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Irritable Bowel Syndrome
Irritable Bowel Syndrome and Anxiety Disorders : Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome is not a specific disease, but is used to describe a group of symptoms that may include:
* Stomach pain
* Flatulence (gas)
* Bloated or swollen abdomen
* Diarrhea, constipation or a combination of both
* Whitish mucus in the stool
The label “IBS” is often used when medical testing does not result in a specific diagnosis for the symptoms. Irritable Bowel Syndrome is usually chronic, but symptoms may be absent for long periods of time between episodes.
IBS Related to Anxiety and Depression
Stress and anxiety have been shown to interfere with gastrointestinal function. It is estimated that up to 60% of people who seek medical care for IBS also report anxiety and/or a mood disorder. Some researchers believe that people with IBS are sensitive to certain stress chemicals, resulting in an exaggerated response of the colon.
Some things that aggravate panic disorder may also worsen symptoms of IBS. For example, stress, alcohol and caffeine tend to trigger panic attacks and have, also, have been linked to increased IBS symptoms. And, if you worry about being away from a nearby restroom, you may experience increased symptoms of agoraphobia.
If you are receiving medication for panic disorder, it is important to talk to your doctor if you have symptoms of IBS. Some medications used to treat PD may produce side effects that worsen your IBS symptoms. On the other hand, some PD medications may relieve IBS symptoms.
Self-Help Tips to Manage Your IBS Symptoms
1. Find Your Dietary Triggers
Many times, the symptoms of IBS are aggravated by certain foods or beverages. These are often called “triggers,” and they are different for everyone. Common triggers that have been shown to increase IBS symptoms, include:
* Caffeine
* Alcohol
* Insoluble fiber (i.e., raw vegetables, the skin on fruits)
* Foods high in fat
* Carbonated beverages
* Dairy products
You may have these and many other dietary triggers. By keeping a food diary and following an elimination diet, you can discover what aggravates your IBS symptoms.
2. Manage Stress
Excessive stress has been linked to increased IBS symptoms and increased symptoms of panic disorder. It is important to help both your IBS symptoms and your PD symptoms by being aware of you stress level and incorporating stress management techniques into your life.
What is IBS?
Irritable bowel syndrome (IBS) is a digestive disorder that many people have, but few people talk about. It is estimated that IBS affects up to 15% of the population with its symptoms of chronic abdominal pain and major disturbance of bowel functioning. IBS can entail bouts of urgent diarrhea, episodes of chronic constipation, or a pattern of alternating between the two. IBS is considered a functional disorder, in that it involves a malfunction in how the intestinal system works, but doesn’t show up in any visible disease process or tissue damage. If you have IBS, you know first hand how intense the disorder can be and how it can cause significant disruption in the ability to attend to the tasks of daily life.
Causes
Researchers are not yet quite clear why people develop IBS. Often the disorder manifests itself following a severe bout of gastroenteritis, otherwise known as the stomach flu. Sometimes symptoms appear after the experience of an extremely stressful event. A high incidence of IBS in adults were the victim of sexual or physical abuse in childhood. As you can see, stress and IBS often go hand in hand, but the relationship is not yet fully understood. New research avenues are looking at dysfunction in the neurochemical systems of the gut and the brain to better understand the role that stress plays in the onset and maintenance of IBS symptoms.
Other Digestive Disorders
IBS is generally diagnosed after other disorders have been ruled out through routine diagnostic testing. The Inflammatory Bowel Diseases, Ulcerative Colitis and Crohn’s disease, have similar symptoms, but involve visible tissue inflammation. Colon cancer is often a concern due to the high level of discomfort of IBS symptoms. However, there are many key differences between the symptoms of colon cancer and IBS. Blood in the stool, anemia, pain and cramping not relieved by a bowel movement, and significant weight loss are not generally associated with IBS and would require further investigation. In any case, if you have any marked change in bowel functioning, it is essential that you bring this to the attention of a qualified physician.
Treating IBS
Individuals with IBS frequently feel as if they have lost control of their life and they just want to “feel normal” again. Although IBS does tend to have a chronic course, there are many interventions that have been shown to significantly reduce the frequency, severity and duration of symptoms. Whether it is through the use of prescription medication (for diarrhea or constipation), over the counter remedies, nutritional changes, psychotherapy or stress management techniques, be assured that the impact of IBS on your quality of life can be significantly minimized. You can also be reassured with the knowledge that IBS does not involve a shorter life expectancy or lead to more serious disorders. In fact, making the lifestyle changes necessary to deal with IBS can lead to a focus on better self care with positive effects seen in terms of your overall health.
IBS Treatment
(IBS) treatment is generally not a 'one size fits all' plan. A multi-faceted approach is often called for, including having a good working relationship with your physician, the possible use of prescription medicine (for diarrhea or constipation) and over-the-counter (OTC) remedies, nutritional and lifestyle changes, and in some cases, psychotherapy. Working with your physician, and with a little trial and error, you can find your own pathway for treating your IBS. As you try to find your way, be reassured that although IBS can be detrimental to your quality of life, it is not detrimental to your overall health or life expectancy.
Medication
Can medicine help IBS? Yes and no. There is no one drug cure for IBS, but a variety of medications are available that address specific symptoms. The problem is that IBS can be a chronic condition, and patients are often cautioned against taking a medication over a long period of time. Thus, for an ongoing condition like IBS, it is a good idea to explore non-drug treatment alternatives instead of, or in addition to, medication.
For the treatment of severe symptoms, your physician does have a variety of prescription options.
* Antispasmodics: These medications may be prescribed for the treatment of abdominal pain and cramping and are best taken on an as-needed basis.
* Antidepressants: Medications in this class can be taken over a longer period of time and may be chosen for their pain-reducing capability or to treat a co-existing depression or anxiety disorder.
* Medications that target the neurotransmitters (chemicals that pass information in the nerves of the brain and gut) that affect the speed of muscle contraction, secretion of mucus, and the absorption of fluids in the intestines are available for the treatment of diarrhea and constipation, but with strict guidelines as to who they can safely be prescribed for. The major medications in this class are Lotronex for diarrhea, and Zelnorm for constipation.
* Antibiotics: A newer, but still controversial, option for IBS is the use of specific antibiotics to target a possible overgrowth of bacteria in the small intestine.
Over-the-Counter Remedies
These products are available without a prescription and may be helpful in reducing certain abdominal symptoms. Remember that it is always important to check with your doctor before using any OTC product.
* Imodium (Loperamide): Used to control the symptoms of diarrhea.
* Fiber Supplements: (Benefiber, Citrucel, Metamucil) Supplements to increase dietary fiber.
* Probiotics: Dietary supplements that contain bacteria that may help to balance the intestinal tract.
Dietary Modifications
One of the most common ways that individuals try to cope with IBS is through dietary restriction. Faced with such traumatic symptoms, it is easy to point to food as a culprit. However, there is limited research support for the role of specific foods in causing IBS symptoms. An important fact to keep in mind is that the simple act of eating, in particular eating large or fatty meals, can stimulate bowel contractions. Stress and hormonal changes also contribute to IBS symptoms, so that a food that is poorly tolerated on one occasion may be enjoyed without consequence on another.
* Keep a food diary. A helpful way to determine the role of food in relation to your symptoms is to keep a food diary, an ongoing account of what you eat and how you feel. It is recommended that if you have identified a particular food as being a possible culprit, to eliminate that food for a period of about three months to see if this has any effect on your symptoms. If not, try eating the food again and repeat the process with the next food on your list. Common offenders are gas-producing vegetables, artificial sweeteners, caffeine and alcohol.
* Eat smaller, more frequent meals.
* For constipation, try to eat a large breakfast, as this may be the best time to encourage intestinal contractions and the urge to defecate.
* Increase fiber, but use caution. Fiber is generally recommended due to its many health benefits. However, research is somewhat mixed as to the effectiveness of the two types of fiber, soluble fiber and insoluble fiber for relieving IBS symptoms, and some types of fiber might actually exacerbate symptoms. So, add fiber slowly and evaluate the effects on your symptoms. A starting guide may be to increase soluble fiber, particularly in the form of psyllium, for diarrhea-predominant IBS, and insoluble fiber for the treatment of constipation.
Psychotherapy
Two forms of psychotherapy have been shown to be clinically effective in reducing the frequency, intensity and duration of IBS symptoms: Cognitive Behavioral Therapy (CBT) and Hypnotherapy. CBT is a form of therapy in which the individual is taught strategies for modifying maladaptive thinking patterns as well as new behaviors for managing anxiety and handling stressful situations. Hypnotherapy involves the induction of a relaxing and comfortable state of consciousness in which specific suggestions are offered in order to lead to a permanent change in behavior. In either form, psychotherapy offers the advantage of helping you to learn long-term strategies for handling your IBS without the risk of possible negative side effects associated with medication.
