Simone Hunter waged a serious battle against irritable bowel syndrome (IBS) for the past ten years. “I got cramps, I had painful gas with constipation, and the bloating was terrible,” she says. “Just the thought of being out of the house and away from a bathroom made me tense. I was totally miserable.”
Unfortunately, her treatment only made things worse. “Foods triggered the pain, so I’d avoid eating,” she says. “But then I’d get so hungry that I’d wind up having bigger meals later on, which only brought the symptoms right back.” One doctor said the pain was all in her head—a common response to IBS until recently—so he prescribed an antidepressant and an antianxiety drug. But these only added to her suffering with a range of distressing side effects, including headaches and loss of libido.
At one point she was even put on the oral steroid prednisone—some doctors think IBS has an inflammatory component, which steroids address—but that just made her gain 30 pounds, also without relieving her discomfort. Seeing her swollen image in the mirror sent her self-esteem down the tubes, causing her stress levels to soar, which, in turn, exacerbated her symptoms.
Ten years after Hunter’s stomach trouble began, experts are still in the dark about exactly what causes irritable bowel syndrome and how to cure it. “The only consensus about this condition, among conventional and alternative practitioners, is that there’s no perfect remedy,” says Leo Galland, physician and director of the Foundation for Integrated Medicine, in New York City. For some sufferers, an intestinal infection (parasitic or otherwise) may be the cause, in which case treatment tends to be more effective. But most people wrestling with the condition have a hypersensitive gut for no apparent reason. Symptoms vary from one person to the next (as do the triggers), but they generally include those Hunter had—only in many cases the constipation is accompanied by alternating bouts of diarrhea. As many as one in five Americans are estimated to have IBS, with women outnumbering men three to one.
Doctors prescribe numerous medications to treat IBS, including antacids, laxatives, antidiarrheal or antispasmodic drugs, and yes, antidepressants. But none of these drugs ultimately work that well, Galland says, and as Hunter discovered, they can come with troublesome side effects.
Still, there’s hope, as practitioners have begun zeroing in on the most promising ways to tame IBS. Hunter, in fact, stumbled upon a combination of remedies that appear at the top of many experts’ lists—dietary changes, stress relief, and more recently, hypnotherapy—and that have helped her keep her symptoms in check. Many people also find exercise useful, and a number of supplements and herbs can help as well. As with so many chronic conditions, there’s no real cure—but with trial and error, most people can find a regimen that allows them to keep their condition under control.
“People with IBS need to think of their gut as a garden,” says Galland. “You can never let a garden take care of itself. You get it into good condition, but then you have to seed it, fertilize it, and weed it to keep it that way.” The following list reflects the major strategies you should consider when tending to your own intestinal greenery.
Even before embarking on any lifestyle changes, Galland says IBS sufferers should first be tested for bowel infections—either bacterial or yeast. “It’s important to find out when the patient’s problem started,” he says. “If it happened after a bout of antibiotics or a trip to Asia, they may get relief just from treating the yeast infection or the parasite they may have picked up.”
Unfortunately, tests for yeast in the bowel aren’t always accurate, says Jacob Teitelbaum, director of the Center for Effective CFS/Fibromyalgia Therapies in Annapolis, Maryland, and author of Pain-Free, 1-2-3!, published this month. Instead, he often bases his diagnosis on the patient’s report of symptoms. A spastic colon, nasal congestion, and sugar cravings are typical indicators of yeast, the most common underlying bowel infection. Teitelbaum says many cases can be successfully treated by eliminating sugar and taking two acidophilus tablets (preferably in pearl form) twice a day for five months.
Dissect your diet
For Hunter, one key was learning to eat five or six smaller meals a day to avoid the all-or-nothing cycle that was aggravating her symptoms. And she’s cut way back on foods that are known to be IBS triggers, such as fat, sugar, alcohol, and caffeine. But many other foods can cause problems for people with IBS as well. Dairy is a big one, as are gas-producing items such as beans and broccoli. And recently, researchers at the University of Iowa looked at patients with suspected IBS and found that more than one-third had trouble with fructose, a common sweetener found in fruit drinks, yogurt, soda, and some cereals.
In many cases, identifying and eliminating offending foods can significantly improve IBS symptoms. You can test for food sensitivities in the lab or try an avoidance diet: Don’t eat any of the foods you think are a problem for a week, then add back one food at a time to see how your gut reacts.
As for what to eat? That depends on which foods bother you. But generally, people with IBS should boost their fiber intake—especially if they’re prone to constipation—by slowly incorporating more foods like whole-grain breads and cereals, fruits, and vegetables. Eating meals low in fat and high in carbohydrates like rice and pasta may help too, as can drinking eight glasses of water a day.
Though stress is no longer considered a direct cause of IBS, there’s no doubt it adds fuel to the fire. When left unmanaged, it can cause increased sensitivity and interfere with the normal movements of the gut.
A useful stress reduction technique might be as simple as breathing—or rather, breathing properly. Breathing slowly from the abdomen instead of the chest helps relax the body and mind. Other good stress-busting activities include meditation, yoga, massage, or exercise. Another benefit of working out, especially aerobically, is that it can help with constipation and other intestinal discomforts.
Get help from hypnotherapy
It’s been known for a while that hypnotherapy can relieve IBS symptoms in the short term, but a study last year proved its effect can last—up to six years, in some cases. It’s not just about relaxation, says Wendy Gonsalkorale, the study’s lead author and a researcher at the University Hospital of South Manchester, in England. Hypnosis taps into the brain-gut connection, she says, and affects various physiological processes, including the body’s immune response and its pain-controlling mechanisms. Earlier research of Gonsalkorale’s has measured actual changes in intestinal muscle movement among users of hypnosis.
Hunter discovered hypnotherapy at the Wellness and Fitness Institute in Tampa Bay, Florida, where director Herb Hamilton developed a three-part IBS treatment program involving diet, stress reduction, and hypnosis. Patients typically get a minimum of seven sessions—once a week after the first week, when they get two—and eventually they learn to use audio CDs at home. The therapist uses several types of suggestions, including advice for how the patient should stick to her treatment regimen, as well as tips aimed directly at the gut. For instance, they may tell someone to visualize her cramps relaxing or her bloated belly deflating.
It’s best to work with a hypnotherapist who has training in IBS. To find one, go to IBShypnosis.com. If you can’t find one in your area, therapists who haven’t been trained can request a treatment protocol from the website.
For Hunter, the triple combo of hypnotherapy, diet, and stress reduction allowed her to turn her IBS from a curse into a manageable condition. “The program was the best thing that ever happened to me,” she says. “I finally took back control of my life.”
Try needling your belly
There’s not a lot of scientific evidence behind it, but many practitioners (and patients) swear by acupuncture to treat a range of intestinal disorders. While experts aren’t sure exactly how it works, acupuncture is thought to reduce gut hypersensitivity, rebalance the GI tract, and relieve pain.
“We know that acupuncture stimulates different parts of the brain,” says Larry Altshuler, medical director of Balanced Healing Medical Center in Oklahoma City, “which releases substances that can regulate the GI tract and desensitize it.” Altshuler says that many of his patients respond favorably within six to eight sessions.
Boost your beneficial bacteria
Studies show that probiotics—live, microbial food supplements that are believed to promote gastrointestinal health—can be especially beneficial for IBS sufferers. “Some evidence suggests that IBS is an inflammatory condition of the mucosa, and that inflammatory activity may be turned down by probiotics,” says R. Erick Pecha, a gastroenterologist in Folsom, California.
Some probiotics are more effective than others, though, so Pecha and his colleagues conducted a review of the available science to determine which organisms work best for IBS. They then combined the top performers into a formula containing probiotics and prebiotics—nondigestible dietary substances that provide fuel for probiotics to grow on. (The formula, called SynBiotics-1, can be found at nutracea.com.) Pecha finds that probiotics combined with fiber supplementation in the form of rice bran helps about 70 percent of IBS patients. And Galland recommends Lactobacillus GG (available under the brand name Culturelle). Though it hasn’t been studied specifically for IBS, he says, it’s been shown to be effective for other intestinal conditions and is considered safe.
Find relief with herbs
In a 1998 double-blind controlled study published in the Journal of the American Medical Association, patients taking a standard Chinese herbal formulation showed significant improvement in IBS symptoms compared to the placebo-controlled group.
Two other herbs that have shown promise are artichoke leaf extract (you can find this at many health food stores) and Padma Lax, a Tibetan herbal formula, by EcoNugenics, made of 13 different herbs. And many practitioners and patients find peppermint oil can be useful in relieving pain, though studies generally haven’t borne that out. Look for enteric-coated capsules, and take a total of three to six every day between meals.