When I went to school they thought Irritable Bowel Syndrome (IBS) was all in our minds as they thought also about other conditions. Then I started developing pains and cramps and couldn't move. The physicians gave me some tests. "Nothing serious. Just try this." More pain. More tests. More tries. Is it in my mind? Finally, a diagnosis: IBS.

What is IBS?

IBS is a pain in the gut. In the history of medicine it is a newcomer - they have only recently begun to view it as a syndrome ¹ or cluster of symptoms. These symptoms typically include pain associated with a bowel movement, difficulties with motility (speed of passage through the gut), and 'abnormalities' of stool shape or texture. Of course, one person's 'normal' is not the same as another person's experience of "normal" because everyone varies in terms of how they perceive and experience symptoms and related situations.

One of the physician's first concerns is to rule out or eliminate other possible problems. Even though it is quite common, IBS is often not recognized as a problem. Most often, it appears in a more benign form which can successfully be treated through reassurance and suggestions for lifestyle changes such as stress reduction and more fiber.

What causes IBS?

It's not clear whether it is just one thing that causes IBS. There are several factors that might contribute towards IBS and include such things as bacterial infection, inflammation, allergy, diet, genetic predisposition and psychological factors such as stress, anxiety or depression. This is something that definitely needs to be decided on an individual basis. There are several theories which have some support and it is also probable that there are several types of IBS.

What IBS means for someone who is not easily cured

While IBS in one of its forms is fairly common (estimates run from 10 to 25% of the population), it does affect some of those people in a serious or life-altering way. It is estimated that possibly 5% of those affected require treatment at specialized treatment centers and many are not "cured" and remain wholly or partially disabled ².

IBS is a significant problem for many but recent research in neuro-physiology and psychology has begun to clarify the problem and point to potential treatments.

Coping with IBS

It's not in my mind. It's in my gut. Or is it? Does it matter?

Getting better is what matters the most. There are things I have done and continue doing, including changes in my lifestyle with regard to such things as ways of working, the goals I set for myself, and, most importantly, changes in my attitude towards life. What also matters for me is the idea that researchers and physicians continue to seek various forms of treatment for the specific aspects of my problem. In other words, research in this area is active and ongoing.

Lifestyle changes

My physician recommended changes in my diet, getting more exercise, cutting down on cigarettes and caffeine. This was easier said than done, but with effort, I have managed to make changes in these areas.

Tracking changes in diet

Dietary changes are difficult to advise on a routine basis, since there are many views as to what needs to be done and what might be helpful. Beyond the certainties like eating more fiber, eating an apple a day, and cutting out fast foods and excess fat from my diet, I have surfed the Internet, consulted dieticians, read books, and haunted health food stores in search of further recommendations. Since there are no general answers yet and each person is different, the best plan is to start with a good basic diet recommended by your physician or a dietician, keep a food diary, track your reactions to various foods, and make adjustments based on the way your body reacts to foods.

Since food intolerance can be a cause of some irritable bowel symptoms and can also co-exist with IBS ³, I have started to investigate this as well. There is no magic bullet yet, as far as diet is concerned. But in my experience, I have found that the best approach is to make reasonable changes I can live with, keep on trying various changes and note their effects.

Getting exercise regularly

I took the same approach to exercise A long time ago I was a runner, and since the problem of IBS first hit, I've tried a number of exercise programs. The best I seem able to do now is walk a mile three times a week. Again it's not a magic answer but it does seem to help so I'll keep working on trying to incorporate walking into my daily life.

Changes in ways of working

The pains in the gut and cramping are worst for me in the morning. There were days I was so cramped I couldn't move, and so could not make it in to work.

Although we all may feel at times like not going in to work, I was dealing with a lot of stress in the office. This happened more and more often, and so I changed my hours. I reduced the number of patients I saw and this meant a reduction in the phone calls and forms to fill out for insurance companies. Having fewer patients also meant fewer crises, emergencies, and fewer other-peoples'-problems to deal with. I also sought psychotherapy myself for help in handling my patients' pain and being able to help them effectively.

I began to pursue other interests as a way of earning a living, and now spend some of my time selling books on the Internet, as well as writing articles like this. I also write poetry. These are activities I enjoy, and which don't require me to leave the house for long periods of time.

Changes in attitude

Along with these changes came what was for me the most important of all: a change in my attitude toward life. I realized I needed to start enjoying what I have and not worry so much about where I'm trying to get. My children are now out on their own which does help considerably with the stress. But looking back, the thing I regret most was not always being able to enjoy them because I was either not there due to my IBS or not able to participate as actively as I wanted with them in activities. I also think this was a more important lack they went through, in comparison to the economic problems that resulted from my seeing fewer clients due to my IBS.

IBS also affected my relationship with my wife in at least two ways. We did have a hectic life and there were times when I couldn't carry out my portion of the household duties such as driving the children to activities. In addition to this, being sick and not understanding why, was depressing. As a result, I was not fully able to participate in my relationship with my wife. And at those times when I did, I did not always have the energy level that I would have liked to have had.

In looking back, if both my wife and I had a better understanding of what IBS is, and had accepted it as a "real" condition, things might have been different. This might have helped us communicate better and understand my situation better.

Please see the link below for Part 2 of this article, where I describe the psychological aspects of coping with IBS.