Irritable Bowel Syndrome (IBS): What It is and How It Affects Me
Around the time I started learning how to better control the misery of MS, I discovered that misery loves company. It came in the form of irritable bowel syndrome (IBS), as unwelcome a medical condition as ever there was - and a familiar one for people with MS.
Common IBS symptoms
According to the Mayo Clinic, common symptoms can include:1
- Abdominal pain
- Excess gas, diarrhea or constipation, sometimes alternating bouts of diarrhea and constipation
- Mucus in the stool
- Cramping or bloating that is typically relieved or partially relieved by pass gas or having a bowel movement
The cause of IBS is unknown and the disease itself is poorly understood. But here are two contributing factors (that I think are relevant to MS): abnormal muscle contractions in the intestine, and an abnormal nervous system. We know that MS can interfere with muscle movement and the nervous system.1
My IBS diagnosis
I was officially diagnosed with IBS in 2016 by a gastroenterologist after undergoing tests to rule out more serious things such as cancer, Crohn’s, celiac, and ulcerative colitis. Additional testing for SIBO (small intestine bacterial overgrowth) and H. pylori. When I tested negative for all of those, IBS was the only diagnosis that fit. A diagnosis of exclusion, just like MS. And like MS, my IBS symptoms evolved gradually over several decades.
It started in childhood with occasional flare-ups triggered by eating baked beans and green peppers. Symptoms were gas pains followed by loose stools.
By my mid-forties, it would come out of nowhere and stick around for weeks regardless of what I ate, then mysteriously disappear. Symptoms were severe gas pains after every meal followed by loose stools. I was diagnosed with MS around this time, too.
In my mid-fifties, it morphed into a more severe form. In addition to cramping, feeling uncomfortably full even after eating a small meal, and constipation, I also developed abdominal distention. It is different from a bloated, full feeling; bloat is uncomfortable, but it is invisible.
Abdominal distention is quite noticeable. It makes me look like I swallowed a beach ball, or that I suddenly became six months pregnant. My abdomen is a smooth distinct arc, very firm to the touch, and tender. It slowly deflates as the digestive cycle advances. Depending on how much I eat, it can take up to 24 hours to return to normal. Passing gas can bring immediate relief and some deflation, but a bowel movement doesn’t have those effects.
My IBS is always active
No matter what I eat, my IBS is always active and never goes into remission. That said, I’ve identified one trigger that cranks it up to an extreme: I have to totally avoid very high fiber foods such as white and kidney beans, and cruciferous vegetables like cabbage, Brussels sprouts, and broccoli. They will cause gas pains that spike a 10 on the pain scale and cause explosive diarrhea and incontinence, even if eaten in small amounts. So, in addition to avoiding these foods, treatment is focused on bowel movements and how to better control them.
Initially, I only suffered from constipation. I used stool softeners with limited results. I had more success with Miralax, a laxative that works by pulling water into the colon to stimulate the bowel to empty itself. I also drank Smooth Move, a tea that contains a natural laxative called senna.
A year after my IBS-C diagnosis, chronic constipation turned into chronic diarrhea. Imodium was very effective in stopping diarrhea but tended to cause constipation. So I would alternate between diarrhea and constipation. Then I tried probiotics, to no effect. But I soon discovered a yeast probiotic called Saccharomyces boulardii, a yeast that relieves diarrhea. I use that now in place of Imodium.
Do you have IBS and MS?
Do you have any of these symptoms? Please share your own experience with us. If you haven’t already, I urge you to see a doctor so they can run tests to determine exactly what you have and recommend an appropriate treatment.
Were you misdiagnosed with something else before receiving a MS diagnosis?