Bare Bellies Speak Of Treatment
For Irritable Bowel Syndrome

by Darline Turner Lee, Physician Assistant, ACSM Exercise Specialist

Article Last Reviewed: Sept. 9, 2006

I hate direct to consumer marketing of medications. As a clinician, I hated when the pharmaceutical representatives came into the office with the newest glossy ad stating it was about to air to the public. That meant our office would be inundated with phone calls from patients wanting the self-proclaimed latest and greatest product. Pharmaceutical companies always say they tell consumers to consult with their physicians before trying any new medication. But that text is usually at the end of the ad, below the dollars off coupons.

My current irritant is the commercial for a medication that treats the symptoms of Irritable Bowel Syndrome (IBS) in women. The commercials feature a queue of women with bare bellies upon which are written the signs and symptoms of IBS. The voice over provides statements that the advertised medication will provide relief. At the end of the commercial, after we see all these tight and slender midriffs, and all the smiling, happy, women, there is a statement to “Consult with a physician to see if this product is right for you.” They also slide in a quick line about potential side effects and a few contraindications to the medication. It’s pretty slick advertising. There are just a few facts that I find lacking.

IBS is defined as irregular contractions of the large intestine (commonly known as the bowel or colon). There are two forms of IBS. The first form occurs when the bowel contracts rapidly and food is moved quickly through the bowel causing cramping and diarrhea. The other form occurs when the bowel contracts too slowly, sometimes halting completely, causing bloating and constipation. In either case, individuals stricken with IBS experience marked abdominal discomfort, the frequent urge to have bowel movements (even if they’ve just had a bowel movement) and sometimes relief following bowel movements.

There is no known cause of IBS. One theory is that some individuals have more sensitive and reactive colons than others. Foods and stress will affect these individuals and cause the aforementioned symptoms. There is some research indicating that bacteria may be partly responsible for IBS. The National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK) has found that the immune systems of individuals with IBS are more sensitive than in other individuals, suggesting a link between IBS and immune system. Many women note that their IBS is worse during their menstrual periods indicating a link between hormone levels and bowel activity. To date, no one can definitively state why IBS occurs in nearly twenty percent of the general population, and more frequently in women than in men.

There is no cure for IBS. It is neither contagious nor life threatening, but will likely recur throughout the affected individual’s lifetime. IBS should not be confused with diverticulosis, diverticulitis, ulcerative colitis or Crohn’s disease. These conditions can be life threatening, and the inflammatory conditions of ulcerative colitis and Crohn’s disease, require medical treatment.

According to NIDDK, a diagnosis of IBS is made in individuals experiencing:
Abdominal pain and discomfort for twelve (not necessarily consecutive) weeks of the previous twelve months, a change in the frequency of bowel movements, a change in the consistency of bowel movements, and relief of symptoms with bowel movements.

The evaluation of IBS consists of a thorough history and physical examination, blood work, and stool tests. The evaluation may also include x-rays with barium and colonoscopy. If the tests all come back normal, the clinician will likely make the diagnosis of IBS based on the symptoms.

Since there is no cure for IBS, treatment consists of relief of symptoms. Many individuals with IBS manage their symptoms with behavioral and lifestyle modifications. Diet plays an important role and there are certain foods known to increase IBS symptoms. These include fatty foods, dairy products, chocolate, caffeine, sodas and alcohol. Eating large meals also seems to worsen IBS symptoms and the American Academy of Family Physicians (AAFP) recommends that individuals with IBS eat six small meals throughout the day. Smaller meals prevent the bowel from becoming overwhelmed and contracting irregularly. A diet high is fiber is also recommended because fiber makes the stools softer, bulkier and easier to pass. While using fiber supplements is acceptable, both the AAFP and NIDDK recommend eating more fruits, vegetables and whole grains to increase dietary fiber intake.

Stress management is essential for IBS sufferers. Stress disrupts the normal rhythms of the bowels, resulting in the characteristic symptoms of constipation and bloating, or cramping and diarrhea. Individuals with IBS are encouraged to employ stress management techniques such as meditation, hypnosis, deep breathing, yoga, and exercise. If individuals have other issues, counseling may be indicated.

There is a role for medication in the treatment of IBS. Antispasmodics, laxatives and antidepressants have all been used effectively in the treatment of IBS. Newer prescription medications target diarrhea or constipation. But IBS sufferers state the best treatments are combinations of dietary modifications, stress management and medications.