I received compensation from Bayer Consumer Health, makers of Phillips’® Colon Health® to write this post. All opinions are entirely my own.

When my patients come to see me for their annual exam, I always ask about nutrition and digestive issues including whether they are experiencing any occasional bloating, gas, constipation and/or diarrhea. Many times my patients answer yes, but aren’t sure what to do about their symptoms. They are so used to living with the symptoms and inconvenience, they don’t take that next step for relief. And yet, with a few questions, we can often get to the root of the problem and then together come up with some solutions.

Are Donuts A Food Group?

I saw a patient, who I’ll call Karen (not her real name) who had a combination of occasional diarrhea, gas and bloating and constipation. As we talked about what she had eaten over the last 2 days, she started recognizing how a few things might be contributing to her symptoms.

A self-described picky eater, who didn’t like vegetables, Karen laughed and asked me if donuts and coffee could be considered a real food group. That’s because she stopped at her favorite Donut shop on the way to work for a few glazed donut holes and an extra large black coffee for the stressful 45 minute morning commute. By the time she pulled into her parking spot at work, she was invariably bloated and though she was a little reluctant to admit it, she sometimes had diarrhea.

I also noticed that Karen’s typical lunches and dinners consisted of mostly breads, potatoes, pasta and some protein with very few vegetables or dairy. She liked to snack on bananas and peanut butter pretzels in the afternoon with another cup of coffee. It was difficult to know exactly what was causing Karen’s digestive symptoms because they can be caused by stress, our food and beverage choices or a combination of factors. […]

By Nurse Barb Dehn

Disclosure: I was invited to attend an event about IBS-D by Salix Pharmaceuticals and am working with them to help get information out about how to talk about IBS-D symptoms and treatment options. Salix provided me with a stipend and paid for my travel and accommodations related to the event; however, all opinions are my own.

Do you often feel that your stomach is in knots?

I really like this photo of models who’ve had their tummies painted to represent what it’s like to have Irritable Bowel Syndrome with diarrhea (IBS-D). Between the cramping, bloating, pain and let’s face it, the frequent and unpredictable trips to the bathroom, if you have IBS-D, this might be exactly how you feel.

Could you have IBS-D? Take Nurse Barb’s Quiz

1. Do you have recurrent and unpredictable bouts of diarrhea?
2. Do you have abdominal pain that keeps coming back at least 1 day/week and is associated with going #2?
3. Has your abdominal pain and diarrhea been affecting your life for 3 or more months?
4. Has there been an increase in the number of times you go #2?
5. Have you noticed that your #2 appears to be looser?

If you answered yes to these questions, then you should talk to your healthcare provider and ask if you could be like the up to 16 million Americans with IBS-D. Your HCP should evaluate your clinical history, perform a physical examination, ensure diagnostic criteria for IBS-D are met and that alarm features are absent before making a diagnosis.

Experts weigh in on IBS-D – It’s unpredictable

Recently I attended an informational event with Dr. Mark Pimentel, Executive Director of the Medically Associated Science and Technology (MAST) program at Cedars-Sinai Medical Center in Los Angeles, California.

Dr. Pimentel explained that living with IBS can be enormously frustrating and that people with IBS-D don’t often know when they’re going to need to visit the bathroom, which can cause people to limit their lives for fear of not being able to find a restroom.

Imagine getting up and not knowing if you’ll visit the bathroom once or let’s say 12 times that day and not knowing when the urgent need to use the restroom will come up.

If you have IBS-D, then you don’t have to imagine this, you may know what it’s like to not know when you have stop what you’re doing and find a bathroom––Quickly. No wonder people start to stay home and skip doing the things they love.

And, despite a lot of well-meaning advice about what foods to eat and which ones to avoid, people with IBS-D may find that they are unable to predict if they will experience symptoms on any given day. It can be frustrating and depressing.

Quick Facts on IBS

• IBS affects about 2 times as many women as men.
• On average it takes about 4 years to finally receive a diagnosis.
• Nearly 70% of people experience symptoms for at least one year before seeing a health care provider.

• Some people with IBS experience constipation in more than 25% of bowel movements and diarrhea in more than 25% of bowel movements, this is known as mixed IBS.

What Causes IBS-D

• While stress doesn’t seem to cause IBS-D, people with IBS-D may experience worsened symptoms during periods of increased stress.

• There DOES seem to be a correlation with a previous history of having severe food poisoning, in some patients.

– Aha! Could this information help us find effective treatments?

– Stay tuned.

• It’s thought that the food poisoning may alter the delicate balance of the bacteria, also known as the microbiota, that live and work in our intestinal tract.

• Altered gut microbiota may contribute to the development of IBS-D symptoms by increasing gas production and activation of the intestinal immune system.

Find a Gastrointestinal specialist

If you think that you might have IBS-D, then DO find a gastrointestinal specialist, known as a GI specialist, who has experience with IBS-D. Your primary care provider may not be as familiar with the latest research and treatments.

I know that this may be embarrassing to talk about, but the talk doesn’t have to be as uncomfortable as the symptoms. I really like this website: LetsTalk-2 that has resources and a list of questions for you to talk to your health care provider about.

My tips for preparing to talk to your health care provider about your symptoms

• It helps to keep a diary of your symptoms and possible triggers for at least 1 week

• Include information about what you’re eating and drinking

• Note anything that may have caused stress

• If you’re a woman, mark down where in your cycle you are

• Make a list of all of your medications

Questions about IBS-D for your health care provider

• Could stress, diet or my medications be contributing to my symptoms?

• Do you recommend any lifestyle changes?

• Should I change my diet?

• What IBS-D treatment options are available?

Treatment options for IBS-D 

Dr. Pimentel presented data about a treatment option for IBS-D that has helped provide significant relief of both abdominal pain and diarrhea. Click here to learn more about an IBS-D treatment option.