Archive-name: medicine/irritable-bowel-syndrome-faq Posting-frequency: every two weeks Last-modified: 1994/12/02 Version: 1.1.1 Irritable Bowel Syndrome Frequently Asked Questions Version 1.1.1 - 12/2/94 Author: Laura J. Zurawski (juniper@uiuc.edu) INTRODUCTION This FAQ deals primarily with questions and problems associated with Irritable Bowel Syndrome (IBS). The newsgroup alt.support.crohns- colitis, on which this FAQ can be found, may look like it only deals with Crohn's Disease and Ulcerative Colitis, but frequenters of the groups also discuss IBS, thus, the need for an IBS FAQ. For a more detailed description of alt.support.crohns-colitis, Crohn's Disease, and Ulcerative Colitis, please refer to the "Inflammatory Bowel Disease Frequently Asked Questions" FAQ, which is posted to alt.support.crohns-colitis once a month. COPYRIGHT AND DISCLAIMER See end of FAQ for complete use and distribution information, and all applicable disclaimers. This FAQ is by no means meant to be a replacement for proper medical treatment from a qualified caregiver. You should always check with your doctor if you have any concerns about your condition, or before attempting any new treatment program. OTHER RESOURCES OF INFORMATION - alt.support.crohns-colitis Information Resources FAQ, posted monthly on this newsgroup - WWW page for bowel disorders: http://qurlyjoe.bu.edu/cduchome.html (sorry for the error in last month's post) ----------------------------------------------------------------------- - QUESTIONS COVERED IN THIS FAQ 1.1: What is Irritable Bowel Syndrome? 1.2: Who gets IBS? 1.2.1: What factors contribute to the onset of IBS? 1.3: What effect does IBS have on one's lifestyle? 2.1: What are the symptoms of IBS? 2.1.1: How severe are these symptoms? 3.1: How exactly does IBS affect the colon? 3.2: Is IBS life-threatening? 3.2.1: Will IBS lead to cancer? 3.2.2: Will IBS lead to IBD (Crohn's, ulcerative colitis)? 3.3: Will my IBS eventually go away, or is it for the rest of my life? 4.1: How do I know for sure if I have IBS? 4.1.1: What medical tests are regularly given for diagnosing IBS? 4.1.2: Is IBS really a "cop-out" diagnosis? Should I just accept it? 5.1: What are the standard treatments for IBS? 5.1.1: What is fiber therapy? 5.1.2: What sort of dietary modifications are required? 5.1.3: What conventional prescription medications are used to treat IBS? 5.1.4: Are there any natural or herbal remedies for treating IBS? 5.2: How can stress affect IBS? 5.2.1: How can keeping a record of my symptoms and triggers be helpful? 5.3: With all these different treatments, how do I know which will work for me? 6.1: How does IBS differ from Crohn's disease or ulcerative colitis? 7.1: How does IBS differ from gluten enteropathy/celiac disease? ----------------------------------------------------------------------- - 1.1: What is Irritable Bowel Syndrome? Irritable Bowel Syndrome, also known as "Spastic Colon", "Irritable Colon", and "Mucous Colitis", is a surprisingly common affliction in this day and age. It is one of the most common complaints treated by gastroenterologists. It is characterized by a wide range of symptoms, including but not limited to frequent diarrhea and/or constipation and abdominal pain. 1.2: Who gets IBS? IBS usually surfaces in the early to mid-twenties of adulthood. It affects about twice as many women as it does men in the United States. 1.2.1: What factors contribute to the onset of IBS? Some factors contributing to its onset are stress level, diet, lack of exercise, or genetics. 1.3: What effect does IBS have on one's lifestyle? Symptoms and effects can range anywhere from barely noticeable to frequently debilitating. Namely, it hits some people harder than others. Each person's IBS is different, which is why it is so often difficult to diagnose and treat properly. -- 2.1: What are the symptoms of IBS? Everyone's set of individual symptoms is different, which is why it is often so difficult to diagnose it in a patient. A person with IBS may experience one, several, or all of the following symptoms: - frequent diarrhea - frequent constipation - excessive intestinal gas (flatulence) - abdominal pain, usually below the navel, and can be sharp and sudden, or dull and achy - "marked urgency", i.e. an overpowering and immediate urge to have to use the bathroom - presence of mucous in the stool (but no blood) - increased sensitivities to certain foods (common offenders are dairy, wheat, raw vegetables, high-fiber foods, fried foods, very spicy foods, but can be anything depending on the person) - possible weight loss, fatigue, lack of energy associated with above symptoms - nausea 2.1.1: How severe are these symptoms? It depends on the individual, and the time in that individual's life. A person can have IBS yet his or her symptoms will only surface at particular times and be "dormant" at other times, or a person may have to deal with his or her symptoms every day. Often, IBS will have it's "good" periods (when symptoms are not as severe) and "bad" periods (when symptoms are at their worst). -- 3.1: How exactly does IBS affect the colon? IBS is characterized as a "motility disorder". Namely, the normal contracting motions of the colon are in some way altered -- either the colon moves too slowly (resulting in constipation), or too quickly (resulting in diarrhea), or it can go in to spasm in certain areas, causing abdominal pain, trapped gas, and similar maladies. 3.2: Is IBS life-threatening? No. Since the problem is in the motility of the colon, and not caused by an inflammation or infectious agent, there is minimal risk of IBS becoming life-threatening. 3.2.1: Will IBS lead to cancer? No. 3.2.2: Will IBS lead to IBD (Crohn's, ulcerative colitis)? It is possible to develop IBS in association with an IBD, but generally not the other way around. Most people who are diagnosed with IBS and eventually realize they have UC or Crohn's are certain that they had had the UC or Crohn's all along, but were simply misdiagnosed with IBS previously. 3.3: Will my IBS eventually go away, or is it here for the rest of my life? Some people have reported that their IBS symptoms went away completely after a certain amount of time or a major change in their lifestyle or treatment program. Other cases have reported having to deal with IBS for life. Again, it depends on the individual. -- 4.1: How do I know for sure if I have IBS? The ONLY way to be absolutely certain you have IBS is through a doctor's diagnosis. A doctor (a *good* doctor, at least) will rule out any possibility of Inflammatory Bowel Disease (IBD) before even considering an IBS diagnosis. Also, it is good to rule out intestinal parasites and other afflictions of the lower digestive tract (polyps, diverticulitis, obstruction, etc.) and be completely sure that there is nothing else wrong with the colon before giving a diagnosis of IBS. 4.1.1: What medical tests are regularly given for diagnosing IBS? Tests given are almost always for the express purpose of ruling out other afflictions. There is no test for IBS itself. Common medical tests a gastroenterologist may prescribe include: - Lower G.I. x-ray (a.k.a. the barium enema) - Small bowel series x-ray - Stool parasite culture - Flexible sigmoidoscopy and/or colonoscopy - Nutrient absorption tests (these usually require blood or stool sample) 4.1.2: Is IBS really a "cop-out" diagnosis? Should I just accept it? Only if NO evidence of existing disease, parasite, nutrient absorption problem, or severe food allergy can be found should a doctor finally diagnose IBS. If you suspect that you have not had a thorough enough examination for other afflictions before the doctor tells you that you have IBS, you should seek a second opinion. Many times a person may think that he or she is being "slighted" by being given a diagnosis of IBS. Unfortunately, to some doctors, IBS is not considered a "true" disease, but rather an unimportant minor condition (when in reality it is hardly all that "minor" to those who have to deal with it), and therefore may not be given the medical attention it deserves. Don't despair; there ARE competent doctors out there who are very good at dealing with IBS cases. A good doctor won't just tell you that you have IBS and give up on you. He or she should be willing to go over your questions and concerns, and outline and monitor a program of treatment for your individual case of IBS. -- 5.1: What are the standard treatments for IBS? Since each person's IBS is unique, therefore there really is no *one* good general treatment for IBS. Different things work for different people, and unfortunately the only way to know exactly what works for you is by trial-and-error. 5.1.1: What is fiber therapy? Fiber therapy involves incorporating more dietary fiber (also called bulk or roughage) into the diet. The premise behind this treatment is to add bulk to the stool, which aids in both constipation and diarrhea. Fiber can be added to the diet through the eating of more fiber-rich foods, or by taking fiber supplements (common brands are Metamucil, Citrucel, and FiberCon). 5.1.2: What sort of dietary modifications are required? In some cases, IBS symptoms may be triggered by certain foods. To determine what triggers one's symptoms, often one will have to start with a very basic, bland diet and gradually add one new food a day and record any symptoms associated with that food. Any food found to be a trigger for symptoms should then be eliminated from the diet. 5.1.3: What conventional prescription medications are used to treat IBS? Conventional medications used in the treatment of IBS include (but are not limited to): - Anti-spasmodic drugs like Bentyl and Levsin - Anti-depressant drugs like Elavil - Over-the-counter antacids/anti-gas medications - Over-the-counter IBS medications ("Equalactin") 5.1.4: Are there any natural or herbal remedies for treating IBS? It has been shown that peppermint and other herbs that calm the digestive system can sometimes be helpful in providing relief for certain symptoms. Some people also claim to benefit from other forms of natural or "alternative" medicine such as acupuncture, biofeedback, nutritional and/or vitamin therapy, massage therapy, and various others. **Note, though, that herbal and other forms of alternative medicine are not accepted by the medical profession as legitimate yet, and should only be used under the supervision of a qualified practitioner.** 5.2: How can stress affect IBS? Many people attest to the fact that stress affects their IBS symptoms. The effects of stress on IBS symptoms vary from person to person, but it has been suggested that stress management is often beneficial to IBS patients. 5.2.1: How can keeping a record of my symptoms and triggers be helpful? This will help you to be more aware of what foods or activities are detrimental or helpful to your condition. By identifying a pattern of foods or activities that cause your symptoms to flare up, you will know what to avoid in the future to keep your symptoms more effectively under control. 5.3: With all these different treatments, how do I know which will work for me? The only way to know for sure which treatment will work best for you is to consult your doctor and discuss which method of treatment would be best for you. Sometimes, one has to try several different treatments before finding the one that will work the best. The important thing is not to get discouraged -- there is something that is right for you. -- 6.1: How does IBS differ from Crohn's disease or ulcerative colitis? IBS differs from IBD's like UC and Crohn's in that there is usually NO trace of blood in the stool, whether the problem be diarrhea or constipation or both, and there is no trace of damage to the intestine that shows up an any medical tests. Those are a few of the keys to recognizing IBS that doctors may use. Also, unlike IBD, IBS is a strictly functional disorder, meaning that there is no part of the colon that is "diseased" or inflamed, as is the case with UC and Crohn's. -- 7.1: How does IBS differ from celiac disease? People with celiac disease experience marked intestinal symptoms such as diarrhea and gas upon the consumption of foods that contain gluten, such as products made from wheat, oats, rye, and barley. Upon the elimination of gluten-containing foods, the symptoms disappear. Some people with IBS may experience an aggravation of symptoms with the consumption of similar wheat-related products, but it is not these foods that actually cause the symptoms. ----------------------------------------------------------------------- - NOTICE: This document is the sole work and property of the author. It may not be redistributed or sold for profit in ANY WAY without consent of the author. Permission is granted for the copying of this document ONLY for one's own personal use or redistribution to others on a strictly informational and NON-profit basis, provided that: A.)the document is not edited or modified in any way, B.)the author is not held responsible or liable for its content (see disclaimer below), and C.)this notice and the disclaimer below remain attached in their entirety. DISCLAIMER: this FAQ is provided by the author as a supplement to the newsgroup alt.support.crohns-colitis, and is meant as supplemental material only. In no way is this document meant to be a substitute for professional medical care or attention by a qualified practitioner, nor should it be implied as such. ALWAYS check with your doctor if you have any questions or concerns about your condition, or before starting a new program of treatment. The author is strictly a fellow IBS patient speaking from her own experience and research, and is _not_ a doctor. The author is not responsible or liable, directly or indirectly, for ANY form of damages whatsoever resulting from the use (or misuse) of information contained in or implied by this document. -- ACKNOWLEDGMENTS: This FAQ was written using the information the author has acquired from a great many sources during the eight years which she has lived with IBS. These sources are mainly licensed gastroenterologists, especially Eric J. Yegelwel, Arlington Heights, Illinois. The author wishes to thank Dr. Yegelwel for his help and support over the years. The author would also like to acknowledge the following people for their suggestions, contributions, and references for this FAQ: Susan Blanc Jeanne Zurawski Elliott B. Hammett Christopher Holmes Michael Bloom Bill Robertson the readers of alt.support.crohns-colitis ----------------------------------------------------------------------- - Please send all comments, suggestions, corrections, or ideas for improvement of this FAQ to: juniper@uiuc.edu -- +===================================================================== =====+ Christopher G. Holmes | Data General Corporation, Westboro, MA Terminals Development Group| holmes@mrx.webo.dg.com & PC Business Unit | Now available in convenient single serving size +===================================================================== =====+