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, the most common symptoms are:1-4
- 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
Are MS and IBS related?
The cause of IBS is unknown and the disease itself is poorly understood. But here are two known contributing factors that are relevant to MS, also according to the Mayo Clinic:1-4
- Abnormal muscle contractions in the intestine. Muscles in the intestines contract as they move food through your digestive tract. Stronger contractions can cause gas, bloating, and diarrhea. Weaker contractions can slow food passage and lead to hard, dry stools. We know that MS can interfere with muscle movement.
- Abnormal nervous system. Poorly coordinated signals between the brain and the intestines can cause your body to overreact to changes that normally occur in the digestive process, resulting in pain, diarrhea or constipation. Studies have identified diabetes and multiple sclerosis as causes of nerve damage.
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. Even though S. boulardii induces constipation like Imodium does, it also provides a health benefit in the gut by controlling the growth of candida, a naturally occurring yeast that can be harmful if it grows enough to change the pH balance of its environment.
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.
How often do you use assistive devices to help manage your MS?