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about ibs

This section contains a basic introduction to irritable bowel syndrome, its symptoms, diagnosis and treatment. It also contains the 'I hate IBS!' section, with 101 reasons why we hate our own guts, and the 'Quotes from non-sufferers' section with such classic gems as 'Why don't you go to the doctor?' and 'Surely it's all in your head?'.

On this page you can also read answers to to the frequently asked questions, from 'Does this sound like IBS?' to 'Why did you set up this website?'

Introduction to IBS

Symptoms of IBS
Looking at the main symptom of diarrhea, constipation and pain, as well as the 'red flag' symptoms.

Diagnosis of IBS
A guide to how doctors decide you have IBS.

IBS sufferers sometimes need to have various tests to rule out other bowel conditions such as celiac disease or inflammatory bowel disorder, so this section also includes descriptions and personal experiences of the most common tests: barium enema, colonoscopy, endoscopy, flexible sigmoidoscopy, sitz marker test, upper GI series and virtual colonoscopy.

Treatment of IBS
An overview of the different treatment approaches to IBS, including supplements, medications and hypnotherapy.

Causes of IBS
The current thinking on the main causes of IBS, in a two-part article. Part One looks at brain-gut dysfunction, low-grade inflammation, mast cells and bacterial causes. Part Two looks at food intolerance, serotonin levels, and psychological factors.

IBS Foods
Guidance on foods that you can eat and foods you should avoid, according to the Heather Van Vorous eating for IBS diet.

Different Types of IBS

IBS with Diarrhea
An overview of IBS with diarrhea and some common remedies.

IBS with Constipation
An overview of IBS with constipation and some common remedies.

IBS and Pregnancy
A look at IBS and pregnancy issues, including personal stories from pregnant women.

Humour and General Ranting

Top 10 Stupid Things Said to IBS Sufferers
You know, stuff like "It's all in your head". Which it isn't, by the way. Just sign up to my monthly mailing list to read the Top 10 list.

I Hate IBS
A collection of reasons why we hate IBS! All submitted by IBS Tales visitors.

IBS Quotes From Non-Sufferers
From the traditional 'It's all in your head' to the highly observant 'There's always something wrong with your stomach'.

Miscellaneous Oddments

Spastic Colon
A short article about some of the alternative names used for IBS over the years, including spastic colon.

IBS and Disability Allowances
Is it possible to receive benefits/allowances when suffering from IBS? I would love to hear your experiences.

Something to Talk About
How the internet can help sufferers to express their feelings, and how sites such as IBS Tales can form a source of support.


FREQUENTLY ASKED QUESTIONS

This section contains answers to some of the questions that I hear most often from IBS Tales visitors. If you have a question that isn't answered by the information on this page or the rest of the site, then please contact me.

Symptoms and diagnosis

What are the symptoms of IBS?
How is IBS diagnosed?
Is IBS a proper diagnosis, or something doctors use when they don't really know what's wrong?
I have diarrhea and pain, but I haven't been to the doctor. Do you think it sounds like IBS?

Treatment and diet

What is the best treatment for IBS?
What is your opinion of [insert name of drug or medication], do you think it will work?
Where can I find a list of good and bad foods for IBS?
Will my IBS go away if I eat a very healthy diet?

Causes of IBS

What causes IBS?
But I thought IBS was caused by psychological problems? My husband/family/friends tell me that it's 'All in my head'.
But I thought IBS was caused by stress?
If hypnotherapy is a good treatment for IBS, doesn't that prove that IBS is in the mind?

Availability of drugs and good doctors

Where can I buy Digestive Advantage in the UK?
Can my doctor prescribe Zelnorm or Lotronex in the UK?
I live in Seattle/London/Aardvarkenville - where can I find a decent IBS doctor near me?

About this website

Why did you set up the IBS Tales website?
What kind of IBS do you suffer from?
I've read your story and I think you have celiac disease/endometriosis/lactose intolerance (etc) rather than IBS - why don't you get tested?
Why can't you give me any medical advice?
I know you can't give me any medical advice, but can you just tell me whether this drug is safe for use during pregnancy?
OK, no medical advice, but can you offer me any kind of help?

Symptoms and diagnosis

What are the symptoms of IBS?

The main symptoms of IBS include diarrhea, constipation, abdominal pain and cramps, nausea, bloating and intestinal spasms. Symptoms vary from person to person, so you may not have everything on this list, and you may have very mild symptoms, or very severe symptoms, or something in between.

Doctors tend to classify IBS sufferers into three main groups. These groups are diarrhea-predominant IBS (IBS-D), constipation-predominant IBS (IBS-C), and alternating IBS (IBS-A, a mixture of diarrhea and constipation).


How is IBS diagnosed?

Firstly, I should point out that IBS can NOT be diagnosed by yourself, or via email, or through reading any of the stories on this website and thinking 'Yes, that sounds a bit like me, IBS it is'. There are a whole range of medical conditions which can produce gastrointestinal (GI) symptoms, including celiac disease, Crohn's disease, colitis and lactose intolerance, and they can all produce IBS-like symptoms.

Unfortunately, at this point there isn't a definitive test for IBS, so your doctor can't give you a blood test for example which will be positive if you have IBS. Instead, the doctor will ask you about your symptoms, possibly refer you for tests to rule out some of the other GI disorders, and then if the tests come back negative you will then be told you have IBS.

Some doctors will send you for more tests than others, and some may not send you for any tests at all - it just depends on your specific symptoms and medical history.

Doctors often use something called the Rome II Criteria to assess your symptoms. These criteria are basically just a list of symptoms which would suggest you have IBS, such as diarrhea or abdominal pain, and a list of criteria which would suggest you don't have IBS, such as bleeding. You can find the Rome II Criteria on this page.


Is IBS a proper diagnosis, or a term doctors use when they don't really know what's wrong?

IBS is an entirely genuine diagnosis, with its own specific set of symptoms, as seen in the Rome II Criteria mentioned above. Some patients do come away with the impression that their doctors have just given up on finding out what's really wrong with them because nothing has been found in any tests.

This is not the case though, as the doctors will just have been checking that you do not have any other GI condition before confirming that you have IBS. They may well have been pretty sure that you had IBS from the start, but used the tests to make sure another gastrointestinal condition wasn't involved.

There have been plenty of studies which have shown common physical symptoms and reactions in IBS patients, particularly in terms of brain-gut reactions and visceral hypersensitivity. We are a genuine patient group!


I have diarrhea and pain, but I haven't been to the doctor. Do you think it sounds like IBS?

Silly answer: 'Yes, it does sound like IBS - if you had celiac disease or lactose intolerance or Crohn's disease or endometriosis then I would be able to tell because little dancing hippos would appear above your email singing 'It's not IBS, oh no no, it's not IBS' to the tune of 'Yes, We Have No Bananas.'

Proper answer: 'I'm afraid it's no good me telling you whether it sounds like IBS or not - you need to see a medical doctor and get a definitive diagnosis of IBS, plus have any tests or investigations that the doctor recommends. It's the only way, and if you rely on self-diagnosis or diagnosis via email then you are putting your health at risk.'


Treatment and diet

What is the best treatment for IBS?

There are lots of different treatments available, including medications, therapies, and supplements. There's no real set route for treatment, and so it's best to educate yourself as much as possible about the various treatments available, and then choose the route (of course with the help of your doctor) that you think could work for you.

Having said that, the treatments that I tend to hear good things about are hypnotherapy and the IBS Audio Program 100, dietary changes such as gluten or dairy-free diets, soluble fiber supplements, and Heather Van Vorous' diets and products.


What is your opinion of [insert name of drug or medication], do you think it will work?

To be honest, your own opinion is just as good as mine is - I'd like to tell you that I was a world-renowned expert on every IBS supplement going, but in reality I'm just an IBS sufferer who runs a little website and collects things with sheep on them.

I do hear a lot of anecdotal evidence about supplements, but the trouble with anecdotal evidence is that one minute I'll get a good report of a product and the next I'll get someone telling me that it's the very worst thing they ever tried and I should tell everyone not to use it.

The best thing to do is look carefully at all of the marketing for the product, specifically at any clinical trials, surveys, and verifiable claims about customer satisfaction - basically anything that is backed up with evidence rather than just written for effect by the advertising boffins. And remember that the very worst products usually give themselves away. I would definitely stay clear of anything that is going to 'cure' your IBS, or is 'guaranteed to work for everyone', or that is a 'new and miracle breakthrough' - you know the kind of stuff.

Plus, you should also look carefully at the ingredients, and try to work out what each of them is doing there. For example, if a colon cleanser has senna in it then it's going to work as a laxative, because senna is a natural laxative, but that's not the same as cleaning your colon. If a product is expensive then take a good look at the ingredients first, check what each of them do (just a google search is usually enough), and then, if you think you need them, check your local health food store for a cheaper product.


Where can I find a list of good and bad foods for IBS?

Believe me, if there was a definitive list of good and bad foods it would be displayed in fluorescent ink on every page of this site! Which is to say, I'm afraid there isn't one. Different people may be affected by different foods, and different experts disagree on what diets can be helpful. Some people think that food intolerance blood tests can be used to find your trigger foods, some think that exclusion diets such as gluten-free diets are best, and others like patient-expert Heather Van Vorous have developed specific eating plans (Heather's is based on using soluble fiber to soothe the digestive tract).

Again, it's important to do you own research and find a diet that helps your own symptoms. However, if you're looking for a place to start, there is some research to suggest that some of the most common trigger foods may be: spicy foods, fried or fatty foods, onions, gluten-containing foods (bread, pasta etc), and dairy products.


Will my IBS go away if I eat a very healthy diet?

That depends. If you currently eat three large yaks and a vat of vodka every day then I expect your health will improve if you stop, yes. In fact, anyone who eats a stupidly unhealthy diet and then complains of IBS doesn't really get a lot of sympathy from me - why is it that you expect to be able to live on hamburgers and chocolate and fried muffins without suffering any ill effects?

I would go so far as to say that someone who eats junk day in and day out and has stomach problems doesn't even have IBS, they just have a perfectly good digestive system that doesn't like being fed on garbage. Your lungs complain if you smoke, and your gut complains if you expect it to digest junk. That's not IBS, that's just how our bodies work.

Most of us, of course, do eat a relatively healthy diet, or at least not a ridiculously unhealthy diet, and I'm afraid that for us the truth is no, our IBS will not disappear if we start eating the perfect diet. However, that's not to say that we shouldn't look at our diets with a view to common sense. If you're drinking a lot of alcohol then that's probably doing you no good, and if you're eating a lot of high fat, fried foods then that might be upsetting you as well. But a healthy diet is certainly not a cure-all for IBS.


Causes of IBS

What causes IBS?

Well, there's a question that I'm not going to be able to answer in a couple of sentences. There are lots of different theories about what causes IBS - you can read about them here. A lot of progress has been made in recent years, and the 'brain-gut dysfunction' in particular is now an accepted part of our understanding of IBS. This means that IBS sufferers process information from the gut in a different way to healthy people, and are hypersensitive to even normal gut contractions (which explains some of the crushing pain...).

If you are researching the causes of IBS, the only word of caution I would offer is that it is vital to differentiate between what causes IBS, and what triggers IBS. Sufferers can have various triggers which will lead to an attack, such as spicy food or a very stressful meeting, but that doesn't mean that the food or stress is the cause of IBS, just the trigger.


But I thought IBS was caused by psychological problems? My husband/family/friends tell me that it's 'All in my head'.

Well then, your husband/family/friends are pretty dumb. Sorry, but they are, and here's why - they have obviously just assumed that your symptoms are psychological, without doing any kind of research on IBS. If they had done some research, they'd soon discover that every leading IBS expert and every gastrointestinal association in the world believes that IBS is not 'all in the mind', nor is it a psychological or psychiatric disorder.

And if your family or friends still believe that IBS is psychological and you could stop all your symptoms if you just stopped being neurotic, then I'd start challenging them. 'What research are you basing that idea on? What clinical study shows that IBS is in the mind? What leading IBS expert believes that IBS is psychological?'

And if they still persist in their ignorance, then I'd start ignoring them. You wouldn't listen to someone running around saying 'The Earth is flat, the Sun is French, the Moon is made of mushrooms', so don't listen to the 'all in your head' rubbish either.


But I thought IBS was caused by stress?

Nope, sorry. Stress can certainly trigger an IBS attack, but stress can make all kinds of medical conditions worse. Asthmatics can suffer from an asthma attack when they're stressed, and IBS patients can have an IBS attack. Doesn't mean that IBS is caused by stress any more than asthma is caused by stress.

All of the leading IBS experts, hospitals and associations agree that IBS it is NOT caused by stress. So there.


If hypnotherapy is a good treatment for IBS, doesn't that prove that IBS is all in the mind?

Hypnotherapy is certainly a good treatment for IBS, and there are many clinical studies which show that it can be effective. However, to say that this proves that IBS is psychological is a huge - and illogical - leap.

Doctors and therapists are still trying to understand exactly how hypnotherapy works and how it affects the body. What they do know already, though, is that it can be a very powerful tool. In fact, it is so powerful that, for example, doctors in Belgium regularly use hypnotherapy as an anesthetic during surgery (combined with small amounts of painkillers). This is clear evidence that hypnosis can block pain signals, and may be one way in which it helps IBS sufferers.

It's important to remember that hypnotherapy is not just an anti-stress device, nor a rather wishy-washy relaxation aid. It's far more powerful than that, and the fact that it works for IBS certainly does not provide evidence that IBS is psychological.


Availability of drugs and good doctors

Where can I buy Digestive Advantage in the UK?

Digestive Advantage is not available in UK shops. However, I contacted the makers of Digestive Advantage and they recommended the following websites for delivery to the UK: www.doctorvicks.com and www.rofay.com.

I have also heard from one or two people who have purchased it through the website Drugstore.com, which offers international shipping options.


Can my doctor prescribe Zelnorm or Lotronex in the UK?

Both Zelnorm (for constipation-predominant IBS) and Lotronex (for diarrhea-predominant IBS) have been turned down for a licence in the UK, and at the moment it doesn't look like that's going to change. Sorry.


I live in Seattle/London/Aardvarkenville, do you know of a good IBS doctor near me?

I'm afraid that I don't have any kind of database of decent IBS doctors, and even when people are telling me their IBS stories they don't usually say where they live in the world. If you're looking for a recommendation for a GI doctor then you could visit the forums at www.ibsgroup.org and ask the members there for some names.


About this website

Why did you set up the IBS Tales website?

IBS Tales was started in 2001, on a free web host, when I was going through a particularly bad phase of my own IBS symptoms. I had started to research different aspects of IBS and had bought a few books on the subject. When I was reading these it occurred to me that, while all the advice about drugs and stuff was useful, the sections that I read the most eagerly were the ones written by the IBS sufferers themselves, describing how they coped with their everyday lives or how they treated their own symptoms.

I could only find a few of these stories in the IBS books, and so I decided to set up a website devoted to the stories of IBS sufferers. I didn't know anyone in 'real life' who had IBS, and so every time someone wrote in with their story I felt just a little bit more normal.

The site moved to the domain www.ibstales.com in 2003 and has lived there ever since.


What kind of IBS do you suffer from?

I would categorize myself as a constipation-predominant suffer, in that constipation is the symptom that most often causes me problems, but I also get occasional major attacks of diarrhea which are indescribably painful. I also suffer from bloating and intestinal spasms. I have suffered with IBS since I was 12, when a terrible attack of food poisoning had me spewing forth gunk from both ends (I'm sorry, that was probably too much information).

I do try to make fun of my IBS to give it less power over me, but the reality is that it has had a huge impact on my life, in all areas - school, work, finance, friendships, you name it it's ruined it. I do get pretty miserable about it sometimes.

You can read my complete IBS story in my book, Sophie's Story.


I've read your story and I think you have celiac disease/endometriosis/lactose intolerance (etc) rather than IBS - why don't you get tested?

I'm pretty certain I have plain old IBS, and I have had tests for various thing over the years. I get quite a few emails from people who think I might have celiac disease, but I already follow a gluten-free diet and although it helps it's not a cure-all, so I don't think that's likely. The fact that I can date my IBS back to food poisoning also suggests IBS. Besides, what would I do if I suddenly got diagnosed with something else - I run a website called IBS Tales, it'd be a big old disaster!


Why can't you give me any medical advice?

Because I've never had a day's medical training in my life. I can tell you what drugs to take if you want, but you'd have to sign a piece of paper that says you relieve me of responsibility if you drop down dead or metamorphose into any kind of fruit bat.


I know that you can't give medical advice, but could you just tell me whether this drug is safe for use during pregnancy?

Um...I would probably classify that as medical advice. Seriously, I have been amazed at the number of pregnant women who seem willing to put the health of their unborn child in the hands of someone who isn't a doctor, doesn't know their medical history, and has never been pregnant. Ask your doctor, please.


OK, so no medical advice, but can you offer me any kind of help?

Hopefully IBS Tales itself offers some help, but in terms of personal emails I am always happy to offer emotional support and swap personal anecdotes about IBS. I'm also happy to answer more general questions about IBS that don't include medical advice, such as what I think about a new IBS treatment, or whether I would recommend a specific IBS book, that kind of thing. Or if you just want to say hello, that's good too!

I am also very happy to have my email address passed on to any non-suffering friends or family members who have questions about IBS.

If you do email me, please remember that I receive a lot of emails and that I am sometimes sick myself, and so it may take me a little while to get back to you (although not usually more than a week).

You can contact me through this form.