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.

If you’re asking this question, you’re not alone. If you’re under 30 about 1/3 of women use something slippery (lube or lubricant) to help everything glide and slide with sex. If you’re in your 50’s or beyond, it’s more like 50- 75%.

Which lubricant is best? Well that depends. Most of the manufacturers of lube have several different varieties for any situation. Here are some guidelines:

Water Based:

– These include Good Clean Love, KY, Sliquid, Aloe Cadabra, Sylk, Yes

– These can be used with any toy made out of anything

– Ok with all condoms

– Available in sugar-free flavors

– If you’ve used a water based lubricant and it’s feeling a little dry, instead of applying more lubricant, you can use a little bit of water to rehydrate the lubricant. (hint- your saliva will also work)

– Won’t stain the sheets and rinses off with water

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