What Is Irritable Bowel Syndrome?
“Irritable bowel syndrome is a sensitivity of your digestive tract to food or stress. It’s the most common reason why people see gastroenterologists,” says Dawn Sears, MD, Gastroenterologist.
According to the National Institutes of Health, it affects as many as 20 percent of the U.S. population. IBS is more common in women than in men.
“Often patients will come in saying their bowels are never regular. They may have three bowel movements one day and be very distressed by that, and then not have another bowel movement for three days,” says Dr. Sears.
“Know that you can control your irritable bowel; it doesn’t need to control you.”
Other symptoms of irritable bowel syndrome include:
- Bloating, primarily in the afternoon
- The urge to have a bowel movement, but afterward you don’t feel fully emptied
“With irritable bowel, your colon can spasm so hard that it keeps things in there longer than they should so that it’s really a hard bowel movement,” Dr. Sears explains, “or it can squeeze it so hard that things zip through very fast before it’s had time for the water to be removed from it and it comes out as urgent, watery diarrhea.”
What Causes Irritable Bowel Syndrome?
There are two primary causes of IBS:
- Improperly digested and absorbed food
Your gastroenterologist will work with you to help you determine whether it’s stress or something in your diet — or both — that’s causing your irritable bowel syndrome.
IBS and Diet
Your gastroenterologist will first help you identify whether it’s an undigested food that’s causing your IBS.
Lactose. “One of the primary therapies is to go lactose free for several weeks. Often when patients do that, the bloating, diarrhea and constipation go away,” says Dr. Sears.
Avoiding lactose means eliminating these food products from your diet:
- Milk, butter and yogurt
- Cheese and cream cheese
- Ice cream
- Cream-based salad dressings, such as Ranch dressing
- Alfredo-type sauces
- Cream of mushroom-type soups in casseroles
Acidic foods. Eliminate tomatoes and citrus, salsa, tomato sauces and ketchup and check for symptoms.
Artificial sweeteners. Eliminate Splenda, NutraSweet, sucralose and note any differences.
Dietary log. If there’s still no improvement, Dr. Sears says you’ll begin a dietary log, noting everything you eat and drink, followed by your symptoms two to three hours later. “You’ll often find out you’re sensitive to something else that’s sneaking into your diet,” Dr. Sears says.
IBS and Stress
Generally, Dr. Sears says, irritable bowel syndrome affects the person who carries the major burden of stress. In most U.S. households, “women wear the weight of the world on their shoulders, so it’s predominantly women who experience it,” says Dr. Sears.
“There’s a huge connection between your brain and your bowel. Your serotonin receptors — which are mood stabilizers and happiness receptors — are hundreds of times denser in your bowel than in your brain,” Dr. Sears explains. Your bowel can indeed respond to the stress in your life.
How Do You Control Irritable Bowel Syndrome?
There’s no way to prevent IBS, but you can control it, Dr. Sears says.
“Know that you can control your irritable bowel; it doesn’t need to control you. Dive into really exploring the factors that trigger it and avoiding those factors,” Dr. Sears suggests.
To further help manage your IBS, Dr. Sears recommends:
- Exercise regularly, which helps regularize your bowels
- Drink lots of water to keep your bowels regular
- Keep something going through your colon all the time — eat small amounts of food frequently rather than large meals
- Have simethicone or Gas-X with you all the time — avoiding gas build-up
- Avoid carbonated beverages, chewing gum and drinking through straws — which are ways you swallow more air
In some cases, you may need a medication to help control your IBS. Dr. Sears says anti-spasmodic medications may be taken as needed or long term to help prevent spasms in the bowel. Narcotics, Dr. Sears says, worsen IBS symptoms and should be avoided.
Dr. Sears: “This is a real diagnosis. It’s not all in your head. Once you’re diagnosed with irritable bowel, you don’t need to keep searching for another diagnosis or trying a gluten free diet or chasing rabbits. This is a real thing, and it’s extraordinarily common. Just work on avoiding those triggers.”