The Painful Embarrassment of IBS: Irritable Bowel Syndrome

As with fibromyalgia, each person experiences an IBS attack differently. Triggers, symptoms, and experiences are unique to each individual. An attack can strike at any time and it can be one of the most embarrassing and painful situation you will ever experience.

There are three types of IBS; Dominant Constipation IBS, Predominant Diarrhea IBS, and alternating diarrhea and constipation. All are painful, debilitating and confusing. Because everyone’s personal story is different, I can only tell my own.

It is 6:30PM, supper is over and I stand washing dishes at the kitchen sink when suddenly, without warning, I am doubled over as pain sears my abdomen. My muscles are in a vice like grip that prevents me from standing upright as I make my way to the washroom praying I will get there in time. After a few minutes the pain eases and the urge has disappeared. I wash my hands and go back to my dishes and wait for the next bout of pain to begin.

I have food induced Pain Predominant IBS. The name tells it all. The symptom is the painful and urgent need to evacuate NOW. This doesn’t mean evacuation will happen right away because sometimes you can be fooled for hours with the painful urgency coming and going while other times it is immediate.

Once it begins, abdominal pain and cramping is severe with frequent bouts of diarrhea that can end abruptly after one bowel movement or keep on for up to three hours or more. My IBS attacks are relentless and incapacitating causing my adrenalin and body temperature to rise. Fierce pain continues non stop as sweat soaks my body and drips from my face, hair, and ears staining my clothes. The room swims before me and I fight to keep conscious and to stay upright while my abdominal muscles squeeze so tight that it pushes the food from my stomach back up into my esophagus. Bowel muscles push down causing the need to evacuate with a tightening force that threatens to tear tissue while the sphincter muscle closes and prevents relief by forcing the movement backwards. The struggle goes on and I am helpless to do anything but sit there and pray that it will soon be over.

Suddenly, it stops. As quickly as it began the clenching has stopped and the pain is gone. I sit gasping, my heart pounding, and my clothes sticking to my body. Every ounce of energy has been drained from me and flushed away with the pain that only moments before, caused unbelievable distress. I make my way to bed and immediately fall asleep exhausted.

What is IBS

IBS is a chronic functional disorder that affects the large and small intestines causing mild to severe abdominal pain. Like fibromyalgia, the cause of IBS is unknown. One theory is that the peristalsis or natural movement of the bowel is more sensitive to normal sensations causing the bowel muscles to become erratic. Another thought is that it could be caused by allergies to certain foods. No one has been able to prove either theory.

Common symptoms of IBS

Stress induced diarrhea

Negative reactions such as tension, nervousness, agitation, fear, or frustration create a fight of flight response in the body. This negative response affects the nervous system which includes the colon. The colon becomes over stimulated causing erratic functioning of the bowel, setting off painful cramps and diarrhea or worse-painful cramps with constipation that will not move.

Food induced diarrhea

Those who have food related IBS onset should keep a diary of the foods they eat. It is possible that a pattern may begin to form when their IBS attacks are compared to the times certain foods are consumed. The task of finding the offending foods can take months of recording and careful scrutiny. Often, it is not just one food causing the problem but a combination of foods. If you find that a food will bring on an IBS attack one time but not the next, you are most likely looking for a combination of foods, or preservatives. Unfortunately, the trigger is often never found. (The task of finding the reason for IBS attacks is often difficult if you have stress induced and food induced IBS.)

Constipation

Because IBS is a functional disorder, it is thought that constipation occurs when bowel functions fail causing an ongoing dysfunction. The bowel muscles tighten causing peristalsis (the normal movement of the bowel) to stop working. Certain foods, stress, or an injury can cause the normal movement of the bowel to freeze up. It is not unusual with constipation-dominant IBS to go one week to one month without having a bowel movement.

Bowel freeze

Bowel freeze can happen when a person who has fibromyalgia and IBS experiences a shock to their body such as tripping, a fall, or acute stress. When the bowel muscles are shocked, peristalsis stops and it is common in this instance to go several weeks without having a bowel movement. Bowel freeze can affect both diarrhea and constipation IBS.

Spastic Bladder

Many people who have fibromyalgia also have spastic bladder. When the bladder begins to spasm, it causes urgent and/or frequent urination and a burning pain similar to the pain of a urinary infection. Often, when bladder muscles spasm it triggers an IBS attack. When bladder spasms occur, you may be able to avoid the onset of an IBS flare by keeping your bladder as empty as possible.

Feeing full

The feeling of being full after eating only a few bites of food or from drinking a glass of water is caused by an IBS variant called Midgut Motility Disorder. The pooling of old contents of the small intestines causes trapped gas and bloating leaving little room for food.

Incomplete evacuation

All three types of IBS leave a feeling of unfinished evacuation.

Other symptoms of IBS

• gas
• bloating
• inability to pass gas
• difficulty swallowing
• nausea
• heartburn
• belching
• frequent bowel movements (with diarrhea)
• infrequent bowel movements (with constipation)

IBS facts

• IBS is the most common bowel complaint
• IBS usually starts in the late teens or young adulthood but it has been known to strike younger children
• The cause of IBS unknown
• There are no chemical or structural problems to be found in IBS as with other bowel diseases
• There is no known cure for IBS
• When the IBS complaint is constipation related, the condition is called Dominant IBS. When diarrhea is the most common complaint it is called Predominant IBS.
• IBS consists of three types of affects; constipation, diarrhea, or an alternation of the two
• IBS causes erratic functions of the bowels
• Severity of an IBS attack can range from moderately painful to pain so intense it causes the sufferer to feel faint, throw up, or pass out
• IBS sufferers usually have slow digestion and it is common to have a food that you have eaten one day, react with a food you will eat two or three days later
• Symptoms of IBS are not the same in all people and it is possible that the symptoms you have now may change sometime in the future
• 20 percent of all people in the US and Canada have IBS. 70 to 80 percent of them are fibromyalgia patients and, 70 percent of those fibromyalgia patients with IBS are women.
• Only about 10% of IBS sufferers ever seek medical help

Foods to eat if you have Dominant Constipation IBS

It is important to eat only the foods that will help soften stool in hopes of alleviating pain and evacuating as much as possible.

Foods high in magnesium such as broccoli, nuts, squash, okra, soy milk, spinach, tofu, whole grain cereals, barley, whole wheat bread, multi-grain cereals, halibut, scallops, oysters, rockfish. If magnesium rich foods don’t seem to help relieve your problem, consult your doctor to see if magnesium tablets are right for you.

Fruit & veggies. Constipation is usually a result of a low carb diet making the carbs in fruit and veggies essential.

Foods high in soluble fiber containing psyllium such as oatmeal, oat bran, kidney beans, apples, barley, prunes, oat bran, dried beans, dried peas, and flax seed. Many cereals contain adequate amounts of soluble psyllium fiber s well.

Legumes

Ground flaxseed can be added to almost any dish by sprinkling on food after cooking. Flaxseed should be introduced to your diet gradually.

Drink lots of water and fruit juice. Keeping your body hydrated is one of the most important things you can do for your body, mind, and well being. Constipation is often a result of dehydration. Drinking insufficient amounts of water will cause your colon to try to restrict water loss through your stools causing the water to be squeezed out of the colon and sending it back into the body leaving you dehydrated and constipated.

While there are herbal teas used for constipation, they should all be used with caution and only on the advice of a professional. Herbs can be powerful medicine but all too often people tend to abuse them by overuse or using wrong combinations that can result in distress and serious illness. When constipation is your dominant complaint, herbs may start to work in only one part of the intestines . When this happens, someone with IBS could spend hours of excruciating pain with one part of the intestines working against another.

What not to eat if you have Dominant Constipation IBS

Try to limit highly refined foods such as bread, cakes, cookies and other baked goods made with refined white sugar and refined flour.

Fatty foods. Fat causes a more powerful bowel reflex than other types of foods causing muscle contractions causing spasms and possible bowel freeze.

Coffee and other caffeinated beverages cause much the same symptoms as fatty foods.

White rice. White rice can cause constipation and should not be eaten often. If you do eat white rice, eat it with vegetables and drink plenty of water.

• MSG or Monosodium Glutamate causes painful affects to those with IBS. While it might not cause diarrhea in Dominant IBS, it can cause cramping, dizziness, nausea, and other related symptoms that can go on for hours. It is important to know what foods contain MSG and to do that, you must be familiar with it’s many names. Find out more about MSG here. http://www.healthmad.com/Health/MSG.11985

Low or no fiber cereal and prepared foods.

Eliminate all trigger foods such as; red meat, dairy, fried foods, egg yolks, coffee, soda pop, and alcohol – from your diet.

What to eat if you have Predominant Diarrhea IBS

• Try to eat foods high in soluble fiber that help retain water and distend the colon to reduce spasms. Soluble high fiber foods include oatmeal, oat bran, kidney beans, most fruits and veggies, whole grain bread, cereals, and pasta.
• White rice to help bulk up the colon but you must be careful of what you eat with it. Sautéed vegetables, tomato sauce, fish, and steamed or boiled chicken are good choices.
• Bananas contain soluble fiber, help to replace electrolytes lost during bouts of diarrhea, and are great for settling the digestive system
• Lean cuts of chicken and fish are good meat choices
• Peppermint tea is a great herb for muscle spasms. It will sooth the colon and expels gas.
• Ginger tea will help gas that becomes trapped in the colon. Fresh grated ginger is best if it is available.
• Thyme tea is one of my favourites. Thyme benefits the whole digestive system. It sooths the stomach, it is thought to dissipate gas, improves many different intestinal complaints, and will dissolve and removes mucus from the intestinal tract. If you have Fibromyalgia related diarrhea with IBS, thyme tea could help relieve muscle pain too.
• Drinking lots of water is one of the most important things you can do. Each attack of diarrhea causes you to lose precious water and quickly causes dehydration. Your colon will try to preserve water by squeezing it from your bowels to replace it in your organs thus causing cramping and triggering another attack.

What not to eatif you have Predominant Diarrhea IBS

• Eat with moderation and avoid large, heavy meals. Eat 4 or 5 small meals a day instead.
• Avoid fatty foods such as red meat, dairy, fried foods, french fries, and egg yolks that stimulate the colon and trigger spasms
• Avoid coffee and all caffeinated beverages that can also trigger spasms
• Avoid alcohol. Beer and mixed drinks contain carbon or are mixed with other drinks containing carbonation and caffeine. Alcohol can pose another problem to those who have fibromyalgia related allergies or are sensitivities to chemicals.
• Limit your dairy intake, especially milk products that tend to irritate the bowel
• Avoid cereals containing low or no fiber
• Avoid gassy foods like broccoli, cabbage, cauliflower, brussel sprouts, sodas, beans, and turnips
• MSG or Monosodium Glutamate causes painful affects to those with IBS cause cramping, dizziness, diarrhea, nausea, and other related symptoms that can go on for hours. Find out more about MSG here.
• Avoid artificial sweeteners. Artificial sweeteners cause gas, bloating, abdominal cramping and urgent diarrhea in many people who have a healthy colon. Some with IBS can suffer greatly after eating foods containing artificial sweeteners and be unaware that the sweetener was included in the ingredients. Find out how to read grocery labels here. http://www.healthmad.com/Nutrition/Grocery-Label-Ingredients-and-What-They-Mean.28485

While there is no cure for IBS, arming yourself with facts and helpful information can make your experience more manageable. Online IBS forums are a great place to begin.