Wed | Sep 18, 2019

Dear Doc | A very embarrassing problem

Published:Sunday | September 1, 2019 | 12:05 AM

Q Dear Doc, I have a problem that is very embarrassing and affecting my life. I am always farting, having belly cramps, and I do the ‘number two’ every minute, and many times it’s watery. It is serious, because now I am afraid to eat in public, or go anywhere, because I don’t want to embarrass myself. It’s just recently that this is happening and I thought it was something I ate, but it’s been going on for too long now to be caused by some bad food I had. What can I do to stop this?

 

A Yes, that is a problem, and it seems that you may have what is called irritable bowel syndrome.

So what is irritable bowel syndrome?

Irritable bowel syndrome, called IBS for short, is a chronic condition of the digestive system that causes belly pain and problems with bowel movements. IBS is the most commonly diagnosed gastrointestinal condition. An estimated 10 to 20 per cent of persons experience symptoms of IBS; however, only about 15 per cent of affected people actually seek medical help.

Some people with the condition have frequent, watery stool (diarrhoea), others do not have enough bowel movements (constipation), while some persons switch back and forth between diarrhoea and constipation.

SYMPTOMS

Persons suffering from IBS commonly complain of:

• Stomach pain and cramping, associated with bowel movement.

• Diarrhoea or constipation or both, as some people switch back and forth between diarrhoea and constipation.

• Bloating.

• Gas.

Unfortunately, there is no specific test for IBS. However, your doctor can figure out your diagnosis of IBS by asking you a few questions, and by running some tests to ensure that you do not have something other than IBS that could be causing your symptoms. There are many medical conditions that can cause the same symptoms as IBS. So it is important that your doctor excludes other possibilities.

REDUCING IBS SYMPTOMS

In order to reduce your symptoms, you can try the following:

• Start a diary to keep track of what you ate each day, what you did, and how you felt. That way, you can figure out if anything you do or eat makes your symptoms better or worse.

• The next natural thing to think would be to stop eating foods that might be making your IBS worse. Although it seems reasonable to eliminate ALL foods that aggravate IBS, it is best to talk to your doctor before you make significant changes to your diet. Eliminating some foods can potentially worsen the symptoms, or cause new problems, if important food groups are omitted.

• Many doctors recommend temporarily eliminating milk products because lactose intolerance is common and can aggravate IBS and also causes similar symptoms to IBS. The greatest concentration of lactose is found in milk and ice cream. It is also present in smaller quantities in yogurt, cheeses, and foods that contain these ingredients.

• You can start by avoiding all lactose-containing products for two weeks. If IBS symptoms improve, it is reasonable to continue avoiding lactose. If the symptoms do not improve, you may resume eating lactose-containing foods.

• Foods that cause gas should also be avoided. Some foods are only partially digested in the small intestines. When they reach the large intestine, further digestion takes place, which causes gas and cramps. Eliminating these foods is reasonable since you are having gas and cramping.

• The most common gas-producing foods are beans, cabbage, Brussels sprout, cauliflower, and broccoli. Some persons also have trouble with onions, celery, carrots, raisins, bananas, apricots, wheat and prunes.

• If you have constipation, eat more fibre. You can do this by eating more fruits and vegetables. Or you can take fibre pills or powders. If eating more fibre makes the symptoms worse, cut back on the fibre.

• Exercise. Do something active for 20 to 60 minutes, three to five days a week. Studies have shown that this helps to improve IBS symptoms.

There are a variety of medications that can ease the symptoms of IBS, but there is no cure for the condition. The medications that help with IBS symptoms include:

• Medicines to ease diarrhoea.

• Medicines to ease constipation.

• Antidepressants. These medicines work by blocking pain. When used to treat IBS, they are given at a much lower dose than would normally be given to treat depression.

• Medicines called ‘antispasmodics’.

• Antibiotics. These medicines sometimes help with bloating and diarrhoea in some people.

Most people who have IBS have the condition for the rest of their life. Even so, most people find ways to improve their symptoms. The key is to keep working with your doctor until you find an approach that works.

See a doctor soon so that you can have a faster resolution to your problem.

deardoc@gleanerjm.com