If you read enough IBS personal stories – and, I would venture to say, I read more IBS personal stories before breakfast than most people do in a lifetime – you quickly realize that there are many shared IBS experiences. From the fear of public accidents to obsessions with our diet to battles with our ridiculously unfeeling colleagues, I’ve read the same experiences over and over again for years and years. This is awful, of course, but also a little comforting, as you begin to learn that your pain is not yours alone, and many other people know just how you feel.
What I haven’t learned, unfortunately, is what causes IBS, because for every IBS patient there is a different story. Some of us get IBS right out of the blue, as if from nowhere. Some of us have surgery and suffer from that point on, some get food poisoning and then IBS, some take antibiotics and blame their broken bowels on that…there’s no one route to IBS.
But one thing that did strike me one day when I was reading through all of these stories was how often IBS sufferers talked about their gallbladders, and, more specifically, the absence of their gallbladders.
The gallbladder is a little internal organ that basically stores bile acids that come from the liver. People often have it removed, and you can live perfectly happily without it, except that without the gallbladder the bile has nowhere to go. And guess what? The bile is then shoved into the intestines instead, and that causes diarrhea, and that, I’m afraid, leads to a diagnosis of IBS.
Now, the wonderful thing about ‘IBS’ (I’ll explain my quote marks in a second) following gallbladder removal is that there are specific medications to control the diarrhea that results. Questran, Colestid and Welchol and are all used for this purpose, and often produce fantastic results.
So what’s the problem, if this portion of IBS sufferers can be so easily treated? Well, the problem is that doctors sometimes don’t even mention that the diarrhea could be related to the gallbladder removal, and just diagnose IBS. And even when they do think that the gallbladder removal has caused the problem, they STILL diagnose IBS.
Why is this daft? Well, obviously it’s daft first and foremost because anyone with no gallbladder needs access to the drugs I have mentioned. But it’s also daft because, to me, bile-related diarrhea is clearly NOT IBS.
If we diagnose bile-related diarrhea as IBS, then morphine-related constipation is IBS too, as is diarrhea caused by having half your colon cut out during surgery. In other words, any vague condition that causes gastrointestinal symptoms is IBS, even if we know exactly what the cause of those gastro symptoms is. That seems crazy.
Now, please don’t think that I have any less sympathy for my gallbladderless readers, because your symptoms are just as tough as anyone else’s. And I’m not about to to stop accepting stories and treatment reviews from people with bile-related ‘IBS’, partly because there are so many of you, and partly because patients often don’t realize that bile is the cause of their problems until they do some reading.
But it does seem like a strange situation when someone with a diarrhea-causing liquid flowing through their body is considered to have IBS – you might just as well drink a gallon of laxative in the morning and then diagnose yourself with IBS. Seems to me it would make as much sense!
