May 18, 2007 8:43 AM   Subscribe

What's the best way to deal with a terrible disease called IBS? ( Irritable bowel syndrome)

In the middle of a flare up, I suffer constant abdominal pain, diarrhea and nausea. I lose a lot of weight and feel so terrible I have thoughts of having to go to hospital for IV treatment because I feel so dehydrated. Any help, advice from other sufferers out there would be greatly appreciated.
posted by anonymous to Health & Fitness (31 answers total) 12 users marked this as a favorite
I used to suffer from this and in my case it was self-inflicted, simply because I found my job so stressful (I was a documentary associate producer). I watched one of my films go out from a hospital bed. However, as I got more control and rose in seniority I became much less stressed and it pretty much disappeared.

My tips are: when you get an attack, stop eating anything solid and drink lots of water. Lay off coffee, alcohol, cigarettes (big culprit) fatty foods, soda & so on completely. Chicken noodle soup worked well for me.

In my case it was totally lifestyle-generated, so if that might be the case for you, hit those root causes as fast as you can.
posted by unSane at 8:59 AM on May 18, 2007 [1 favorite]

Eat small meals. Never over-indulge in one sitting, that brings on attacks.

Really cut down on soda, fatty foods...unSane is definitely right on there.

I suffered from this for a short while but since my lifestyle is healthier now, it's virtually disappeared.
posted by misha at 9:13 AM on May 18, 2007

My dad has IBS also and it seems to be mostly triggered by certain foods. Do you notice that your symptoms are worse when you eat specific things? Things like tomatoes, which have lots of small seeds, can irritate your gut, or it might be triggered by acidic things like coffee, vinegar, etc. Just try to be observant of how your symptoms correlate with your diet.
posted by number9dream at 9:15 AM on May 18, 2007

No caffeine or alcohol. Avoid heavy greasy meals.
Eat light, take fiber and drink lots of water.
Most of all: No spicy foods! EVER! (I can't stress that one enough!).
posted by milarepa at 9:18 AM on May 18, 2007

No one has suggested marijuana yet?

I've heard nothing but success stories. See if you can get a prescription in your state.

Good luck!
posted by unixrat at 9:24 AM on May 18, 2007

Unfortunately, IBS/IBD/Crohns sufferers all seem to have different 'triggers'. Some common ones include soda, caffeine and alcohol.

Find a set of 'safe foods' that you can eat during a flare-up. These will typically be fairly bland, easily digestible items, like pasta. Many sufferers swear by Ensure during these times, since it is essentially a meal in a can. Don't stop eating all together, even though it's tempting. Your body needs the energy and nutrients - it's up to you to find safe ways to get that intake.

Too much fiber (roughage) during these flare ups can exacerbate symptoms. When recovering from a flare up, ease back into tricky foods. Make sure you give your gut adequate time to heal.

If your case is relatively severe, you might see a doctor about getting on an intestinal anti-inflammatory, like Mesalazine (sold as Pentasa). Unless your case is very severe, it's doubtful that more drastic steps (immune supressant drugs) are needed.
posted by chrisamiller at 9:24 AM on May 18, 2007

In my case, like unSane, the ultimate cause of my terrible IBS was stress -- at the time I was in a very difficult relationship. So the most useful long-term answer was to solve the stressful situation.

But shorter term, I found a couple of things that helped. One was zinc, in the form of tablets and also a favorite food, raw oysters. Zinc is an important element in the "zinc finger" proteins that line the intestinal wall and facilitate nutrient uptake. It helped a lot!

Also, stop the coffee, fatty foods, etc. Get more aerobic exercise, eat more whole grains and fibers. No refined sugars, or foods with lots of chemical ingredients. Basically, go back as much as possible to the "primordial" diet. Raw, organic foods, no red meat, very little fat, lots of fiber. Also, get to bed early and sleep at least 7 hours. Give it a week or two and see how you feel.

Good luck. IBS is so painful and debilitating. Non-sufferers seldom have any idea of how bad it can get.
posted by metabeing at 9:24 AM on May 18, 2007 [1 favorite]

I've got IBS-D, and I've had it most of my life. I've done the allergy tests (and also been told that IBS might not be related to allergies) and food diaries, and just about every reasonable-sounding bit of advice I've ever gotten.

The only things I've found to make a difference are a high-fiber diet (which sounds counter-intuitive for someone with D) and the most important part:

Strenuous regular exercise

When I'm good about working out five or six days a week and eating lots of fruit and fibrous vegetables, I can be 90% normal. And when I'm not normal, it's not nearly as bad. And it takes a lot of commitment. But here's the concept that you need to visualize to motivate:

You can spend 60 minutes shitting every day (seriously, keep track of your toilet time for a week and average it out.) and worrying/feeling off the rest of the time, or you can spend 60 minutes working out and feeling good the rest of the time.

Of course, there are benefits to regular exercise besides the ones in your intestines. You owe it to yourself to at least try it if you're not already exercising very regulary.

(these results aren't immediate. The fiber diet is about three days of hell followed by a week of normal (for us) followed by "hey, this is better." The exercise takes a couple weeks, but if you get the results I did, it will change your life.)
posted by Mayor Curley at 9:25 AM on May 18, 2007

My situation is slightly different, because I have colitis, but here are a few things you can do that will help.

1. Absolutely NO CAFFEINE. It causes things to move through way too fast. I had to cut it out entirely.
2. Eat small meals. Eating till I feel stuffed is almost always a recipe for disaster.
3. Cut out all sodas and chewing gum. They'll give you gas and gas just makes you feel that much worse.
4. Take Imodium if you need to be somewhere and it's absolutely crucial that you keep things in. Sometimes just knowing you've taken it will give you the confidence you need to make it to the bathroom in time.
5. Start writing down what you eat and see if you can detect any common foods on days when you feel especially bad.

Good luck!
posted by MsMolly at 9:27 AM on May 18, 2007 [1 favorite]

It's interesting that chrisamiller says too much fiber was a problem, while for me the increased fiber seemed to help a lot. Just goes to show that IBS can respond differently in different cases. Pay attention to what works for you and stick to it!

Again, take care of the stress. That will help the most of all!
posted by metabeing at 9:27 AM on May 18, 2007

As stated:

- don't overeat
- eat slowly (don't be swayed by people who wolf down their food without tasting it)
- avoid greasy foods.

I also suffer from lactose intolerance, so I avoid dairy if I can, also purchase Lactaid tablets and Milk. That may be something you want to also consider.
posted by EastCoastBias at 9:53 AM on May 18, 2007

Fibre can be something that has to be managed.

For instance, someone with diverticulitis (or -osis? someone who has it will tell me because the distinction is crucial) needs to get lots of fibre when they feel well to keep the gut toned and moving. When they’re having a crisis though, the gut is irritated and inflamed and fibre will make that worse. So they actually have to manage two diets.

Judging from the posts here, I’m thinking the same thing seems to apply to IBS.
posted by kika at 9:56 AM on May 18, 2007

An ex of mine suffered from IBS-D and was very nearly "cured" after being prescribed Amitriptyline.

During outbreaks he would only eat bananas, rice, and water-based soups. His regular diet excluded meat, caffeine, raw fruits and vegetables (except for the aforementioned bananas), spicy foods, chocolate, and tomato-based products (salsa, pasta sauce, etc). But after the Amitriptyline he was able to eat all of the above (except that he was a vegetarian so he never tried to eat meat).

He still had occasional outbreaks (1-2 a month each lasting between 1-3 days) until be adopted a vegan diet and now suffers outbreaks very rarely (once or twice a year).
posted by mezzanayne at 10:12 AM on May 18, 2007

Help for IBS

Best. IBS. Tips. Ever.

Thing is, it's not necessarily the food itself. When are you eating it? With what other foods? And so on. I mean, hell, drinking water on an empty stomach will bloat ya!

Re: Fiber.... It's all about the KIND of fiber. Soluble fiber versus Insoluble fiber. The website I linked to above will tell you all about it.

My personal don't-start-the-morning-bloated-recipe: Throw some berries, soy milk, and Benefiber in a blender. Blend. Drink. Wait a while before consuming anything else.

Exercise. Eat small meals. Avoid prepackaged crap. Eat fresh wherever possible. I can't avoid coffee, but I do avoid alcohol. Drink water all day long. Follow the other tips from that website. Be patient.
posted by Menomena at 10:41 AM on May 18, 2007

Oh and by the by, IBS is not a disease.
But I agree it is terrible.
posted by Menomena at 10:43 AM on May 18, 2007

Hi. I'm a fellow IBS sufferer. (My MeFi handle predates the diagnosis, so it's a stupid coincidence, not a tasteless joke.) That said, I take these supplements. One every morning, and if I wake up feeling uncomfortable, I take two. They're terrific. Soluble fiber supplements (Metamucil, Citrucel, etc.) help a lot also. Finally, have you consulted with a gastroenterologist? There are prescription medications that will do you good-- unfortunately, I forget the name of the one that I'm taking, but it does help.
posted by Faint of Butt at 10:54 AM on May 18, 2007

If you haven't done this already, ask for a referral to a gastro-enterologist. Make sure that you really do have IBS, not IBD. I suffered with "IBS" for years, while listening to the recommendations of family doctors. Finally, I got a referral to a gastro-enterologist. After several tests, I was told I probably had Crohn's Disease. I have had far better treatment ever since. One problem was that I was being told to take Ibuprofen, which was giving me gut bleeding, among other things. Now I'm in remission and pain free. Do make sure they've done a full history and set of tests on you.
posted by acoutu at 10:59 AM on May 18, 2007 [1 favorite]

It's interesting that chrisamiller says too much fiber was a problem, while for me the increased fiber seemed to help a lot

The whole gamut of gastrointestinal disorders is really poorly defined. Though patients are broadly characterized as IBS, Crohns, Ulcerative Colitis, etc, there are a great number of factors at play, and there are likely many actual disease-causin mutations and events at play. Diet, exercise, microbial growth in the gut, stress - all of these things are clearly factors, and depending on your specific subtype, may contribute in different amounts.

I have Crohn's and personally have no problems with fiber. Many others do, though. For them, all that volume and roughage passing through the GI tract can irritate things more, especially during a flare up.

Until the research catches up, your best bet is always to go with what works for you. Trial and error will tell you which foods and situations to avoid, and then you have to be a responsible adult and follow your own dietary advice (which can be hard sometimes!)

As a heavy social drinker in college, giving up alcohol absolutely sucked, but l deal with it. One night of fun just isn't worth a week of misery.
posted by chrisamiller at 11:43 AM on May 18, 2007

One problem was that I was being told to take Ibuprofen, which was giving me gut bleeding, among other things.

Yes - Ibuprofen is generally a bad idea. You'll probably be better off using acetaminophen as a painkiller.
posted by chrisamiller at 11:45 AM on May 18, 2007 [1 favorite]

Seconding acoutu's suggestion that you make sure it really is just IBS and not IBD (my dad has the latter, in the form of severe ulcerative colitis). IBS is not always fun, but it's not as serious as IBD.

That said, my IBS has improved dramatically over the past several years by doing the following things:

- getting adequate daily fiber (as others have said, it must be both soluble and insoluble); my gastroenterologist says this is crucial for most IBS patients. I take fiber supplements if I'm not happening to get enough through my diet.
- giving up coffee -- this was the hardest part! (I still drink tea.)
- giving up fast food (and severely minimizing junk food in general)
- cutting down on spicy and greasy food
- cutting down on red meat
- minimizing ibuprofen/naproxen use for pain (I can use them occasionally without a problem, but NOT regularly)
- regular yoga/exercise
- managing my depression/anxiety

For others, minimizing dairy helps too, but that's not been a significant factor for me. Good luck!
posted by scody at 11:56 AM on May 18, 2007

my co-worker had terrible terrible times with IBS. While she still suffers occasionally (i believe it is mostly brought on by stress), she experienced great relief after making some major dietary changes and using hypnosis tapes. I can't remember exactly what she removed from her diet, but i know she cut out caffeine, soy products, things with gluten, red meat, chocolate (because of some binding agent in most chocolates) and many other things. when we would take office lunches, she would frequently just order a plain baked potato. After some time of seriously restricted diet and using hypnosis tapes, she was well enough to start re-introducing foods and even travelled to Italy, something she'd always wanted to do but never able to specifically because of the IBS.
posted by Soulbee at 12:35 PM on May 18, 2007

Celiac disease is often misdiagnosed as IBS. Try eliminating gluten from your diet and see what happens.

I'm very intrigued by the possibility mezzanayne alludes to that Amitryptiline can help IBS. If this were true, I might expect people with IBS to have much greater than average sleepiness after eating. Is this the case?
posted by jamjam at 1:12 PM on May 18, 2007

Gotta second unixrat's suggestion. I've had a pretty much none stop case of IBS since that developed after finishing chemo about 3 years ago, and weed is honestly the only thing that helps. Fiber lessens the frequency of the nastier flare ups, but it certainly hasn't cured the condition.

Stay away from coffee though. It is probably the worst thing an IBS suffer can drink short of sulfric acid. I made the mistake of drinking a cup an hour ago and now I'm pretty sure I'm gonna die.
posted by MostHolyPorcine at 3:07 PM on May 18, 2007

Another Crohnie here, with a recent adult onset diagnosis. Some 7 months later, I'm still trying to pound it into remission and am finding what things trigger. It's been helpful in my case to track my food because I get a pretty good idea of what I need to avoid. The thing that I hate is that there are a lot of foods I've found that give me problems, but I love them and miss them. Asparagus, apples, beans, spinach, and so on. But honestly, I'd rather give up asparagus and pine for it than getting the stabbing intestinal pains and the inevitable rectal BLARRRMF it will induce.
posted by plinth at 5:10 PM on May 18, 2007

I had horrible IBS for many years and it ended instantaneously the day I quit my job and went back to school. I really liked my job (commercial photographer) but apparently I was totally stressed (I also got a divorce at the same time, so perhaps the job wasn't the issue).

Stress is a funny thing. You can be so used to it that you don't even notice it. I had IBS while on vacations, but the day I started grad school I never had it again. No changes in diet, no changes in exercise. So my prescription is, quit your job and get a divorce.

Or something like that.
posted by KingoftheWhales at 5:39 PM on May 18, 2007

Actually the above (and this) is not by KingoftheWhales, but by johngumbo, his Dad. Sorry about the confusion.
posted by KingoftheWhales at 5:40 PM on May 18, 2007

Specific Carbohydrate Diet (SCD)
(google it)
Breaking the vicious cycle by Elaine Gottschall

Lots of evidence, testimonials, strategies, recipes, all towards total recovery / remission.
good luck!
posted by kch at 7:02 PM on May 18, 2007

A lot of misinformation here, probably from bad acronyms.

Irritable bowel syndrome is VERY different from Inflammatory Bowel Disease (Crohn's, Ulcerative Colitis).

IBD is much more serious than IBS, which is generally a self-limited upset stomach and diarrhea with certain foods or reactions to stress.
posted by gramcracker at 9:11 PM on May 18, 2007

IBS and IBD are very different. Different symptoms, different causes, different underlying aetiology. Make sure you have them straight and make sure your diagnosis is correct. (as has been mentioned but it's really important so I decided to repeat it). Basically, IBD is an inflammatory disorder whereas IBS is a smooth muscle disorder most likely with a dysfunctional enteric nervous system.

There has been a lot of research done on IBS in the past ten years and both understanding and treatment has improved in leaps and bounds since I was diagnosed in 1993. I'm always amazed at how fast the literature is growing and how much useful information is being discovered. This is good because treatments have been improved, and bad because it's hard to keep up with.

Have you seen a doctor? One who is up on recent developments and has a clue what they're talking about? This is really important, IBS is a syndrome (i.e. collection of symptoms) and there are ranges of symptoms and scales of intensity and all this matters as to what will work and what you should do. IBS is also often associated with other problems, most particularly dyspepsia (i.e. stomach problems), and this changes treatment significantly. What works for me probably won't work for you, and you need proper medical advice rather than just internet hearsay.

But keep in mind, not all doctors will know about this problem. I've found it really variable as to what knowledge any given GP will have about it all, it depends on how up to date they are on their reading and suchlike. I've never been to a specialist, and unless you have a really serious case I don't know if you need to do so or can get by with a well informed GP. But be prepared to move through doctors and get referrals until you get someone who knows their stuff, whatever level they are. I can point you towards review articles and possible readings (email is in profile, they will likely be aimed above the layperson sorry), but you need a more specific diagnosis than just 'IBS' to get truly useful advice about how to deal.

Once you've been properly treated and are on your way to maintaining the problem, or even just understanding exactly what type you have and what your triggers are, then come back and post again. That's when advice about what to look up or ways to deal can help with fine-tuning. It's totally possible to have a normal life with IBS and be mostly symptom free, but knowing where you are with regards to Rome criteria etc and working out appropriate medications/lifestyle changes is going to help you more.

FWIW, I took anti-spasmodics for years which were wonderful. Stress was always a trigger, as was diet. Now I exercise more and manage the stress so can limit the IBS with diet alone, and rarely feel ill. It's not even a major dietary change, just be careful of what I eat (coffee, btw, is fine and I love it). But it took one clued up doctor and years of work to get here, find that doctor sooner rather than later.

(I am a digestive physiologist studying Crohn's disease and have IBS, but am not a doctor)
posted by shelleycat at 1:49 AM on May 19, 2007 [1 favorite]

My experience has been rather contrary to most of the advice given here. I'm least susceptible to attacks when I maintain a low carb diet: lean meat (any color, as long as it's lean) and low-starch veggies. Before I learned that, I discovered that a beer before dinner (the evening meal was almost always a trigger) worked wonders.

That's just what works for me, of course.
posted by sgass at 10:05 AM on May 19, 2007

Before I forget - my GI Guy referred me to the CCFA website.
posted by plinth at 7:57 AM on May 21, 2007

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