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Understanding Irritable
Bowel Syndrome

by Heather Van Vorous, author of Eating for IBS

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This devastating condition afflicts up to 20% of the world’s population and is the most common chronic health disorder in America. Irritable Bowel Syndrome or IBS (also known as spastic colon, and sometimes improperly termed spastic colitis) is a devastating and incurable condition. It is the most common chronic health disorder in America, Canada, the United Kingdom, Australia, and New Zealand. It affects more people than asthma, diabetes, and depression combined.        
Irritable Bowel Syndrome affects more than twice as many women as men, for reasons that are not yet understood. IBS is a physical disorder--not psychological--characterized by lower abdominal pain (spasms or cramps) or discomfort, diarrhea, constipation (or alternating diarrhea and constipation), gas, bloating, and nausea. There is no cure for IBS, which is actually a brain-gut dysfunction, but there are many very effective ways of controlling and even eliminating IBS symptoms through safe IBS treatments.

Do you have IBS?
If you do, you’re not alone.  If you’re still wondering what exactly Irritable Bowel Syndrome is and whether or not you have it, it’s important to see a physician. IBS cannot be self-diagnosed, as there are many other disorders that can mimic Irritable Bowel Syndrome symptoms and must be ruled out by clinical tests.

What are the Symptoms?
It’s important to verify that your symptoms match those of IBS before you accept this diagnosis. As noted, IBS is characterized by continuous or recurrent lower abdominal pain or cramping (from mild to excruciating) in association with altered bowel motility (diarrhea, constipation, or both). Attacks may strike suddenly at any time of day or night, and may occasionally--though not typically--wake you from a sound sleep. Gas and bloating are common, but vomiting isn’t; though it can occur due to nausea from the pain.    
Upper GI symptoms are not a typical part of Irritable Bowel Syndrome. For women, attacks are often associated with menstruation. Passing blood, running a fever, swollen extremities, and joint pain are not symptoms of IBS, and point to other disorders. IBS is diagnosed in part by the use of the official diagnostic criteria known as the Rome II Guidelines for Irritable Bowel Syndrome.

Confirming the Diagnosis
In addition to verifying that your symptoms match those of the Rome II Guidelines, it’s also important that the following diseases are excluded before you accept a diagnosis of IBS:
Colon and carcinoid cancer
Inflammatory bowel diseases (such as Crohn’s and Ulcerative Colitis)
Bowel obstructions
Diverticulosis / Diverticulitis
Gallbladder Problems
Food allergies
Celiac (gluten intolerance)
Bacterial infections
Intestinal parasites
Ovarian cancer
As a rule, all possible physical, structural, and infectious abnormalities of the GI tract need to be unquestionably eliminated before you agree to an IBS diagnosis. This requires a physical examination, preferably by a board-certified gastroenterologist. The medical tests needed to rule out disorders other than IBS will depend upon your age, health history, family health background, and specific symptoms.
Once you have a firm IBS diagnosis, take heart. While there is no cure yet, there are many ways to successfully manage (and prevent) all IBS symptoms. For 20 years I thought I was the only person in the world with IBS. I wasn’t, and neither are you. You can control your IBS, not vice versa.

Dietary Recommendations
One of the best ways to begin is with dietary changes. Unfortunately, much of the dietary information given to IBS patients is outdated and useless—or so inaccurate it’s actually likely to trigger symptoms instead of prevent them. What’s a reliable, fast, and easy way to start following a diet that will actively help your IBS symptoms, instead of making them worse? A terrific first step is to start following the:

The 10 Commandments of Eating for IBS©

1. ALWAYS eat soluble fiber first. Eat soluble fiber whenever your stomach is empty, and make soluble fiber foods the largest component of every meal and snack. 

2. Minimize your fat intake to 25% of your diet, maximum. Read labels and at restaurants, ask.  Focus on small quantities of heart-healthy oils.

3. Never eat high fat foods, even in small portions, on an empty stomach or without soluble fiber. Better still, don’t eat them at all. 

4. Eliminate all red meat, dairy, fried foods, egg yolks, coffee, soda pop, and alcohol from your diet. This may be the most difficult dietary strategy to adopt, and I know it probably won’t be fun or easy, but neither are Irritable Bowel Syndrome attacks. 

5. Never eat insoluble fiber on an empty stomach, in large quantities at one sitting, or without soluble fiber.  

6. Eat small portions frequently, calmly, and leisurely. 

7. If you’re unsure about something, DON’T EAT IT. It’s not worth the risk. 

8. Food is fun and eating should be pleasurable. Take the time and make the effort to eat safely, and then enjoy yourself. 

9.  Remember that you have absolute and total control over your diet. No one can force you to eat something you know you shouldn’t.

10. Practice creative substitution, not deprivation. Use soy or rice replacements for dairy, two egg whites to replace a whole egg, try low-fat vegetarian versions of meat products, replace some oil with fruit purees in breads or cakes, use veggie broth instead of oil in sauces, bake with cocoa powder (it’s fat free) instead of solid chocolate. Use herbs, baking extracts (vanilla, peppermint, maple, etc.) and mild spices generously to heighten flavors. 

©2007 by Heather Van Vorous. All rights reserved. No information may be copied or reprinted without authorization.

Heather Van Vorous is the author of Eating for IBS and The First Year: IBS. She is the founder of www.HelpForIBS.com, and the CEO of Heather’s Tummy Care. The mission of Heather’s Tummy Care is to offer education, support, and products that allow people with Irritable Bowel Syndrome to successfully manage their symptoms through lifestyle modifications. For more information visit www.HeathersTummyCare.com or call (206) 264-8069.


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