HEALTH MATTERS: Seek treatment for IBS

By Kevin S. Skole, M.D. Princeton HealthCare System
    If you have irregular bowel habits and experience chronic abdominal pain, bloating and cramping that worsens with stress, you might be one of the millions of Americans who suffer from irritable bowel syndrome (IBS), one of the most commonly diagnosed medical conditions in the United States.
    While IBS can cause a great deal of inconvenience and discomfort, the good news is that, it can often be managed and controlled through diet and lifestyle changes, along with medication. It is important to see a doctor to get a diagnosis and rule out the possibility that you are suffering from a more serious condition such as celiac disease, Crohn’s disease and ulcerative colitis, which have symptoms similar to IBS.
What is IBS?
    In addition to abdominal pain or discomfort accompanied by changes in bowel movements, patients with IBS may experience constipation, diarrhea or alternating bouts of both.
    Symptoms vary from person to person, can range from mild to severe and are generally temporarily relieved after a bowel movement. Symptoms are often worsened by:
    • Large, heavy meals.
    • Certain foods such as dairy products, chocolate, wheat, rye, barley or alcohol.
    • Caffeine.
    • Stress, conflict or emotional upsets.
    • Certain medications.
    IBS is more likely to affect women than men and develops before age 35 in 50 percent of patients, according to the National Institutes of Health. Patients with IBS may also have a family history of the disorder. For many people, symptoms come and go, but for some they are a constant concern.
What Causes IBS?
    The exact cause of IBS is unclear. In some cases, the muscular activity in the small bowel or colon may be abnormally fast or slow. In others, IBS may develop after an intestinal infection. Scientists also suspect that in IBS patients, the intestine’s nerves may be over-sensitive to normal stimulation, which is why stress can trigger IBS.
How is IBS Diagnosed?
    If you have signs and symptoms of IBS, the first step is to see your doctor. Often, diagnosing the disorder is a process of elimination.
    Your doctor will go over your complete medical history and symptoms and perform a physical exam. He or she will also ask you about any bleeding or weight loss associated with your symptoms, which could indicate something more serious than IBS. In these instances, your doctor will likely order additional tests to assess your condition.
    IBS is generally diagnosed if you have symptoms that occurred for at least 12 weeks, though the weeks don’t have to be consecutive. You also must have at least two of the following:
    • Change in the frequency or consistency of your bowel movements.
    • Straining, urgency or a feeling that you can’t empty your bowels completely.
    • Mucus in your stool.
    • Bloating or abdominal distension.
How is IBS Treated?
    Treatment for IBS typically involves a combination of lifestyle and diet changes along with medication. Depending on your condition your doctor may recommend fiber supplements or laxatives to relieve symptoms.
    Low-dose anti-depressant medication may be prescribed to help reduce nerve oversensitivity and modulate pain. Other medications may be used to relax muscles or control diarrhea. However, if used improperly they could make problems worse, which is why it is important to work with your doctor to find a solution that is right for you.
    Lifestyle changes may include getting regular exercise and adequate sleep, and reducing stress. Diet recommendations may include:
    • Increasing the amount of fiber in your diet to help relieve constipation. (It may not help relieve pain or diarrhea.)
    • Drinking six to eight glasses of water a day.
    • Eating smaller meals that are low in fat and high in carbohydrates.
    • Avoiding carbonated beverages or beverages containing caffeine or alcohol.
    • Avoiding certain dairy products that may trigger your symptoms.
    In addition, patients have reported improvement with alternative therapies such as acupuncture, meditation and hypnosis.
    It is important to remember that there is no one-size- fits-all approach to treating IBS. Talk to your doctor about an appropriate approach that works for you.
    Also keep in mind that while IBS is uncomfortable and can interfere with normal daily life, it does not cause permanent damage and once diagnosed is typically not cause for alarm.
Want to Learn More?
    Join Dr. Skole for a live Web-chat hosted by Princeton HealthCare System on Thursday, May 19, at 7 p.m. He will take questions and discuss how to manage GI health. To participate, simply go to the UStream Channel at www.ustream.tv/channel/ princetonhealth. To pre-register visit www.princetonhcs.org or call 888-897-8979. Basic computer requirements for the chat are a PC or Mac with Adobe Flash Player installed and a broadband Internet connection.
Kevin S. Skole, M.D., is a board-certified gastroenterologist and a member of the medical staff at University Medical Center at Princeton.
Parkinson’s fundraiser
    “Princeton Dines Out for Parkinson’s Disease Research.”
    Enjoy dinner at any of the participating restaurants on Thursday, April 28, and a percentage of the proceeds will be donated to The Parkinson Alliance. Donations by the restaurants will be matched by The Tuchman Foundation. One hundred percent of all individual donations and the net proceeds of all events go directly to Parkinson’s research.
    Participating restaurants include Blue Point Grill, Elements, Eno Terra, Gennaro’s, Mediterra, Teresa Caffe, Witherspoon Grill and Yankee Doodle Tap Room.
    The Parkinson Alliance is a nonprofit organization, located in Kingston, dedicated to raising funds to help finance the most promising research to find the cause and cure for Parkinson’s disease. On the Web: www.parkinsonalliance.org.