Irritable Bowel Syndrome Frequently Asked Questions

Irritable Bowel Syndrome Frequently Asked Questions - Causes, Symptoms, Diagnosis and Treatment

I?ve always had a "nervous stomach." Does this mean I?m more likely to have serious gastrointestinal (GI) problems later in life?

The term "nervous stomach" is often used as another name for irritable bowel syndrome (IBS). IBS most often occurs in people in their late teens to early forties. Symptoms of IBS include abdominal cramps, diarrhea alternating with constipation, and excess gas. It gets the name "nervous stomach" because symptoms can occur at times of emotional stress, tension, and anxiety.

Although this condition can be uncomfortable, it is not life-threatening. IBS does not make a person more likely to develop other colon conditions, such as colitis, Crohn?s disease, or colon cancer.

Is there really such a thing as a "nervous stomach?" What is it, what causes it, and what can be done to prevent or treat it?

The term "nervous stomach" is often used as another name for irritable bowel syndrome (IBS). Others call it "irritable bowel," "irritable colon," or "spastic colon."

IBS is a common disorder of the colon or lower bowel that affects both sexes but is more common in women. Risk factors for IBS include a family history of IBS, psychological stress, food intolerance, or a history of physical or sexual abuse. The cause of IBS is not well understood; possible etiologies include a change in motility of the colon, low-grade inflammation, or change in intestinal bacterial flora, along with genetic and environmental factors.

Symptoms of IBS include recurrent abdominal pain or discomfort accompanied by a change in bowel habits for at least 3 months. The change in bowel habits can include diarrhea alternating with constipation or in some cases, predominance of either diarrhea or constipation. IBS gets the name "nervous stomach" because symptoms can occur at times of emotional stress, tension and anxiety. Other factors that can "trigger" IBS include certain foods and medicines.

Nearly all people with IBS can be helped, but treatment should be individualized for the patient since there is no specific treatment that works for everyone. Usually, with a few basic changes in diet and activities, IBS will improve over time. Here are some steps you can take to help reduce symptoms of IBS:

  • Increase fiber in your diet (found in fruits, vegetables, grains, and nuts).
  • Add supplemental fiber to your diet (there are several types such as Metamucil, Citrucel, Benefiber).
  • Drink eight 8-ounce glasses of water a day.
  • Exercise regularly.
  • Don't smoke.
  • Avoid caffeine (found in coffee, chocolate, teas, and sodas).
  • Learn to relax, either by getting more exercise or by reducing stress in your life.
  • Try limiting how much milk and cheese you consume, since lactose intolerance can be more common in patients with IBS. Eat smaller meals more often or smaller portions. However, if you have IBS and are concerned about your calcium intake, you can try other sources of calcium, including broccoli, spinach, turnip greens, tofu, yogurt, sardines and salmon with bones, calcium-fortified milk and breads, calcium supplements, and some antacid tablets.
  • Keep a record of the foods you eat so you can figure out which foods bring on bouts of IBS. Common food "triggers" of IBS are red peppers, green onions, red wine, wheat, and cow's milk.
  • Anti-depressant medications may be an option if you have significant abdominal pain or discomfort, as well as psychological distress such as depression or anxiety.
  • Talk to your health care provider if your symptoms persist. He or she can perform an examination and order tests to make sure that there is no other cause for your symptoms.

Foods to Choose if You Have Mixed Irritable Bowel Syndrome

Although irritable bowel syndrome (IBS) can cause a great deal of anxiety and misery, most people can control their symptoms with diet, prescribed medications, and stress management.

Different people can have different triggers for their IBS symptoms. Things that may make the symptoms of IBS worse include:

  • Alcoholic beverages
  • Chocolate
  • Dairy products
  • Drinks with caffeine such as coffee, teas, or soda
  • Sweets
  • Fatty foods
  • Fructose syrup-containing foods and drinks
  • Sorbitol (sweetener usually found in gum)
  • Certain medicines
  • Emotional events and stress
  • Smoking

What foods should I eat if I have IBS?

Even though there is no cure for IBS, the symptoms can be reduced with the proper diet. Recording your current diet in a journal can help you find foods that trigger your IBS symptoms. Be sure to discuss the results of your journal with your doctor. He or she may recommend a dietitian who can help make changes to your diet.

The best way to battle IBS is to change your diet. Avoid foods that seem to make you feel worse and find ways to deal with your stress. Fiber can be helpful because it improves the way the intestines work.

Fiber may also decrease bloating, pain, and other symptoms of IBS. It does this by making the stools softer so that they can pass out of your body more easily. Soluble fiber found in foods such as dried beans and other legumes, oats, barley, and berries may help diarrhea by slowing down the passage of food from the stomach to the intestines and by giving stool form. Foods such as dairy products, carbonated beverages, raw fruits, and cruciferous vegetables such as broccoli, cauliflower, cabbage, and Brussels sprouts may trigger bloating and gas. Try a lactose-free diet to see if bloating and gas decrease. Eating a low-fat diet will also help with the symptoms of IBS.

What foods are high in fiber?

Good sources of fiber include fruits, vegetables, whole grain breads, and whole grain cereals. Eating foods from any of these groups will help add fiber to your diet. It is important to add fiber in your diet slowly to minimize bloating and gas that can be brought on by a sudden increase in fiber. These symptoms usually improve as your system gets used to the new amounts of fiber you are eating.

The following foods are examples of those that are excellent sources of fiber:

  • Barley
  • Black beans
  • Bran cereal
  • Brown rice
  • Dry fruits
  • Flaxseed meal
  • Fresh fruit with skins (may be better tolerated cooked or canned)
  • Fresh vegetables (may be better tolerated cooked)
  • Garbanzo beans
  • Kidney beans
  • Lentils
  • Lima beans
  • Navy beans
  • Nuts
  • Oats
  • Raisins
  • Soybeans
  • Split peas
  • Whole grains, including breads and cereals
  • Yams

What are some other sources of fiber?

Besides eating fiber-rich food, to increase fiber intake you can also take bulk-forming supplements such as:

  • Methylcellulose (Citrucel)
  • Polycarbophil (Equalactin, FiberCon, Mitrolan)
  • Psyllium (Fiberall, Konsyl-D, Metamucil)

As you increase fiber in your diet, it is also important to drink more liquids (water and decaffeinated beverages). Aim for 6 to 8 glasses of water per day. Probiotics, like the healthy bacteria found in yogurt or in probiotic supplements, may help decrease symptoms of IBS. Exercising can also help relieve the symptoms associated with IBS.

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