Question: I have suffered with IBS for many years. It usually lasts for one to four months, but my last bout has been going on for eight months. Is there anything I can take or do to cure, or at least reduce this? I go from moderate to extremely severe diarrhea at all times, even when I watch my diet.
Dr. Hibberd's Answer:
IBS is the abbreviation for irritable bowel syndrome. I see no information in your question regarding bowel investigation, which I regard as pivotal for your care and management. Having such prolonged attacks is unusual. I strongly recommend re-evaluation of your condition if this has not been done within the past three months.
IBS has no known physical cause, but seems to be exacerbated by stress, emotions, and changes in diet. IBS is characterized by the absence of structural bowel disease, with symptoms that include varying degrees of abdominal pain, cramps, bloating, and diarrhea or constipation. There are no consistent motility abnormalities, and excess mucous production typical of this disorder is not related to any demonstrable bowel wall inflammation. IBS can be triggered by stress, food or drugs, and may have a hormonal base in some patients.
All patients with IBS deserve a complete bowel workup for structural and motility disorder, and probably all should have at least a baseline colonoscopy with biopsy of bowel wall as indicated. Red flags for further investigation include weight loss, fatigue, age over 40, vomiting, rectal bleeding or fever. Although blood testing is normal with IBS, screening studies are important that include CBC, CMP, amylase, sed rate (ESR), TSH, and urinalysis to exclude other disorders. Appropriate stool stain and culture studies are usual for resistant cases, especially if you have been travelling to third world nations or have been exposed to well water.
Changes in IBS, persistence of symptoms for protracted periods, or non response to treatment may reflect other disorders; so be sure to keep your doctors up to date. Many cases of IBS with constipation respond well to dietary increase in fiber, appropriate anti-spasmotics and treatment of any underlying medical disorders. Aim for 30-40 grams of fiber daily. Remember that soluble fiber products are good for your bowel function and for lowering cholesterol, while insoluble products have only bowel function benefits.
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