Who is at risk? Irritable bowel syndrome affects two to three times more women than men, and chronic stress—including current stressors, as well as a history of physical, sexual or verbal abuse, parental divorce or parental alcoholism— seems to be a contributing factor. “We think there is an early, adverse life event [that boosts IBS risk],” says Chang. While the condition isn’t “all in your head,” as many people are told, stress and emotions do affect the colon, since its many nerves connect it to the brain. “People who are prone to anxiety, who hold stress in, are more likely to have problems with IBS,” says Peter Galier, M.D., an internal medicine physician at Santa Monica UCLA Medical Center.
What can be done? No single treatment for IBS works for everyone. “The initial management of IBS is really about managing your lifestyle,” says Locke. “People need to pay attention to stress in their lives. Regular exercise is also crucial, as is eating smaller amounts of food frequently rather than large meals,” he adds. After that, treatment is based on whether diarrhea or constipation is predominant. For mild symptoms, Locke says, you can self-treat, using milk of magnesia for constipation and nonprescription Imodium (loperamide) for diarrhea. If symptoms worsen, consider the following options:
Eliminate the triggers Steer clear of foods that exacerbate your symptoms. Among the common culprits are greasy foods, milk, grains, alcohol, chocolate and caffeinated beverages. “Up to 50 percent of patients will relate a worsening of symptoms to specific foods,” Chang says.
Focus on fiber Although it might sound counterintuitive, eating more fiber aids both diarrhea-predominant and constipation-predominant IBS. “Fiber has water-holding capacity, so it bulks up the stool,” Bruninga says, explaining how it can ease diarrhea. “And it can also help bring fluid into the bowel,” lessening constipation. Eat plenty of fiber-rich foods, such as fruits, vegetables and whole grains, chia or flaxseeds, or consider adding a fiber supplement. “Take Metamucil or FiberCon twice a day,” advises Galier. You can also try Garden of Life’s Detoxifiber ($15; gardenoflife.com), an organic food-based blend that has a balanced ratio of soluble and insoluble fiber and is free of gluten, psyllium and harsh laxatives. Since taking too much fiber too quickly can cause bloating, gradually work your way up to the dosage recommended on the package.
Go pro(biotics) These microorganisms, believed to make the intestinal environment friendlier by populating it with “good” bacteria, are worth a try. Several studies presented at the American College of Gastroenterology’s annual scientific meeting in 2008 found probiotics to be effective at normalizing bowel habits after 28 days of use; however, there was not enough information to determine whether any one strain was particularly effective or whether combinations are required. However, one study did find that IBS sufferers who took Bifidobacterium infantis and Lactobacillus acidophilus for four weeks had fewer symptoms and a higher quality of life; no side effects were reported. Try American Health Priobiotic CD ($30; americanhealthus.com), a vegetarian supplement that contains 12 billion bioactive microorganisms, including Bifidobacterium infantis and Lactobacillus acidophilus.