IBS Tales

50 Things You Can Do Today To Manage IBS is a new book which takes a simple look at some of the self-help methods that can be used to reduce IBS symptoms. It’s part of a series of books which take the same approach to conditions such as insomnia and migraines and are written by the same British author, Wendy Green.

Let’s take the exact same no-nonsense approach with this review, and just tell you the pros and cons of this book.

Pros: I liked the straightforward approach, and the fact that the book concentrates solely on possible treatments. A lot of IBS books take whole chapters to explain the intricate workings of the duodenum when I just want to know how to get better.

The book covers most of the common IBS treatments, such as diet modification, drugs, fiber supplements and stress reduction. The sections on alternative therapies are useful, with interestingly detailed bits about herbal and food supplements, and I was pleased to see mentions of calcium and magnesium for diarrhea and constipation relief respectively. Brand names etc are the British versions as this is a UK publication but most products mentioned are available in the US too.

There’s a nicely balanced approach to more controversial issues such as candida and homeopathy, describing these treatments while also saying that many doctors remain skeptical about them, and there’s a clear message that IBS is definitely not ‘all in the mind’ which is always a quick way to win me over!

There were also some good, quick tips that could prove useful – for example, trying Imodium melts if you are traveling and don’t have access to water, and contacting the Gut Trust to get hold of a RADAR key which allows access to disabled toilets.

IBS Tales is mentioned in the book too, and I am even name-checked myself (“Sophie has had the the condition for 19 years”) which is rather groovy.

Cons: The book is short at 150 pages, and we’re told very little about the author, Wendy Green – just that she is a health project co-ordinator and that she has some personal experience of IBS. As the author of such a wide range of other health books I presume that she doesn’t have a particular interest in IBS, which of course is not necessarily a downside, but as someone who has studied IBS in detail for 20 years (entirely against her will) I would perhaps prefer to know a little more about the author’s expertise in the IBS arena.

I was also a little surprised by several of the statements in the book that were presented as facts. For example, the author states “Most sufferers experience flare-ups that last between two and four days”, which seems very specific, and I’m not sure I’ve ever read anything that gives that particular time-frame before. Many sufferers I hear from experience symptoms for weeks or even months at a time.

The author also says that urgent diarrhea is probably the most distressing aspect of IBS, which I would suggest is a bit of a myth – it’s certainly awful for many sufferers, but for a lot of others the severe pain is their most hated symptom.

Finally, a couple of statements in this book are contradicted by the last IBS book that I reviewed, IBS: Answers at Your Fingertips by the gastroenterologist Dr Udi Shmueli. Wendy Green states, for example, that laxatives can cause dependency, which Dr Shmueli says is highly unlikely and not backed up by modern studies.

He also disagrees with Wendy Green’s assertion that IBS is probably related to a Western lifestyle (stress, refined foods, couch potatoism) and says that IBS “exists in every society that has been examined” and affects 30% of people in Nigeria.

Conclusion: 50 Things You Can Do Today To Manage IBS is a simple, useful guide to the treatment options available for IBS, and a good introduction to the somewhat bewildering array of treatments that we sufferers are faced with.

Alissa has written in with an interesting question – what happens if you are an IBS sufferer already when your gallbladder is removed? Regular readers of this blog will know that gallbladderless people can be prone to diarrhea because of an excess of bile in their intestines, and this bile can often be treated with medications like Welchol and Questran.

But what you have gut troubles before your gallbladder goes? If anyone here has experienced that, Alissa would like to hear from you (just leave a reply in the comments section). She says:

“I’ve noticed that quite a few sufferers experienced the onset of IBS after removal of their gallbladder.  I’ve been dealing with IBS since I was 14, and I was diagnosed at 16.  I guess I’m a ‘C’ type – I deal with (thankfully) very mild constipation, that now with a careful diet erupts into an all-day bathroom session with progressive diarrhea (you must really love this work to deal with all this TMI! )

Anyway, I am now faced with gallbladder surgery.  The surgery bothers me not one wit – it’s a simple procedure and it will be what it will be – but I am very concerned that my now blessedly-easy-to-deal-with IBS will turn into a nightmare situation.  Even knowing I have IBS, my current doctor actually said to me, ‘You’ll try different foods – if something gives you diarrhea, you know not to eat it.’ (!)

Has anyone experienced having gallbladder removal while already having IBS? I know we all are different and have different symptoms and triggers, but I would appreciate hearing other people’s experiences.”

Thought I’d write a brief guide to the different types of IBS, as this can be a confusing subject when you are first diagnosed. It really doesn’t need to be though, so let’s make this as simple as possible.

There are basically three main types of IBS. Firstly, there’s diarrhea-predominant IBS, which, you will be astounded to learn, means that you suffer predominantly from diarrhea. It doesn’t mean though that you won’t have any other symptoms. You may well have pain, discomfort, bloating, or nausea alongside the diarrhea. It does mean though that you will have more diarrhea than constipation. It is often referred to as IBS-D.

Then there is constipation-predominant IBS, which is just the opposite of IBS-D, ie: more constipation than diarrhea. This is called IBS-C.

The third group is sometimes called alternating IBS and sometimes called mixed IBS, and means that you suffer from alternating diarrhea and constipation. This is sometimes referred to as IBS-A.

I occasionally see people refer to IBS-P on messageboards, with the P standing for pain, because they feel that pain is their predominant symptom, but this term isn’t really used beyond the web as far as I’m aware.

There are more IBS-D sufferers than IBS-C or IBS-A sufferers, which is probably why IBS is often more famous for its diarrhea than any of the other symptoms. The ratios are sometimes quoted as about two IBS-D sufferers for every one IBS-C or IBS-A sufferer.

And that’s really all there is to it! IBS classifications are not an exact science, and sometimes people can switch between categories over time, but I expect that most of you reading this will know what category you fit into, either because you’ve been told by a doctor or just because it’s pretty obvious.

There is one IBS sub-category that I should probably mention here – sometimes doctors refer to post-infectious IBS, which means IBS that occurred after an infection such as food poisoning. But that tends to be the only subgroup that gets singled out.

Things do get more confused when doctors (or often patients themselves) start labeling sufferers as having mild, moderate or severe IBS, as these labels are completely subjective, and I’ve never seen any criteria at all to suggest what the differences between mild, moderate and severe IBS might be, so I would take these labels with a pinch of salt. But it doesn’t mean to say they can’t be useful.

So – what kind of IBS do you have? My name is Sophie, and I have IBS-C, and it can be mild, moderate or severe, according to my own personal criteria and the kind of day I’m having!

Researchers at the Boston Medical Center would like your help. They are doing an online study to learn whether writing about IBS symptoms and experiences can actually affect the symptoms themselves – an interesting topic for someone who runs a site called IBS Tales!

They are offering $25 for everyone who completes the full study. All you need to do is write for 30 minutes a day for either one day or four consecutive days, and complete three or four sets of questionnaires over a three-month period.

You need to be a US resident between the ages of 18 and 65 to take part, and you must have been diagnosed with IBS by a physician. Your information will be kept confidential and will only be accessible to the staff in the Office of Clinical Research at Boston University Medical Center.

To participate just go to http://www.bmc.org/ibs

I’ve decided to start a new series of frequently asked questions for 2010, looking at some of the things that newbies to the IBS world need to know. This post, and all subsequent posts, comes with my “I’m not a doctor” disclaimer which basically says that anyone who relies on internet information without seeking help from a doctor is a bit of a pillock.

So, our first topic of 2010 is an easy one – does IBS cause blood in the stool? Answer: nope. IBS is a functional disorder, which means that something has gone wrong with the actual function of the intestines, but not their physical structure (or, at least, nothing is wrong with the physical structure that is obvious to the eye or colonoscopies etc).

Some gastrointestinal disorders do cause bleeding, so it’s very important that any bleeding is checked out by a doctor. It’s also possible to have bleeding with hemorrhoids that may be the result of IBS, but you won’t know either way unless you get yourself to a doctor.

There’s no way that IBS alone can result in bleeding though, it’s just not that type of condition. Bloodless, if you like.