Irritable Bowel Syndrome Awareness Month

By Riva Preil

April marks Irritable Bowel Syndrome (IBS) Awareness Month. IBS is a condition characterized by abdominal pain, discomfort, and bloating as well as abnormal bowel habits.  There are four main subcategories of IBS: IBS-D (predominantly diarrhea), IBS-C (predominantly constipation), IBS-A (alternates between diarrhea and constipation), and IBS-PI (post-infectious).  It is unclear to date what causes IBS.  IBS is associated with chronic pain, fatigue, a feeling of urgency prior to passing bowel movements, and tenesmus (a feeling of incomplete emptying of the rectum after passing a bowel movement).  Due to the extreme pain and its effects on the suffering individual, IBS is also associated with psychological disorders, such as anxiety and depression.  In fact, one study indicates that up to 60% of individuals with IBS also present with a psychological disorder.

Testing for IBS includes performing a stool culture (to rule out any infectious disease), blood work (to rule out celiac disease), an abdominal ultrasound (to rule out biliary tract diseases, such as gallstones), and endoscopy.  Unfortunately, there is no current cure for IBS; however there are many treatment options available for symptom management.  One important factor to consider is diet, especially because lactose and fructose tend to exacerbate the symptoms of IBS.  Therefore, the FODMAP diet (which restricts lactose, fructose, and other carbohydrates which the small intestine has difficulty absorbing) is recommended.  In addition, it is important for people with IBS to eat soluble fiber (which can be supplemented through the use of psyllium husks) as opposed to insoluble fiber (ex. bran), which can make symptoms worse.  Some medications (such as tricyclic antidepressants) have been shown to alleviate IBS related pain, and one should speak with their primary care physician regarding medications.  Furthermore, stress relief strategies such as yoga, tai chi, medication, and exercise may reduce the intensity of the pain.  Finally, individuals with IBS often benefit from pelvic floor physical therapy to help manage musculoskeletal related changes that occur in the abdomen and pelvic floor in response to the assault on their system created by IBS.

3 thoughts on “Irritable Bowel Syndrome Awareness Month

  1. Abigail

    Thanks for your helpful and interesting blogs! I suffer with ibs and also joint problems and pelvic floor issues. I live in the uk and keep trying without much success to see a physio who specialises in that area. My dr seems to think it cant be my pelvic area that causing the problems as i havent had children.
    I am currently seeing a general physio but they tell me to strengthen my pelvic floor, which i dont think is right, its too tight already and out of control! How do i explain to the dr and get referred for the right treatment? Help

    1. bbpt1

      You are correct, in that strengthening will not help if the muscles are already too tight, and could actually aggravate the current symptoms. IBS is closed linked to pelvic floor dysfunction, so I strongly believe that you may have this as well. I know of a physiotherapist in London, Marie Elliott, and she may also know of other pelvic floor physical therapists in the area. And, a physician, Beverly Collett, MD. You can look on the International Pelvic Pain Society website: to see if there is anyone in your area. Another suggestion is to buy my book: Heal Pelvic Pain ($11 US on, and show that to the doctors and the physios.
      And, last, we frequently have patients that travel to the US for one to six weeks to get intensive physical therapy treatment and an extensive home program. We welcome a family member, a friend, or even better, a physical therapist, to come and learn what we do, to help in the healing process. Hope that helps to guide you in the right direction. Warm regards, Amy Stein

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