Bowel Disorders

Irritable Bowel Syndrome

The Irritable Bowel Syndrome is a motility disorder that will involve the small and large bowel. It has been estimated that 20 percent or more of the adult population are affected by this disorder. There have been no anatomical reasons found that can be attributed to as a causal factor for this condition.

There can be a variety of symptoms accompanying this disorder. These symptoms may include an erratic frequency of bowel movement and a variation of stool consistency. Complaints are varied among individuals who suffer this very distressful syndrome. These complaints can include disagreeable and often distressful feelings and sensations, and possibly pain. Frequent complaints are of bloating and gas. Stools may be of a hard consistency causing constipation. If this occurs the individual will very often resort to the use of laxatives to alleviate the constipation. The end result of laxative use will result in a softer stool, and can possibly cause diarrhea.

There are basically two major types of irritable bowel syndrome:

1. The “Spastic Colon” type, will exhibit periodic constipation or diarrhea, or can alternate between the two. These individuals can have pain or a dull ache in the lower abdomen, very often occurring on the left side. This pain may occur off and on, and at times can be of a constant nature. When constipation becomes a persistent symptom, the stool can become extremely hard and can become impacted. When fecal matter becomes impacted, it may have to be removed manually before there can be a bowel movement. Quite often the individual, using a finger cot or rubber glove that is well lubricated, can remove the hardened stool, so that they will be able to have a bowel movement. If they are not successful in doing this, they will have to have it done by their healthcare provider. Over a period of time, as these symptoms occur, the individual can undergo a feeling of increased anxiety. Should the individual remain in this state over an extended period of time, this anxiety very often turns into a state of depression? The longer the individual is in a state of depression, the probability is that they will often neglect the condition and not seek the much-needed help from their healthcare provider, who can help alleviate the condition.

2. The other type of irritable bowel syndrome affects the individual who will exhibit a painless form of diarrhea. In this type of irritable bowel syndrome, the individual will complain of urgent diarrhea that usually occurs after eating and in the morning upon arising. Both types may exhibit pain when pressure is applied over the lower left abdomen. It is imperative for anyone exhibiting these symptoms to seek the advice of their healthcare provider.  They will be able to make a definitive diagnosis, so that other conditions may be excluded. Other conditions that can have similar symptoms are, Crohn’s disease and Ulcerative colitis. One caveat for the individual with irritable bowel syndrome is that they should avoid taking laxatives when constipation does occur.

As previously mentioned, anyone exhibiting the above symptoms should not hesitate in seeing their doctor. He or she will be able to diagnose the condition by taking a clinical history and various tests. These tests can include a stool culture, a proctosigmoidoscopy and a barium enema. By making a definitive diagnosis of irritable bowel syndrome, and ruling out the more serious Crohn’s disease and ulcerative colitis, the patient will be more at ease and their depressive state will be reduced. Once the patient has been reassured, he/she will then be able to make the necessary lifestyle changes that can help alleviate and improve their condition.

Once the individual has seen their healthcare provider and a definitive diagnosis has been made, this reassurance will go a long way in reducing their state of anxiety. It is then up to the patient to examine their lifestyle. This will include their diet and their physical and mental state. The proper diet is of the utmost importance as there will be foods that need to be excluded, and foods that will need to be included.

At the early start of the dietary changes, foods to be excluded are; peas, beans, corn and cabbage. These are high in fiber and fiber acts as an irritant. Once conditions calm down, and the bowel has returned to a more normalized state, they will later be added to the diet. Having enough fiber in the diet will also aid in preventing and alleviating constipation, but should be added slowly until the diet consists of at least 30 Gms daily. Vegetables are an excellent source of fiber. Fresh fruits (with skins) should be eaten with skin intact. Also to be excluded are fermentable carbohydrates, especially if gas is a symptom. The diet should consist of enough bulk so that the stool is moved along in the bowel. Whole grains should become a diet staple, but should also be added slowly until the bowel stabilizes. Dietary fibers absorb the water and oils that was causing the stool to harden. The fiber retains the water and keeps the stool soft. The amount of water that you drink needs to be increased, and at least 1 ½ to 2 quarts of water is needed. Liquids can also include juices, etc. A softened stool will be more easily evacuated.

Whole grains are an excellent source of fiber and should be included in your diet on a daily basis. Adding flaxseeds to the diet also aids in attaining a healthy peristalsis in the bowel. Flaxseed oil can be used as a supplement and can be taken in 1000mg softgels, taken twice daily with meals. Whole flaxseeds or bran can be used and taken daily. One tablespoon sprinkled over cereal or placed in a blender with fruits or vegetables and made into a healthy shake. This should be increased until you take 3 tablespoons. When taking flaxseed or bran in powder form, be sure to drink plenty of water to lubricate the stool so that it moves freely along the bowel. Prunes, raisins and dried apricots are excellent foods for keeping the stool soft.

Sugars and fermentable carbohydrates that are not completely digested by the normal flora found in the bowel will result in excess gas, such as methane, hydrogen and carbon dioxide. Lactic acid and ascetic acid is also a by-product of this incomplete digestion. Reducing the fermentable carbohydrates and sugars will reduce the amount of gas that is formed. The reduction of these foods will prevent the distention and belching (flatulence) that is due to the large amount of gas that is being produced.

Once the diet is adjusted as above, there are additional lifestyles that need to be addressed. Stress needs to be avoided as much as possible. Stress can be an important factor in that it can be an extremely upsetting catalyst in causing a derangement of the digestive process. Stress can cause a hyper-secretion (increase) or hypo-secretion (decrease) of the gastric acids needed for the normal digestive process. Too much acid production can cause gastro-esophageal reflux disorder (GERD). Too little can cause the food to enter the bowel undigested. This can lead to diminished absorption of the needed nutrients that a healthy body requires, which in turn can lead to anemia and/or poor calcium absorption leading to osteoporosis.

The final and extremely important tool in combating irritable bowel syndrome is exercise. This is one tool that must not be discounted or avoided. Having an exercise program that will keep the muscles toned is absolutely necessary. The abdominal muscles in particular play a very necessary role in the peristalsis that is required in moving the stool through the bowel in a normal fashion. Doing a little exercise one day, skipping another day or just avoiding it when you feel like it won’t do the job. You must find an exercise program that you can be happy with…and stick with it. In addition to your regular exercise program, you must get to be more active. Take walks, swim, bicycle ride, and walk up and down stairs, play sports if you desire…whatever, just keep moving. Adding the above regime to your lifestyle will improve the irritable bowel syndrome as well as your overall health as well.