TIPS TO HELP YOU TAKE CONTROL OF YOUR IBS
Irritable bowel syndrome is a painful and sometimes embarrassing condition of the gastrointestinal tract that a ects roughly five million Canadians. Luckily, there are relatively easy ways to manage its symptoms — it’s just a matter of figuring out what w
IF FREQUENT STOMACH CRAMPING AFTER MEALS IS
keeping you from enjoying dinners out with friends, or you’re often running for the bathroom (or wishing you were running for the bathroom because you can’t remember your last successful trip to the loo), it’s time to talk to your doctor.
Irritable bowel syndrome (IBS) is a chronic condition that affects the gastrointestinal (GI) tract, causing abdominal pain, bloating, cramping, constipation or diarrhea. Some IBS sufferers experience just a few of these common symptoms, which will wax and wane over time. They’re exacerbated by stress, changing eating patterns and illness. There can be good days, weeks or months, followed by times when symptoms flare and make day-to-day life unmanageable.
“IBS has a major impact on many people’s lives,” says Dr. Geoffrey Turnbull, a gastroenterologist, GI motility expert and professor of medicine at Dalhousie University in Halifax. Its painful and often embarrassing symptoms can interfere with intimacy, playing sports, travel, going to the movies and even making it to the office. “According to one study, IBS is one of the most common reasons for workplace absenteeism, next only to the common cold,” he says.
The variability of symptoms is one of the challenges of the condition, says Dr. Jennifer Tanner, a naturopathic doctor with the Integrative Health Institute in Toronto. “People can suffer with it for quite a few years before they seek treatment, because they start to think it’s just normal for them,” she says. Or they try to ignore it because they know that eventually, in a matter of days or weeks, it will pass. “We don’t really talk about these kinds of problems either, so that doesn’t help,” she says.
There’s no test for IBS. To make a diagnosis, your doctor will evaluate your medical history and symptoms over the past six months, screening for the following criteria: pain and discomfort related to passing stool, whether the frequency is altered to a point of constipation or diarrhea, and whether your pain is relieved after a bowel movement.
IBS most commonly f lares up for the first time in people in their 20s and 30s. The reason for this isn’t clear, but some practitioners attribute it to the stressful time of life. For a person with a sensitive GI tract who’s starting a career, beginning a family and making other major life decisions, stress can be what tips them over the edge. “It’s when real life responsibilities start and this can be a time of a lot of anxiety and stress,” says Dr. Tanner. “Stress is known to be a huge component of IBS.”
IBS can’t be cured, but it can be managed. Read on for everything you need to know about controlling your IBS symptoms, so they’re not controlling you.
a food symptom journal. If you don’t yet have a handle on your trigger foods, this can help you figure out what you’re eating or drinking that’s upsetting your sys-
tem. Write down everything you eat along with any symptoms you experience throughout each day. At the end of a week, you and your doctor may be able to see some helpful patterns. Dr. Tanner typically follows this with a month of elimination of the suspected trigger foods to see if symptoms ease up, or even disappear. It takes approximately 21 days for your intestinal cells to rejuvenate, which creates a type of clean slate on which to test the foods again, she says. “If we then reintroduce cheese, for example, and all those old symptoms come back, that creates an awareness for the patient that this is a food they’re not going to feel well with.”
serious about your diet. Wheat and dairy are classic trigger foods that many people with IBS need to eliminate from their diets, or eat in strict moderation, but there are other foods that some people need to tweak or remove to get relief. Gas-producing foods like beans, lentils and cauliflower can be no-nos for people with cramping issues, for example. Raw veggies in general can also be gaseous and therefore problematic for some IBS sufferers. “You may need to cook or gently warm your foods to make them easier for you to digest,” says Dr. Tanner. “Some people with IBS also respond well to a low-FODMAPs diet,” says Dr. Turnbull. FODMAPs (fermentable oligo-, di- and monosaccharides and polyols) are carbohydrates found in certain grains, vegetables, fruits and dairy products that cause symptoms in IBS patients.
TRY to think about what you eat as an adventure
— it’s a chance to sample something new, not just cut out favourites. You may have compiled a long list of foods that are “don’ts,” which can feel defeating, so why not make an even longer list of IBS diet “dos?” If you’re following a low-FODMAPs plan, mangoes may be out, for example, but mandarin oranges are in! Or you may need to cut out regular cow’s milk, but your system could probably tolerate an occasional glass of lactose-free milk or coconut milk.
While you’re thinking about all the great new things you’re adding to your diet, don’t forget about supplements. Since your body may not be absorbing nutrients properly, especially if you’ve had chronic diarrhea, you could be deficient in key vitamins and minerals. Talk to your practitioner about whether a multivitamin will do the trick or if you need more targeted supplements.
medication, if you need it. Diet and lifestyle changes aren’t always enough to relieve severe symptoms of IBS. There are drugs designed to relax the colon and slow the movement of waste through the bowel if diarrhea is an issue, or increase f luid secretion in the small intestine to assist with the passage of stool if constipation is the primary problem. Antidepressants or antianxiety medications may also be required if emotional issues are your biggest IBS trigger.
your symptoms closely. Your doctor will assess whether they might suggest something more serious or require further investigation. If, for example, you’re over 50 and experiencing IBS-like symptoms for the first time, or have experienced rapid weight loss, rectal bleeding or recurrent vomiting, you will need additional tests — which could include stool studies, a colonoscopy or CT scan, amongst others — to rule out inflammatory bowel disease (IBD). This is an umbrella term for ulcerative colitis and Crohn’s disease, two diseases that involve chronic inflammation of the digestive tract and can sometimes lead to life-threatening complications or the need for surgery.
time for meditation. “Learning how to manage stress is very important for anyone with IBS,” says Dr. Turnbull. Mindfulness and meditation are helpful tools, especially for people whose symptoms are clearly triggered by stress or anxiety.
The IBS Elimination Diet and Cookbook by Patsy Catsos to help you build a fulfilling and nutritious diet plan to get lasting relief from your symptoms while still enjoying delicious meals with your family — and some of the treats you enjoy!
what works for you. If you know you don’t feel as well when you eat dairy, but love milk or yogurt, you may decide to have a planned cheat day once a week or opt to splurge on a special occasion, like at a birthday party. “Once you know what your body can handle you can make the choice to have the cake if you want it, so it becomes about awareness,” says Dr. Tanner. b