If you have IBS, you are at risk for having this syndrome as well
No one wants to talk about it. However, one out of every 6 individuals suffers from some form of Irritable Bowel Syndrome (IBS). Classically there is recurrent and debilitating abdominal pain, and change in bowel habits for at least 3 days per month. But did you know that there may be a direct connection between IBS and Fibromyalgia?
As a nurse, I have cared for many patients that have suffered in silence with IBS. They feel as though they are either complaining of constipation or diarrhea. Some poor souls have suffered from both symptoms intermittently. In addition, the many Fibromyalgia patients I have cared for often have IBS symptoms within their myriad of symptoms. From my experience it appears that there is no “quick fix” and no particular treatment that works consistently. It is very individual and can change throughout a person’s lifetime.
Just like trying to diagnose fibromyalgia, the diagnosis of IBS is usually made based on symptoms. There is no one test that can determine a finite diagnosis. Doctors however may try to exclude other diagnosis such as intestinal parasites, infections or lactose intolerance. Treatment usually consists of dietary modifications (increasing fiber and fluids), stress reduction and sometimes medications such as antidepressants and the medication Amitiza. These are often however only partially helpful and are often done in conjunction.
Do you have IBS?
If you have two or more of the following chances are you do.
- Pain with improvement with having a BM
- Changes in frequency of stool
- Changes in appearance of stool
- Straining, urgency or feeling of incomplete evacuation
- Passing mucus and increase in gas
Often there is loss of appetite, muscle aches and sometimes even headaches. Strange association here, I know.
Nervous system connection
Symptoms of IBS occur either because of abnormalities of intestinal motility or because of abnormalities of sensation. Sometimes it is both. In an individual without IBS, distention within the digestive system will trigger nerve fibers to transmit signals to the brain registering discomfort. In a person with IBS, the pain is perceived at a much lower level of distention. This is sometimes called hypersensitive gut.
It has been shown that IBS patients tend to have an increased incidence of psychological issues and have been exposed to more trauma (verbal, physical, emotional, sexual) than the non affected population. Interestingly enough this is true of Fibromyalgia patients as well. Along this thinking the same type of psychological treatments that target Fibro symptoms may work for IBS as well. They include counseling, guided imagery, breathe work, hypnotherapy and antidepressants.
Millions of individuals have at least one of these conditions – if not both. Fibromyalgia affects over 5 million adults in the United States, and an estimated 35 million in the U.S. have IBS. In addition if you have one diagnosis you are likely to have the other as well.
In one study, 32% of people with IBS also had fibro symptoms in comparison to only 4% without IBS. In addition, another study showed that Fibromyalgia occurred in 20 % of individuals with IBS.
Despite the obvious differences in these syndromes, what is the possible link is that it appears to be that those who have them respond differently to pain than other individuals. IBS patients are hypersensitive to gastrointestinal pain while fibromyalgia patients are hypersensitive to muscle and tactile pain. There appears to be a lowered threshold to pain sensation in general with both.
If the hypothesis of hypersensitivity and psychological connection is true, then common sense will tell you that anything that will balance serotonin levels and reduce stress may help. Also any treatments that focus on maintaining a healthy GI tract with help both IBS and Fibro
Eliminating sugars and reducing starches and grains can go a long way in both conditions. It will reduce inflammatory responses in the body and reduce the possibility of Candida over growth. Reducing processed foods and increasing fiber through minimally processed vegetables may help as well. As with any wellness plan, an increase in pure clean water helps as well.
St. John's wort
Also known as Hypericum perforatum is an herb that's been used to treat depression. It's not approved by the FDA to treat depression in the United States, however it's a popular treatment in Europe. Usual dose is 900mg a day. It can interfere with other medicines used to treat people with heart disease, seizures, cancer and organ transplant. Check with your doctor first. Research has shown however that St John’s Wort is more effective in treating depression and Fibro than IBS.
Pronounced "Sammy". It is the abbreviated name for S-adenosylmethionine. It's is also not approved by the FDA to treat depression in the United States and is classified as a dietary supplement. SAMe has however been shown to trigger mania in people with bipolar disorder.
Essential fatty acids
Omega-3 fatty acids are the basis of any healthy diet. Eating a diet rich in omega-3s or taking omega-3 supplements may help ease depression as well as quell fibro and IBS symptoms. These healthy fats are found in cold-water fish, flaxseed, flax oil, walnuts, eggs and some other nutritious foods.
Bifidobacteria and lactobacillus have both been shown to have beneficial effects on IBS as well as Fibromyalgia. This is because probiotics help heal “leaky gut syndrome” that causes many health conditions that include IBS and Fibro. It is caused by microscopic holes that develop in the intestinal wall and cause poisons to leak into the blood stream. The first step is following the diet suggested above. Then you can start to heal the intestinal tract with a good quality probiotic supplement.
Take Home Message
It is always good to eat healthy and reduce processed foods. Adding fish to your diet is also a positive move. Meditation, yoga and guided imagery can reduce stress and a plethora of ills.
Before making any changes to your medication or supplements speak to your healthcare provider first.
Lubrano, E. International Journal of Colorectal Disease, August 2001; vol 16: pp 211-215.
(O’Mahoney et al., 2005; Kim et al., 2003; Halpern et al., 1996)
Michael J. Pellegrino, MD, fibromyalgia expert, Ohio Pain and Rehab Specialists, North Canton, Ohio.