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Posted 21 July 2001 - 01:44 AM

MY IBS SURVIVAL STRATEGIESI am a 38-year old male who has had chronic illness for approximatelythe last 12 years, though I had had episodes infrequently before. Myprimary chronic illness is Irritable Bowel Syndrome (IBS). But I preferto characterize my illness as a disease-complex that includes otherchronic illnesses such as perennial allergic rhinitis, asthma, arecently acquired sleep disorder and functional dyspepsia (for a briefperiod in my life). I have other periodic, secondary symptoms that arelikely a result of these illnesses and include such things as occasionalmigraine headaches, frequent colds, fatigue, mild "feverish" feeling,back pains, itchy/scratchy tongue, skin rashes, sexual dysfunction,muscle twitches, and other seemingly "random" health problems.My IBS symptoms can be described as primarily a sensitivity to a host offoods. These sensitivities cause a wide range of symptoms includingpain, intestinal spasms, diarrhoea, constipation, gas, bloating, urgentbowel movements, etc. The actual symptoms vary from day to day, week toweek, month to month or year to year. The symptoms are madesignificantly worse with stress. My symptoms in the past have alsoincluded that of functional dyspepsia in the early stages of thedisease. Functional dyspepsia symptoms include frequent stomachacidity, heartburn and potential for ulcers.The primary means for coping with symptoms include:- Identifying trigger foods is a long, arduous process that isconstantly a work in progress because trigger foods can change withtime. My symptoms and food sensitivities are always worse when myseasonal nasal allergies are worst. One would need to maintain a diaryof foods, to track down the culprits - though the general patterns aresimilar for a lot of IBS patients. For example, dairy products, friedfoods, spicy foods, etc. Dairy product sensitivity is commonlyattributed to lactose maldigestion but it could also be due tosensitivity to the milk protein casein. One needs to learn thedifferences between dairy products : fully cultured yogurt is normallygood for most IBS'ers but frozen yogurt is only partially cultured sohas plenty of lactose.- Diet control involves controlling one's food intake to avoid orminimize trigger foods and at the same time getting sufficient caloriesto maintain a reasonably normal body weight and to provide sufficientnutrients and vitamins needed by the body. Diet control is often madedifficult by the fact that one's trigger foods can change with time.Another difficulty is the ability to control one's desire for certainfoods and tastes. Also add supplemental fiber to your diet. Generally,as a matter of policy, eating smaller meals (and may be eating morefrequently) works well.- Knowledge of the disease and its range of symptoms is a huge factor indecreasing the anxiety associated with the disease/symptoms. Theanxiety and stress clearly exacerbate the symptoms of the disease.There is a lot of new research that is being conducted on IBS andinformation is fairly easy to find on the internet.- Online support groups are of great value for several reasons: 1) youget to chat with others with similar symptoms, especially symptoms thatare awkward and difficult to talk about with most people; 2) hear otherpeople's approach and solutions to problems; 3) hear of othertreatments, efficacy of herbal treatments; 4) helps keep up to date onarticles and news related to disease.- Relaxation, abdominal breathing, meditation, massage and otheralternative therapies have great value even if they do not offer a cureto the disease. Approaches learnt from relaxation, abdominal breathingand meditation helped me to listen to my body better and find simplesolutions to ease some of the spasms and pain. I was able to sense thecoming of an attack earlier take some precautions. Overall, I havelearnt to suffer less with these approaches. Also, this is a constantwork in progress, always learning new ways to deal with problems,especially because symptoms often change from year to year or season toseason. Regular physical exercise also is a great contributor tooverall health.- Lifestyle change is another approach that can be beneficial, though isoften very hard to do. Especially, for example, changing one's job orcareer to reduce stress. I have stayed in my somewhat stressfuloccupation but I have incorporated some lifestyle changes such asworking regular hours, eating regular hours, taking frequent shortbreaks in office to relax and breath deeply, letting my co-workers knowof my sensitivity to stress, not taking on additional responsibilities(often needed to attain excellence or rapid advancement in career), etc.- Medications (OTC and Prescription) - I mention this last but it hasbeen a very critical part of my survival of IBS symptoms. Every time myIBS got really bad, the only way I was able to bring things undercontrol and still go to work every day, was through medication. I haveto reluctantly admit, that the medicine that helped me the most was thelong-term use of low dose antidepressants (amitriptyline, 20 mg/night).I say reluctantly, because there were many a times when I was frustratedwith what seemed like very slow effect or some nasty side effects.Other drugs that can be useful include anticholinergics, such as, levsin(hyoscyamine). Also for me, since my allergies and asthma are almost asbad as the IBS itself, controlling those with drugs has also helped me agreat deal.Several of these coping mechanisms are a constant work in progress thatneeds to be frequently modified or updated.Miscellaneous TipsConsider upgrading health insurance to a PPO to provide flexibility tochoose the best doctors;Find a good gastroenterologist who has significant experience with IBS;One sure place to find that is at a teaching hospital associated with agood university;Keep a daily/weekly log of health conditions/problems;Buy books, Search Internet - Knowledge is key to symptom management;Join internet bulletin boards/online support groups, chat with otherpatients.Books I have found useful:Irritable Bowel Syndrome and Diverticulosis, Shirley TrickettIBS and the Mind-Body Brain-Gut Connection, William SaltGastro-Intestinal Health, Steven PeikinThe Complete Book of Better Digestion, Michael OppenheimIrritable Bowel Syndrome - A Natural Approach, Rosemary Nicol (Not amedical doctor)Sneezing Your Head Off?, Peter BoggsAllergy Relief & Prevention, Jacqueline Krohn


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