Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is one of the most common disorders of the digestive tract. Symptoms of IBS often increase with stress or after eating and include:

Abdominal bloating, pain, and gas.
Mucus in the stool.
Feeling as if a bowel movement hasn't been completed.
Irregular bowel habits, with constipation, diarrhea, or both.

The cause of IBS is unknown. Symptoms are thought to be related to abnormal muscle contractions in the intestines. However, when tests are done they find no changes (such as inflammation or tumors) in the physical structure of the intestines.

IBS can persist for many years. An episode may be more severe than the one before it, but the disorder itself does not worsen over time or lead to more serious diseases such as cancer. Symptoms tend to get better over time.

If you have not yet been diagnosed with IBS, try to rule out other causes of stomach problems, such as eating a new food, nervousness, or stomach flu. Try Home Treatment for 1 to 2 weeks. If there is no improvement, or if your symptoms worsen, call your doctor for an appointment.

Your doctor may prescribe medication for you to take in addition to doing Home Treatment. The amount of testing your doctor will do to determine the cause of your symptoms depends on your age; how your symptoms come on and how severe they are; and how you respond to initial treatment.

Prevention

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There is no way to prevent IBS. However, symptoms often worsen or improve because of changes in your diet, your stress level, medications, the amount of exercise you are getting, and for other reasons that may or may not be known. Identifying the things that trigger your symptoms may help you avoid or minimize attacks.

Gallstones

Gallstones are tiny stones (usually made of cholesterol) that form in the gallbladder.

Sometimes gallstones cause the gallbladder to become inflamed. The main symptom is a dull aching or cramping pain that starts in the upper right abdomen and may radiate to the centre of the upper abdomen or to the right upper back or shoulder blade. The pain may be severe and usually lasts several hours. Fever and vomiting also may be present.

Symptoms often occur at night, usually at about the same time every night. Symptoms may be worse after you eat a high-fat meal.

Risk factors for gallstones include a high-fat, high-sugar diet, obesity, lack of exercise, rapid weight loss, estrogen replacement therapy, diabetes, high cholesterol, and high blood pressure.

Gallstones that don't cause symptoms don't require treatment. If gallstones cause pain or infection, surgery to remove the gallbladder is the most common treatment.

If you have mild symptoms, it is safe to wait until symptoms recur several times before seeking treatment. See Signs of shock. to decide what to do if your symptoms become more severe.

Home Treatment

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If constipation is your main symptom:

Eat more fruits, vegetables, legumes, and whole grains. Add these fibre-rich foods to your diet slowly so they do not worsen gas or cramps. See Fibre.
Add unprocessed wheat bran to your diet. Start by using 15 ml (1 tbsp) per day, and gradually increase to 60 ml (4 tbsp) per day. Sprinkle bran on cereal, soup, and casseroles. Drink extra water to avoid becoming bloated.
Use laxatives only if your doctor recommends them.

If diarrhea is your main symptom:

Using the fibre-rich food and wheat bran suggestions for relieving constipation can sometimes help relieve diarrhea by absorbing liquid in the large intestine.
Avoid foods that make diarrhea worse. Try eliminating one food at a time; then add it back gradually. If a food doesn't seem to be related to symptoms, there is no need to avoid it. Many people find that the following foods or drinks make their symptoms worse:
- Alcohol, caffeine, nicotine
- Beans, broccoli, cabbage, apples
- Spicy foods
- Foods high in acid, such as citrus fruit
- Fatty foods, including bacon, sausage, butter, oils, and anything deep-fried
Avoid dairy products that contain lactose (milk sugar) if they seem to worsen symptoms. However, get enough calcium in your diet from other sources. See "Lactose Intolerance" on See Lactose Intolerance.
Avoid sorbitol (an artificial sweetener found in some sugarless candies and gum) and olestra (a fat substitute used in some processed foods, such as potato chips).
Avoid foods that don't digest well, such as corn, carrots, peas, etc.
Add more starchy food (bread, rice, potatoes, pasta) to your diet.
If diarrhea persists, a non- prescription medication such as loperamide (the active ingredient in products such as Imodium) may help. Check with your doctor if you are using loperamide twice a month or more.

To reduce stress:

Keep a record of the life events that occur with your symptoms. This may help you see any connection between your symptoms and stressful occasions.
Get regular, vigorous exercise such as swimming, jogging, or brisk walking to help reduce tension.
See Relaxation Skills for more tips on managing stress.

When to Call a Health Professional

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If you have been diagnosed with irritable bowel syndrome and your symptoms get worse, begin to disrupt your usual activities, or do not respond as usual to Home Treatment.
If you are becoming increasingly fatigued.
If your symptoms frequently wake you.
If your pain gets worse with movement.
If you have abdominal pain and a fever.
If you are losing weight and you don't know why.
If your appetite has decreased.
If you have abdominal pain that does not get better when you pass gas or stools.
If there is blood in your stools that is not obviously related to previously diagnosed hemorrhoids.

FAMILY HEALTH CARE +

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