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Living With and Managing Your IBS
By Daniel Casciato

Irritable bowel syndrome (IBS) is a common bowel disorder of the large intestine. This condition makes the intestines contract faster and work harder, which can lead to some painful issues. While it is not known what exactly causes IBS, there are some possibilities as to how it may occur in some people.

"Sometimes the intestines have weaker contractions, which causes slow food passage and constipation," explains Susan Zikos, RD, LDN, CDE, Outpatient Dietian at Ohio Valley Hospital. 

Common symptoms of IBS include cramping, abdominal pain, gas, bloating, diarrhea and constipation.  Zikos says that most people can control these symptoms by watching their diet, managing stress, exercising and making positive lifestyle changes. 

"You should tell your doctor about the symptoms because you may benefit from additional counseling or medications to alleviate some of the symptoms," she says.

If you have IBS, pay close attention to your body and the triggers which can cause symptoms. Common triggers include:

  • Foods. Some people have more severe symptoms when they eat certain things. A wide range of foods has been implicated including chocolate, spices, fats, fruits, beans, cabbage, cauliflower, broccoli, milk, carbonated beverages and alcohol.
  • Stress. Most people with IBS find their signs and symptoms are worse or more frequent during times of increased stress, such as finals week or the first weeks on a new job. Keep in mind; while stress may aggravate symptoms, it doesn't cause them.
  • Hormones. Hormonal changes, particularly among women, play a role in IBS. 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.

When someone comes in for IBS counseling, Zikos first asks about their medical history, because IBS can be aggravated by certain medical conditions.

"Then I get an in depth diet history, including any foods that they do not eat, or have had problems with," she says. "Many times people have eliminated foods, especially milk, from their diet without realizing why." 

For instance, if there is a lactose intolerance, having a large amount milk, ice cream or other dairy product can cause an stomach upset.  By using a lactase product instead, these symptoms can be controlled. Zikos pays particular attention to the amount of fiber in a person's diet. Fiber plays a role in preventing diarrhea and constipation. However, it has to be increased gradually to prevent further bloating and gas.

"The best sources of fiber are natural; fruits and vegetables, whole grains, beans and legumes," she adds. "Some people prefer a fiber product, like Metamucil or Citrucel, which may cause less gas and bloating. Any of these may help prevent the symptoms of IBS. We also discuss their everyday life, to see if there are stressors which produce symptoms.  We further discuss the role of exercise in stress relief and stimulate the normal contractions of the intestines."

By thoroughly discussing symptoms, their timing, foods consumed before the symptoms started, stresses the person has been under, and illness, Zikos says that sometimes the symptoms of IBS can be controlled.

There are some probiotics that may also be good for people with IBS, including yogurt with active cultures. Zikos cautions that some IBS symptoms are caused by lactose intolerance, so in those cases, adding extra milk products to your diet will not help.

"In many cases, simple changes in your diet and lifestyle can provide relief from irritable bowel syndrome," she says. "Although your body may not respond immediately to these changes, your goal is to find long-term, not temporary, solutions." 

These additional suggestions from the Academy of Nutrition and Dietetics and the Mayo Clinic may help:

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.

Exercise regularly. Exercise helps relieve depression and stress, stimulates normal contractions of your intestines, and can help you feel better about yourself. If you've been inactive, start slowly and gradually increase the amount of time you exercise. If you have other medical problems, check with your doctor before starting an exercise program.

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. 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.

A healthy diet is important for everyone, but even more so for someone with IBS. Food may not be easily digested and absorbed, so that makes it more important to eat healthy foods whenever you can. 

"Drink at least 8 cups of fluids each day, because fluids may be lost with loose stools," says Zikos.  "A multivitamin may be needed, as well as calcium and Vitamin D supplements, if dairy products are limited.  Start new foods one at a time, in small amounts, to test tolerances.  Eating small meals every 3 to 4 hours may also help during bouts of IBS."

For more information, visit www.ohiovalleyhospital.org.

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