Only recently you say?  Just since you’ve been having abdominal cramps, can’t go to the bathroom – or can’t get there fast and frequently enough?  IBS, or “Irritable Bowel Syndrome,” is a disorder of the intestinal tract.  It’s so prevalent among people of all ages, many doctors consider it second only to the common cold.  The pain, discomfort, or irregularity you’re experiencing now is the body’s way of saying – “Hey, enough already.”  “Enough of what?” you ask.  That’s what you and your provider need to figure out together.  IBS is your digestive tract’s abnormal reaction to the stresses and strains of daily life as well as the routine activity of processing your food.

Think About Normal Digestion
“Over the teeth, over the gums…Look out stomach, here it comes…”  Food enters the stomach through the esophagus.  The stomach breaks down food and regulates its flow into the small intestine.  The small intestine digests the food and absorbs nutrients.

The remaining watery waste material is then passed on to the colon.  The colon, which makes up the last five feet or so of the digestive tract, conducts indigestible portions of food out of the body with gentle, wavelike contractions of its muscular walls.  Normally the colon solidifies the stool by absorbing about two-thirds of the water from it.  During this process, bacteria in the colon generate a variety of gasses, some of which are absorbed by the body and rest of which are excreted.  The sigmoid colon stores the stool and gasses until a convenient time to pass them to the outside.  The rectum is the final six inches of the colon, where the stool and gasses exit from the body.

IBS disrupts this process of digestion when the bowel reacts abnormally to stress or food, drinks, or other substances.  Abdominal pain, constipation, and diarrhea are the result, most often in the colon, especially in the sigmoid colon and the rectum.  If you’ve been diagnosed as having IBS, rest assured there’s nothing structurally wrong with your bowel.  IBS does not involve any organic disease such as cancer, colitis, or ulcers.  Rather, one or more parts of your digestive tract are not functioning as they should.

IBS – A Motility Problem
With IBS, the problem is that the natural motility of the bowel muscle is disrupted.  Motility is the rhythmic, wave-like motion the bowel makes to move body waste along – much like a conveyor belt.  It’s like having a nervous motorman who speeds up or slows down the normal, rhythmic movement of the bowel.  The speed at which body waste moves through the bowel determines whether too little or too much water is absorbed.  Abrupt changes in speed cause diarrhea, constipation, spasm, or gas.

Diarrhea – Rapid motility causes stool to pass too quickly through the bowel.  Waste then becomes loose and watery because the bowel does not have enough time to extract water.

Spasm – Abdominal cramps can occur when the bowel rapidly changes speed – blocking the flow of stool and gas, causing painful pressure to build in the bowel.

Constipation – Slow motility stops movement of the stool, causing the bowel to extract too much water.  Stool then becomes dry and compressed, and is painful and difficult to pass.

The demands on the bowel vary from hour to hour.  Tension, eating, smoking, and alcohol all can alter normal motility.  You and your health care provider will need to work together to create an individual treatment program aimed at freeing you of pain, allowing you to work and play normally again.  Treatment may include medication, changes in your diet, and modifying your lifestyle to reduce stress.

Treatment of IBS - Diet Change
Your diet may be an important cause of IBS symptoms.  You may be asked to avoid certain foods or substances, one at a time, for a trial period to see how each affects you.  During this time, it may be helpful to keep a daily diary of your diet and symptoms.

Lactose Intolerance
Many people with IBS also have milk sugar, or lactose, intolerance.  Your provider may ask you to avoid milk and all foods containing milk.  If some or all of your symptoms disappear, it may be helpful to stay away from milk products for good.

Fiber
Your provider may ask you to include more high-fiber foods in your diet to increase the bulk of the stool.  The bulkier stool requires less muscle contraction to move along the colon, thus relieving pressure in the bowel.  Larger stools are also softer and easier to eliminate.  You may include more fiber in your diet by eating whole wheat bread, baking with whole wheat flour, eating more salads and fresh fruits, and switching to high-fiber cereals.  You can also add a few teaspoons of unprocessed bran to cereal or baking.

Caffeine in coffee, cola beverages, and tea is a muscle stimulant that may have severe effects on hypersensitive bowel muscles.

Nicotine in tobacco, like caffeine, is a strong muscle stimulant and has the same effect.

Alcohol - Liquor and other alcoholic beverages are proven gastric irritants and often contribute to symptoms of IBS.

Medications
There are a number of medications available to help regulate bowel motility.  If one becomes ineffective for you, your provider will probably prescribe another.  For people whose irritable bowel is primarily stress related, medication may have only a minimal effect.  You might be on a prescribed medication for some time or even on and off for the rest of your life.

Stress and What to Do About It
The bowel is very vulnerable to stress for some people.  While one person may react to the pressure of everyday life with a headache or a case of itchy hives, your tension may result in increased bowel sensitivity.  If your IBS attacks are caused by stress, prescribed medication and diet changes may not help.  It is only by approaching all of these factors together that your provider can design a treatment plan that may stop your symptoms.  A successful stress reduction program begins with your recognition that stress is or may be a contributing factor to your IBS.

The next step in approaching the problem of stress is to choose a method of regularly releasing stress from your body.  You need to find a reliable release valve.  The following suggestions may help:

Share your concerns with someone else.  Talking about your concerns with your doctor, counselor, clergyman, or good friend may release unacknowledged pressures.

Regular exercise eases the tension in your body by stretching the muscles that store and hold stress.  This may mean taking frequent walks, dancing, or following a physical fitness program of calisthenics.  Discuss your choice of exercise with your provider.

Biofeedback and meditation are techniques many people use to reduce tension.  You may want to explore these methods.

Learning to Cope - After you release stress, try to identify and remove the cause of stress from your life.

Keep a diary of events surrounding each episode of IBS.  A pattern of events or people that cause you stress may be revealed.  When you feel tense, take a minute to stop and think what caused you to feel this way.  Remove the direct cause of your stress when possible.