Irritable Bowel Syndrome
Irritable bowel syndrome! Surely a curious use of an adjective almost always applied to a human emotion. But when you consider the perverse behavior of this condition – its definition is too elusive to be called a disease – perhaps the description is apt.
Perverse, because IBS (to use the shorthand) has no identifiable cause, is considered incurable (though it’s probably not), defies diagnosis under clinical tests, and mimics the symptoms of so many other diseases/conditions, it is easier to define by saying what it is not than what it is.
IBS is characterized by mild to severe abdominal pain, general discomfort, bloating, diarrhea or constipation or wild fluctuations between either. But so also are colitis, Crohn’s disease, celiac disease, plus infections and parasites of several kinds. The difference is that all these complaints can be linked to an identifiable cause, while IBS cannot.
Skeptics have called it a “garbage disease” because it is the dumping ground for gastrointestinal conditions that defy explanation. But make no mistake: it is real enough. An estimated 6% of Canadians suffer from it, often chronically for years on end. Interestingly, that figure jumps to a whopping 35% in Mexico City.
No surprise, you might say – Mexico City is an extremely septic environment, with bad sanitation and water. But the researchers who generated these statistics insist that it is not bacteria that are causing the problem, so much as the stress of living in the world’s most populous city. IBS, they say, is mainly a psychosomatic disorder, a sort of nervous breakdown in the link between the brain and the gastrointestinal tract.
If this sounds like New Age medicine, bear in mind that the mind-body explanation has persisted through study after study since IBS was first named as a distinct syndrome sometime around 1950. Not until the late 1990s were connections made to possible organic causes, and these findings are still so tentative that the psychosomatic theory remains the best we have.
With all this uncertainty, treating IBS becomes a process of elimination, checking off similar conditions that might be confused with IBS. The first of these is celiac disease, which is an allergic reaction (not a disease) to gluten in grains that causes the immune system to attack the lining of the small intestine. Celiac is frequently misdiagnosed as IBS, which is strange, because identifying it is a simple matter of cutting gluten out of the diet.
Dietary changes can also address IBS symptoms directly. Food and drinks to be avoided are red meat, oily, fatty or fried foods, milk products, chocolate, coffee, alcohol and carbonated beverages, especially if they contain sorbitol or other artificial sweeteners. Substituting soy or rice products for milk products and eating smaller, more frequent meals can also help.
Research has shown that ingesting beneficial strains of yeast and bacteria in the form of supplements can dramatically reduce stomach cramps and normalize bowel function in IBS sufferers. Called probiotics, these organisms occur naturally in the gut but may be depleted by infection or food allergies.
Finally, in these difficult economic times, it’s perhaps worth noting that IBS is extremely debilitating, costing the US an estimated $30 billion a year and Canada, to use the one-in-10 formula, $3 billion. A considerable pain in the wallet, not to mention the stomach.
©Dr. Ashely Gordon, 2008