If you’ve ever spent time in a public restroom, you know how embarrassing passing gas can be. Now multiply the fear of flatulence by 10 and add cramping, diarrhea or bloating to the mix. Do you feel like flushing yourself down the toilet?
Irritable bowel syndrome, or IBS, impacts 10 to 15 percent of Americans – roughly half of whom are women – but only 5 to 7 percent receive a diagnosis for the distressing digestive disorder. Typically marked by gut pain or discomfort, IBS can manifest in different ways: Some patients have a constipation-dominant form of the syndrome, while others are more prone to diarrhea. Some even have frequent bouts with both bathroom burdens. Beyond irritated by your symptoms? Try these routes to relief:
Dissect your diet. You are what you eat – and that’s especially true when it comes to IBS, says Melody Hartzler, assistant professor of pharmacy practice at Cedarville University School of Pharmacy, and a pharmacist practicing at a primary care clinic in Dayton, Ohio. Many sufferers experience IBS flare-ups after eating dairy, wheat, garlic, onion, legumes, avocados, apricots, cherries, nectarines, peaches and high-fructose corn syrup. Keeping a food diary can help you identify problem foods and guide your treatment options, Hartzler says. For instance, if you notice your symptoms worsen after eating dairy products, take one to two tablets of Lactaid pre-emptively.
Chill out. Stress is thought to exacerbate IBS symptoms. That’s due in part to elevated levels of the gut-disrupting hormone cortisol, which the body pumps out when stressed. “Sometimes, just taking some deep breaths before you start to eat, and making sure you’re eating in a relaxed environment can help,” Hartzler says. Some psychologists even recommend holding your food, sniffing it, tasting it and concentrating on how many chews you take before swallowing it. The practice, called “mindful eating,” can both calm you down and give your body a chance to prepare digestive enzymes, she adds.
Try over-the-counter medications and supplements. Peppermint oil, sold in capsules, acts as both a muscle relaxant and a repellent of certain gut microbes that are believed to cause symptoms in some people, says Dr. Ali Rezaie, assistant director of the GI Motility Program at Cedars-Sinai Medical Center in Los Angeles. Probiotics are also commonly used, but Rezaie doesn’t usually recommend them due to a lack of research on their effectiveness for IBS.
For those whose IBS triggers constipation, Rezaie recommends the laxative Miralax. “It doesn’t taste bad, it’s easy to take and dissolves in water,” he says. A bonus: It keeps you hydrated, since it must be downed with 8 ounces of water. Another way to ease constipation is by taking an over-the-counter fiber supplement like Metamucil. However, stay far away from fiber supplements if you’re feeling more bloated than constipated, R ezaie says.
On the flip side, Imodium products may help if you’re suffering from diarrhea, says Cortney Mospan, a clinical pharmacist at East Tennessee State University’s Charitable Pharmacy in Johnson City, Tennessee. “Imodium is the sort of tried and true diarrhea treatment. Make sure there’s no potential cause of infectious diarrhea, because [Imodium] can trap bacteria,” she says, putting you at greater risk for symptom flare-ups.
Pepto Bismol is also an option for adults with diarrhea-dominant IBS, but should be used cautiously in children because of its aspirin compounds. The National Institutes of Health advises against the use of aspirin in children under 12 due to the risk of Reye’s syndrome – a potentially fatal condition that can trigger swelling of the brain and liver.
Stop snacking between meals. The body generally takes four to five hours to push food from the stomach to the small intestine, Hartzler says. For certain people, between-meal snacking doesn’t allow the digestive process to work properly, she adds. “Eating three meals and trying not to snack may be helpful,” she explains. Give your body at least four hours of rest between snacks and meals. And it’s not just snacking, but the type of snacks, that matter. If you eat a sugar-laden snack (even fruit) immediately following a high-protein meal, you may experience gas or bloating.
Exercise. It does a body – and bowel – good. Research published in 2011 in the American Journal of Gastroenterology suggests that people who participated in physical activity had fewer IBS symptoms than those who did not exercise. Hartzler adds that walking for as little as 15 to 30 minutes after a meal might aid digestion.
Go to the doctor. If you feel you’ve exhausted your options and are still crippled by symptoms, book a visit with a gastroenterologist. Make sure to discuss your family history of gastrointestinal issues, since IBS can be hereditary, Mospan says. Speak up if you’ve experienced unusual weight loss or had bloody or black, tarry stool. These could signal a more serious problem like cancer. Also bring a list of your symptoms and the medications you’ve tried to manage them, Mospan says. Your doctor can then determine if prescription medications such as Lotronex, Viberzi or Xifaxan are needed.
Lotronex is indicated for women who have severe diarrhea-dominant IBS. Approved in 2002, the drug works by blocking serotonin in the intestines. On May 27, the U.S. Food and Drug Administration approved Viberzi and Xifaxan for both men and women with diarrhea-dominant forms of IBS. Viberzi activates receptors in the gut that reduce bowel contractions and diarrhea. Xifaxan is an antibiotic that works by altering gut bacteria, thereby reducing diarrhea.
If you haven’t been taken seriously, don’t give up on finding help, Rezaie says: “It is important to know the underlying cause is in your belly – not your head.”