Dear Dr. Garner,
I am one of your biggest fans. I never miss a TV show or Tablet column, so I really hope you can help me.
For the past few months, I have been having cramps in my stomach with gas all day. Either I feel constipated or have diarrhea, but nothing you would describe as normal.
I am embarrassed by the gas and the times that I have to run to the bathroom and sometimes spend an hour trying to empty my bowels.
I went to my doctor, who ordered tests for me, and he told me I have irritable bowel syndrome.
This has been going on for over six months, and I am so depressed that I might have to live with this condition for the rest of my life.
I am 30 years old. Aside from being nervous all the time about nonsense, I am in pretty good shape.
What do you think causes this condition, and will it last for the rest of my life?
Irritable Bowel in Brownsville
Dear Irritable Bowel,
I was just talking about this subject with my good friend and colleague, Dr. Antonio Mascatello.
Unfortunately, nobody knows what causes Irritable Bowel Syndrome (IBS). It can be extremely disabling and interfere with normal life activities.
What is it exactly? It is a condition that is extremely debilitating, can mimic colitis, cause gas, swelling, diarrhea and constipation. The good news is that it is not dangerous to the bowel. It leaves no permanent problems, and there is no increased risk for cancer.
It causes all of the symptoms you are experiencing by affecting the large intestine. It usually can be controlled by adjusting diet and controlling things that cause episodes, like stress.
Normally, the muscles of the intestines work in a coordinated fashion. In someone with IBS, there is no coordination, and some food gets pushed through the large bowel and out the rectum before it can be fully digested. This causes the diarrhea, constipation and gas.
A possible cause of the disease is the presence of abnormal chemicals from the brain that make the intestines malfunction.
How do you know if you have it? The criteria to make the diagnosis include abdominal discomfort or pain, for at least 12 weeks in the preceding year (and need not be consecutive weeks), plus any two of the following:
• The feeling that you can’t empty your bowels all the way
• A change in the consistency of your stool
• Mucus in your stool
• Increased gas causing a distended belly
Various Triggers
Certain factors, known as triggers, can set off the condition. These include stress, hormones (it may be related to the menstrual cycle) and certain foods, such as chocolate, soda, fruit, vegetables, dairy products, caffeine and artificial sweeteners, to name a few.
Some of the risk factors for the disease include being young (under 35), being a woman or having a family history of IBS.
Treatment may include fiber pills, diarrhea medication, avoiding high-gas foods, medication to slow down the intestines if diarrhea predominates, antidepressant medication (for those, like yourself, who feel depressed and hopeless), antibiotics and linzess, a new medication especially for IBS.
There are simple things you can do at home to improve the condition, including getting more fiber from your diet, eating smaller meals, avoiding dairy products, using probiotics, drinking a lot of liquids, exercising regularly and even acupuncture and hypnosis.
It is useful for patients to join support groups as it is comforting to meet others with similar problems, get tips on how to live better and cut down on episodes. Counseling is also helpful.
IBS can be a very distressing condition. Fortunately, unlike other types of colitis, it does not cause permanent harm to your bowel. With the proper treatment, your condition should improve.
Have a wonderful Memorial Day.[hr] Dr. Steven Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on NET, Tuesdays at 8 p.m. on Ch. 97 Time Warner and Ch. 30 Cablevision.