A recent study performed by researchers in Los Angeles, CA demonstrated the strong link between anticipatory anxiety and brain reaction in those with Irritable Bowel Syndrome.
The study documented decreased brainstem inhibition during anticipated pain and an enhanced reponse to stimuli in those suffering from IBS; this exaggerated response shown in the laboratory is a harsh reality for thousands of sufferers.
What is IBS?
IBS is the term for Irritable Bowel Syndrome, a “syndrome” because although it is a grouping of common complaints, the symptoms can differ greatly from individual to individual.
What are the symptoms of Irritable Bowel Syndrome?
The symptoms can include all or just some of the following:
- Abdominal bloating and gas
- Abdominal cramping
- Diarrhea and/or constipation, or both intermittently
- Mucus in the stool
- Straining, urgency or feeling that the bowel is not emptying completely
- Changes in frequency or consistency of stools
Who is affected by IBS?
The statistics to date on IBS include the following:
- 1 in 5 US citizens suffers from IBS regularly
- Women are twice as likely as men to have IBS
- 50% of patients diagnosed with IBS are under the age of 35
What causes Irritable Bowel Syndrome?
The cause is currently unproven, however there are several working theories:
- IBS is caused by disturbances in the normal contractions within the walls of the intestines. The contractions in IBS patients are stronger and longer in duration than those of patients without IBS.
- IBS patients seem to be more sensitive (or generally just "more aware of") to the nerves of the intestinal area when bowel are stretched by normal gas patterns.
Does IBS cause long term harm?
No, no long term effects have been documented other than an increased aggravation of hemorrhoids in IBS patients.
What medications treat IBS?
The following medications may be helpful in alleviating IBS symptoms:
- Imodium - Can alleviate gas, bloating and diarrhea but should be utilized with care as not to disrupt the normal bowel patterns.
- Fiber supplements such as psyllium (Metamucil), a great source of soluble fiber or methycelluloseLucin (Citrucel). By adding fiber, bowel contractions and patterns are regulated. Lucinda Bassett, in her widely popular program "Attacking Anxiety", strongly recommends daily fiber supplementation and insists that adding a bit of fiber to her diet calmed her own symptoms of IBS remarkably.
- Anticholinergic medicines - anticholinergics affect the nervous system and can relieve the bowel spasming that can be extremely painful, irritating and stress invoking.
- Antidepressents - Although certainly not all IBS sufferers would consider depression treatment, antidepressents can inhibit the activity of the neurons controlling the intestines. For those with mostly diarrhea an MD may prescribe imipramine (Tofranil) or amitriptyline. For those with mostly constipation, an MD may prescribe fluxetine (Prozac, Sarafem) or paroxetine (Paxil).
What is the connection between anxiety and IBS?
It is an interesting one as IBS itself is an anxiety provoking illness and on the flip side, anxiety (specifically panic disorder) patients can suffer from IBS as a secondary symptom. It is a connection that is self-fed and can cause a spiraling effect causing even greater anxious symptoms. Identifying a place or situation with an IBS event can cause anticipatory anxiety, avoidance behavior and anticipatory IBS in the future; the sufferer is left to escape out of the swirling cycle on their own. This connection, now documented in the recent LA study, must be broken slowly.
Steps to escape the cycle of anxiety and IBS
- Recognize and identify the offending situation - Use your "sensitiveness" to your advantage. Be an "IBS detective" and name the offending situation so that control can be taken.
- Return to the situation in small steps - don’t run away from it. Overcome the natural flight or fight response and stay to fight.
- Always recognize and prepare your out. Stay in control by formulating an exit strategy.
- Review the “worst case scenario” in your mind.
- Don’t accept defeat. You are doing this yourself to gain control for you and you only.
- Return to the scene again and again to gain comfort.
- Turn the negative connotations of the surroundings into a place of comfort and relaxation.
- Support yourself continually with the at home treatments even when you're feeling fine, stay on course.
Are there home treatments for IBS?
Certainly. The most successful treatment for each individual is determined through trial and error often found at home (not to discount the actions and aid of supplemental medication).
Due to the individual nature of each case and the multiple combinations of causal factors (including emotional, physical and environmental) many factors should be experimented with and considered:
- Decrease foods known to cause gas to the individual (carbonated drinks, cruciferous vegetables as major offenders).
- Examine common dietary offenders. In addition to the gas producers as listed above, evaluate any distress after consuming chocolate, milk, alcohol, fruits and vegetables, caffeinated beverages and sorbitol (present in most sugar free gums and/or candies).
- Identify stress provoking situations, break the cycle of avoidance and try to take control.
- Learn the "relaxation response" method of self relaxation (written by Herbert Benson). This twenty five years old book discusses the fight or flight response and its impact on the body internally. Its progressive relaxation methods (that can be performed anywhere) are an amazing tool in the quest to relieve IBS.
- Increase the amount of and make a regular habit of exercising.
- Consume meals and snacks at regular intervals throughout the day.
When should I see a physician for IBS symptoms?
It is important to note that there are other illnesses that a physician should rule out with symptoms that may mimic Irritable Bowel Syndrome including (but not limited to) Crohns Disease, ulcerative colitis and colon cancer.
Medical attention should be sought if any of the following symptoms are experienced:
- Weight loss
- Any change (from the individuals own pattern) in bowel habits
- Onset of symptoms past the age of 50
- Weight loss
- Fever
- Vomiting
It is also important to remind oneself that the quest for the solution to Irritable Bowel Syndrome is a journey that 1 out of 5 are on and should not be viewed as a solitary one.
