More than 20 percent of the US population lives with irritable bowel syndrome (IBS) and for many Americans it is an ongoing challenge. But when it comes to treatment, old advice from Mom was right. Often, the key is to eat right and go outside and play.
"IBS is a complex mind-body medical condition," says Richard Benya, MD, gastroenterologist at Loyola University Health System. "Psychiatry and gastroenterology intersect as all three systems - the central, peripheral and the enteric - are affected."
According to Dr. Benya, IBS is an abnormal communication between the mind and the gut. "There are actually more nerves in the gut than in the spinal system," says Dr. Benya, professor, Department of Medicine, Loyola University Chicago Stritch School of Medicine. "Unfortunately, patients with IBS suffer from a real garbage bag of symptoms."
Symptoms of IBS include chronic:
•Burning pain in the abdomen
"Just like hypertension and diabetes, there is no cure for IBS," says Dr. Benya. "Sufferers can just improve the condition through lifestyle changes and/or medications."
IBS is something that many have suffered from their whole lives. "IBS does not suddenly appear in your 50s and 60s," says Dr. Benya. "Patients will say that as a child they experienced similar symptoms and, with time, learned how to control them. As we progress through life, sometimes symptoms get worse and a doctor's attention is finally sought."
IBS has a high correlation with stress. "When people say they had a tough day they often gesture to their stomach, representing the bad feeling they get in their gut," says Dr. Benya. "There is a strong connection between stress and their health."
Dr. Benya recommends these changes to improve or control symptoms of IBS:
•Avoid foods such as beans and cruciferous vegetables
•Avoid processed foods
•Talk to your physician about medicine that could control symptoms
Exercise is important to reduce the physical and emotional triggers of IBS such as stress and many IBS symptoms including constipation. "In addition to promoting overall physical wellness, staying active is a mood enhancer," says Dr. Benya.
The most popular treatment for IBS is an elimination diet called FODMap. "Three out of four people with IBS find relief in trying the FODmap diet, but it can be difficult to consistently follow and sustain," says Dr. Benya.
Many FODmaps linger in the gut and ferment, and absorb water in the digestive tract, leading to bloating. Examples of FODmaps to eliminate from the diet include:
•Fructose: fruits, honey, high fructose corn syrup, agave
•Fructans: wheat, onions, garlic
•Galactans: legumes, such as beans, lentils, soybeans
•Polyols: sugar alcohols and fruits that have pits or seeds, such as apples,
avocados, cherries, figs, peaches, or plums
"Anti-depressants are commonly prescribed when the elimination diet is not sufficiently alleviating symptoms," says Dr. Benya. "It is not that the patient is depressed, but that the drugs cause the mind and body to better communicate and the gastrointestinal system to relax."
With one out of ten people suffering from IBS, awareness for the condition has greatly increased. "There is more education now on gastrointestinal diseases like IBS, Crohn's and Ulcerative Colitis," says Dr. Benya. "Relief from symptoms is available but it does take time and something of a trial and error approach."
Loyola University Health System