As part of our daily existence, we occasionally feel abdominal discomfort. We all know the feeling: a feeling of general abdominal discomfort, bloating that can make you feel very nauseated, bothersome and embarrassing flatulence, and perhaps a need to have bowel movement at an uncharacteristic time. We pass it off as the food we had last night, perhaps a minor stomach bug, or some interpersonal stress. Usually, the symptoms resolve on their own, and occasionally it may require some over the counter medication. But nonetheless, we only live with the symptoms for a short time. However, sometimes these symptoms can persist for weeks or even months, and you may be told you have irritable bowel syndrome or IBS.
What is irritable bowel syndrome? There is no good answer for it. It is a syndrome that is defined by having chronic abdominal pain and changes in bowel habits without any identifiable cause. It is extremely common and is estimated that 30% of patients who see a gastroenterologist evaluated for these symptoms. There are many proposed reasons for why these symptoms occur. Problems with natural muscular movement of the gastrointestinal tract, a hyper-stimulated state in the gastrointestinal nerves, altered microbial populations in the intestines, imbalanced inflammatory responses in the gut, food sensitivities, and genetic risk factors are all thought to play a role in the development of IBS.
Though we may not know where the disorder comes from, we aim to treat the symptoms so that patients can enjoy their life as best as possible. IBS can sometimes be distinguished as being predominantly constipating, predominantly affected with diarrhea, or a mixed pattern. Dietary approaches to IBS include food journaling to be able to identify if symptoms arise after eating certain foods, exclusion of foods that promote gas formation (beans, onions, bananas, carrots, raisins), avoidance of stimulating beverages such as caffeine and alcohol, and lactose avoidance. Specific dietary recommendations can be made by your physician or a trained nutritionist.
For patients who suffer predominantly from IBS with constipation, increasing water and fiber intake can help symptoms. Soluble fiber, such as the kind bought at your local pharmacy, can be tried. If these interventions fail, your physician may be able to recommend prescription medication to help with symptoms. If predominantly affected with the diarrhea IBS variant, a trial of anti-diarrheal medication can be attempted. If symptoms are not successfully managed with over-the-counter medications such as loperamide (Imodium®), your physician may be able to prescribe something stronger. Other medications, such dicyclomine (Bentyl®) may be prescribed by your physician to help relieve the abdominal spasming sometimes seen with IBS. If your symptoms are not managed well with over-the-counter medications or with prescription medications, your physician may refer you to see a gastroenterologist for further care.
IBS is not life-threatening, but it certainly can be challenging and make your day uncomfortable. However, with proper management, the symptoms can be managed, and you can get back to living your life in a comfortable manner. Please speak with your physician should you have any further questions or concerns regarding IBS.
Dr. Whitt is a resident physician who sees patients of all ages and provides obstetrical services at Lone Star Family Health Center, a non-profit 501©3 Federally Qualified Health Center operating facilities in Conroe, Spring, Willis, Grangerland, and Huntsville, and serving as home to a fully integrated Family Medicine Residency Program to increase the number of Family Medicine physicians for Texas and our community.