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Relief is available for those living with irritable bowel syndrome

After the common cold, what’s the second highest cause of an employee calling in sick to work? The surprising answer is irritable bowel syndrome (IBS).

A chronic digestive disease, IBS is characterized by abdominal pain and alterations in bowel patterns, including diarrhea and/or constipation. Those living with IBS may also experience bloating or gas.

Ten to 15 percent of American adults have symptoms of IBS, according to Dr. Aslam Godil, a specialist in gastroenterology at Sierra Nevada Gastroenterology Medical Associates in Grass Valley. Notably, it is estimated that only 15 percent of those living with IBS actually seek medical care for their symptoms.



“Patients tend to think the symptoms they are experiencing are normal for them, so they often ignore them,” said Godil.

IBS does not affect every person in the same way; women are twice as likely to suffer from the condition as men.




There’s also a higher incidence of IBS in younger patients. Some symptoms may start as early as the teen years and continue on throughout a person’s life.

IBS is also intermittent. There are times when the symptoms seem to get better, only to worsen again.

Although no definitive cause has been found for IBS, Godil noted there are several theories about what causes it, such as abnormal colon contractions, food intolerances caused by food sensitivity or possibly an infection that resets the baseline bowel function and triggers IBS.

“Those with stress or anxiety seem to be at a higher risk of developing irritable bowel syndrome,” Godil continued.

As there is no single clear-cut cause for IBS, there is also no single test to diagnose it either. Godil said physicians decide which tests to order based on the patient’s symptoms. Testing typically starts with blood and stool tests, followed by colonoscopies, when necessary.

“The patient should be investigated more thoroughly if there are more alarming symptoms, such as blood in the stool, weight loss, anemia or a family history of inflammatory bowel disease or colon cancer,” said Godil. 

Part of the objective of testing is to rule out other diseases that can mimic IBS, such as inflammatory bowel disease, Crohn’s disease, celiac disease, microscopic colitis or malabsorption.

Once an IBS diagnosis has been confirmed, treatment generally begins with the patient keeping a “trigger” diary. This diary notes what factors, such as food or stressors, worsen the patient’s symptoms. The patient then shares this diary with the doctor, who creates a treatment plan.

“Treatment for IBS is a long-term process because it’s a chronic disease,” said Godil. “It’s important to develop a good patient/doctor relationship and to communicate well with each other.”

Treatment usually includes dietary management, eliminating foods that exacerbate symptoms while identifying those foods that are better tolerated by those with IBS.

According to Godil, foods that contribute to more gas production, bloating and abdominal cramps include dairy products, legumes and cruciferous vegetables, like cabbage, broccoli or Brussels sprouts.

Those foods that generally don’t aggravate IBS symptoms include pasta, white rice, potatoes, white bread, fish, chicken and eggs, to name a few.

Other treatment strategies that may play a role include fiber supplements, probiotics, exercise, and methods to reduce stress and anxiety.

Some patients may need medication to treat symptoms. Anti-spasmodics can provide relief from painful abdominal cramping. Antidepressants have been helpful in increasing the pain threshold for those who are hyperalgesic (a higher sensitivity in the intestines to normal sensations).

Prescription or over-the-counter antidiarrheal agents are often helpful to those with predominantly diarrhea symptoms. And studies show that some patients who have IBS with diarrhea and bloating may improve with antibiotics, but that is not the case for every patient, according to Godil.

There are also new medications on the horizon that hold promise for patients whose symptoms do not respond quickly to other treatments.

“It’s very rewarding when you start seeing improvement in your patients after beginning treatment. They can return to work. They’re happier. You immediately feel rewarded,” Godil said.

Godil practices with fellow gastroenterologists at Sierra Nevada Gastroenterology Medical Associates: Andrew Chang, MD; Roy Foliente, MD; and Kevin Hill, DO.

“We get lots of thank you cards from grateful patients,” said Godil. “We hang them on the wall of the break room, so everyone in the office can see them, since treating our patients is a team effort. It’s very touching to have that.”

For more information, visit the website at www.sngastro.com.

All physicians providing care for patients at SNMH are members of the medical staff and are independent practitioners, not employees of the hospital.


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