Publisher: Natural Health
Irritable Bowel Syndrome (IBS) affects up to 20 percent of Americans. Herbs, supplements, nutrition, and hypnosis can get your insides back on track.
It's 2005, and we'll talk about anything. From fetishes to toenail fungus, maximum frankness pervades talk shows and chat rooms. Yet only about half of Americans with Irritable Bowel Syndrome (IBS) discuss their symptoms with their doctors, says gastroenterologist G. Richard Locke, M.D., professor of medicine at the Mayo Clinic College of Medicine in Rochester, Minn.
When they do, it's because the constipation, diarrhea, or pain has gotten so disruptive that it's affecting their ability to function on the job, dine out, or exercise.
"Some people don't find their IBS symptoms bothersome or unusual, and some may be a little shy about talking to a doctor about bowel problems," Locke says. These silent sufferers remain unaware there's a growing array of strategies to help them achieve inner peace.
Irritable Bowel Syndrome is a combination of symptoms that may consist of abdominal pain, cramps, bloating, flatulence, mucus in the stools, food intolerances, and constipation or diarrhea (often alternation between the two). The diagnostic criteria include having abdominal pain or discomfort for at least 12 weeks out of the previous 12 months, not necessarily consecutively. Generally, pain is relieved after a bowl movement: the frequency of bowl movements alters when pain or discomfort begins: and/or there are changes in the form or appearance of the stool.
"For most people, symptoms occur now and then, a couple of days a week or so," says Locke. "To meet the definition of IBS, you have to have the symptoms 25 percent [or more] of the time."
IBS isn't caused by structural or biochemical abnormalities. Instead, it appears to be a functional disorder stemming from a disturbance in the interaction between the digestive tract, the brain, and the autonomic nervous system. As a result, the motility of the colon may be disrupted: It can move too fast, resulting in diarrhea, or too slow, resulting in constipation; sometimes it's spasmodic.
"IBS used to be called spastic colon or spastic colitis, but those terms are not accurate," says Lin Chang, M.D., and associate professor of medicine in the division of digestive diseases at UCLA's David Geffen School of Medicine, and a member of the advisory board of the nonprofit International Foundation for Functional gastrointestinal Disorders. "Colitis means inflammation of the colon, and that's not true in IBS."
IBS is also confused with a category of conditions known as inflammatory bowel disease. See "What's Happening Down There?". The good news is that IBS has not been linked to more serious bowel problems: nor does it raise the risk of colon cancer.
"IBS is not a life threatening condition, but it is nuisance," says Keith Bruninga, M.D., a gastroenterologist at Rush University Medical Center in Chicago. And it can take a financial and emotional toll, with patients reporting missed workdays, feelings of nervousness or hopelessness, sleep problems, low energy, and reduced sexual interest.
"You don't know when it's going to come on," notes Chang. "You don't know how long it's going to last, and you don't know what might trigger it. It's constant anticipation."
No one can say for sure why one person gets IBS and another escapes it. It affects more women than men, and chronic stress seems to be a factor, including a history of physical, sexual, or verbal abuse; Parental divorce; Or parental alcoholism. "We think there is this early, adverse life event [that boosts IBS risk]," says Chang.
The condition isn't "all in your head," but stress and emotions can affect the colon, since its many nerves connect it to the brain. "People who are prone to anxiety, who hold stress in, tend to be more likely to have problems with IBS," says Peter Galier, M.D., chief of staff at Santa Monica UCLA Medical Center.
No single method works for everyone, so treatment responses are multifaceted. "The initial management of IBS is really about managing your lifestyle," says Locke. "People need to pay attention to stress in their lives." Regular Exercise is recommended; "it also tends to help if you eat smaller amounts of food frequently rather that large meals," Locke adds.
After that, treatment is based on whether diarrhea or constipation is predominant. For mild symptoms, you can self-treat, says Locke, using milk of magnesia or constipation and non-proscription Imodium (Loperamide) for diarrhea. If symptoms worsen, consider the following options:
Focus on fiber rich foods, like fruits and vegetables, or consider adding a fiber supplement. "Take Metamucil or Fibercon twice a day," advises Galier. Since taking too much fiber too quickly can cause bloating, start small and gradually work your way up to the dosage recommended on the package.
Kim believes the amount used in the study would be reasonable dose for people to try, since there were no significant side effects among the participants. However, typical probiotic formulas deliver only 1 to 4 billion bacteria per day. "Whether 1 billion or 2 billion is as good at 450 billion, I don't know," says Kim. "Without having a controlled trial, you can't conclude anything from using low doses." (To get the formula used in the study, go to http://www.vsl3.com/.)
"Peppermint oil has been very effective for a lot of patients with IBS," says Drew Francis, O.M.D., a licensed medical herbalist and owner of the Golden Cabinet Medical Healing Center in Los Angeles. Francis suggests trying two 200 milligram capsules three times a day before meals. Look for enteric coated capsules, which target the intestine more effectively, he adds.
The standard formula used in the study, called IBS-F, is made by Brion Herbs (http://www.brionherbs.com/) and is available only through healthcare professionals. To find a practitioner of Chinese medicine in your area, log on to http://www.aaom.org/. Francis, who is familiar with the study, says the dose used - five capsules three times a day - is ideal.
Hypnosis might be the most effective tool for relaxation and soothing symptoms, asserts Olafur Palsson, Psy.D., and associate professor of medicine in the division of gastroenterology and hepatology at the University of North Carolina at Chapel Hill. Citing several published studies, Palsson says the response rate to hypnosis is 80 percent or better. On his public information website, http://www.ibshypnosis.com/, he offers a list of practitioners. For a do-it-yourself hypnosis technique, see "Visualize Inner Peace".
Antispasmodic medications, such as hyoscyamine sulfate (Anaspaz, Levsin, Levbid), can help if bowel spasms occur, adds Locke. A low dose of antidepressants may be useful as well, not by lifting depression, but because they block the brain's perception of gut pain.
In the search for the right mix of treatments, persistence and patience pay off. You may have to go through a period of trial and error, but chances are good that you can lead a normal, productive life. As Locke says, "You don't have to suffer with IBS."
Hypnosis is effective for improving the signs of IBS, says Olafur Palsson, Psy.D. He offers this visualization technique for DIY relief:
Irritable Bowel Syndrome (IBS) is often confused with other intestinal conditions. Here's a quick glossary: