even sound likely.
Heather, I have not seen studies in regard to Vitamin D deficiency in IBS , but I was told by my own experienced MD approximately 2 years ago that he had recently attended continuing medical education that Vitamin D has a beneficial effect on pain metabolism. I was advised to supplement a borderline level on that basis. Of course, I don't know what my level was prior to first onset of IBS, and I don't know if it applies to IBSers in general. A few researchers I have asked in the context of my advocacy efforts were not able to answer my specific questions regarding this, but I continue to keep my eyes open for any information.
I was found to be severly vitamin d deficent and with only 2 doses of vitamin D I have been free of IBS-D and have my life back. I take 50,000 units once per week. I will have my blood tested in 3 months for adjustment of dose if necessary. I have been suffering for 10 years. Ironically I had a bone density and they found I had osteoporosis which triggered a vitamin D test. Google d and IBS you will learn much.
As an IBS advocate and patient this was an interesting review. I tried to find other reviews and search inside the book to see if I could get further insight. One take-away from this review is that while the physician can help to a degree, you are basically on your own for your full care and treatment. This was certainly my case, and that of many frustrated IBS patients I speak with. The message is clear from physicians (not all, but many) - be glad it isnt cancer and don't keep harboring on it which makes you worse. I have felt guilty that I did not have cancer, yet was suffering, sometimes what seemed to be longer and more severe than my friends who had cancer. I have written articles to that effect - My own gastroenterologist told me he could better deal with his colon cancer patients' pain than that of an IBS patient. He told me to research new treatments and get back to him on what I found. Well, at the time, in 2000, I found that clinical hypnotherapy was helpful as an adjunct to other treatment, and has shown excellent efficacy since studies beginning in 1984. This is what helped my condition and it has so many research studies behind it, I find it interesting that this is not mentioned - only in generalities such as 'relaxation' and avoid stress. In most cases, I believe that IBS pain and motility issues CAUSE the stress and anxiety cylce. And it has to be gut-specific clinical hypnotherapy to be fully effective. The hope in all this is that many times, this is the treatment that works after all else has failed and is used as a last resort. I used an audio program for IBS over the course of 100 days at home with email/phone support - I had such a severe case that I used it 3 times, and could not travel, but it helped break the brain-gut component so prevalent in IBS and addressed motility, urgency and pain issues as well. There is hope - and this program is recommended by gastroenterologists and used in the clinical setting.
I must support Marilyn's comments and suggestion. IBS IS the cause of stress not vice versa. Like research has shown we have a lot of "brain and nerves" in our gut. So the stress we feel is not like other stress... it is gut-centric and must therefore be addressed that way. I have been an "un-patient" for 10 years... and I have finally found a working relationship with IBS-D. Gut-specitic hypnotherapy helps a lot. Immodium taken in small doses before eating and after. Welchol, the cholesterol treatment drug, has also done wonders... Thank you for the book. It is kind and non-dismissive which a lot of gastro doctors still are about IBS.
This is not a very useful article at all.
This article is absolutely no help and provides false information. I suffered for 10 years and just found out I am vitamin D deficent. Have been on 50000 units of d once a week for 6 weeks and I am cured of IBsD . I do not know what the future holds or how long I will be on vitamin d but for now I have my life back. If you google vit d you see that this vitamin is a big part of several health issues.
Are you suggesting everyone with IBS would be treatable with vitamin D? I think your case might be isolated perhaps. For those that don't have a deficiency of the vitamin, the article could be useful. Just another opinion.