Having good digestive health gets a lot of attention these days, and with good reason: The gut is connected to other major body systems, and has a huge impact on our overall health. When our gut feels good, we feel good.
So if you’ve recently been diagnosed with Irritable Bowel Syndrome (IBS) or if you think you may have it, you’re probably a bit concerned (not to mention, having some issues on the toilet). But fear not—life with IBS is manageable.
What Is IBS, Anyway?
“Irritable bowel syndrome is the name given to a condition that involves a group of symptoms that cause chronic abdominal pain and abnormal bowel movements,” says Christina Tennyson MD, Associate Physician, Mount Sinai Hospital.
“It is very common and some studies show that it can effect more than 10 percent of Americans. People that have IBS can have abdominal pain and experience diarrhea, constipation, or both.” IBS is most common in young women.
How Docs Diagnose IBS
To help doctors diagnose IBS, a group of researchers recently published updated diagnosis guidelines (these guidelines happen to be called Rome IV).
“According to these guidelines, IBS should be diagnosed by a careful history, physical examination, limited laboratory tests, and sometimes tests like a colonoscopy,” says Dr. Tennyson.
“All patients with IBS have abdominal pain. According to the current definition of IBS, individuals must experience pain at least one day per week over the previous three months. The symptoms should have started at least six months prior to a diagnosis of IBS. Also, the pain should be related to having a bowel movement, frequency of bowel movements, and/or the appearance or form of bowel movements.”
Doctors will often order some laboratory tests in order to exclude anemia and other markers of inflammation. They also try to rule out celiac disease, an autoimmune disease triggered by gluten. And, to make sure it’s not a parasite infection, doctors will sometimes order stool studies.
Learning To Live With IBS
Once IBS is diagnosed, there are a variety of possible treatments, depending on the type of IBS and how severe it is. Holly Lucille, ND, RN, frequently starts with an elimination diet. “Ruling out food sensitivities is very important,” she says. “Look at the top culprits, which are often wheat, dairy, eggs, soy, caffeine, and sugar.”
She also often employs the blood type diet.“If you know your blood type and avoid those foods for four weeks, that has been a successful way without extensive testing to avoid food sensitivities,” she explains.
“There are other drugs specifically for IBS that act on receptors in the gut. These are used to treat diarrhea or constipation,” says Dr. Tennyson. Doctors may also suggest the use of laxatives, small doses of anti-depressants, peppermint oil, probiotics, antibiotics, and medications that stop diarrhea.
Luckily, there are a few lifestyle tweaks you can make to help IBS become more manageable, including:
1. Skipping Caffeine
“People with IBS should limit caffeine, as this can cause symptoms to become worse,” says Dr. Tennyson. “Some people may report improved symptoms with certain herbal teas that may help with nausea, such as ginger. Unfortunately, there are limited studies to date using teas.” However, recent research shows peppermint oil can provide some benefit.
2. Slashing Stress
Yep, stress really does make everything worse, and it can have an impact on your IBS symptoms. Daily exercise, yoga, or meditation may help aid in preventing and managing stress, so if you don’t have a regimen in place, it may be time to create one. “Our days end and begin, but there is no end of constant stressors,” says Dr. Lucille. “I like people to get out of that. Take five minutes to have a little time with yourself, such as journaling. At work, take a break for 10 minutes to go outside and take a couple of deep breaths.”
3. Eating Right
Talk to your doc before making major dietary changes, especially an elimination diet. Dr. Tennyson says another common option is a low FODMAPs diet. Basically, FODMAPS (or Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols) are complex molecules that are sometimes hard to absorb.
“The aim of this diet is to remove foods that cause excessive fermentation in the gut,” she explains. “It removes food high in fructose, lactose, and long chains of carbohydrates that are not easily absorbed. Doctors can sometimes test for absorption of carbohydrates.” Still not sure what is safe for you to chow down on? A visit to a registered dietitian with expertise in IBS can be helpful.
4. Getting Enough Shut-Eye
“Sleep has an impact on everything—it’s when you rest, relax and repair,” says Dr. Lucille. “If you’re not going through all the stages of sleep and getting that growth hormone being made and tissue repaired, you’re going to be set up across the board.” Not snoozing enough can lead to elevated levels of cortisol, the hormone that triggers sleep, and that in turn has an affect on digestion. And if you try to perk yourself up with a coffee, that can sometimes make it even worse.
“It is helpful for those with IBS to know they are not alone and the symptoms they experience are real,” says Tennyson, who recommends armoring yourself with a team of people who are ready to help your condition. Be sure to follow up with your doctors and seek help when you need it.