The Best Things You Can Do for IBS-D

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Self-Care of IBS-D

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Diarrhea-predominant IBS (IBS-D) can wreak havoc on your life, with its unpredictable symptoms of abdominal pain, cramping, urgency and seemingly continual bowel movements. Since medication options are limited, it is reassuring to know that there are some common sense things that you can try to ease your symptoms and help your system to function in a healthier way. In this slideshow, you will find my top tips for dealing with IBS-D.

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1. Understand the Problem

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There are two things going wrong in your system that result in your IBS-D symptoms.

The first is a motility problem. The muscles throughout your large intestine are propelling contents too quickly. Because of this rapid passage, sufficient amounts of water are not being pulled out of the stool, resulting in stools that are loose and watery. And in a strange quirk of nature, loose stools seem to trigger the urge for further evacuation - meaning more trips to the bathroom.

The second issue is visceral hypersensitivity, in that the nerves within your intestines are hyper-reactive to stimulation and pressure. This is what accounts for the pain and cramping you are experiencing.

Therefore the goals of a self-care plan would be to do what you can to slow down your intestinal tract and reduce your system's reactivity to triggers. We will explore some of your options over the next series of slides.

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2. Get Clear about Your Food Triggers

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It can be so hard to try to figure out what foods are causing your symptoms! Because many people who have IBS-D  run the risk of excessively - and unnecessarily - restricting foods for fear of setting off symptoms, you will need to get a little scientific about the whole thing.

Don't panic! This is not as hard as it sounds. You would simply start to keep a food diary and use an elimination diet to cut out the foods most likely to cause a sensitivity.

You will want to record other factors (e.g., stress levels and hormonal changes) that might be contributing to any symptom flare-ups, so as to be sure that an individual food is truly problematic for you. If you are struggling with finding foods that you feel are safe to eat, you might want to consider consulting with a qualified nutritionist or health coach.

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3. Consider the Low-FODMAP Diet

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The low-FODMAP diet has strong research for its effectiveness in reducing symptoms of IBS-D. This diet requires that you eliminate foods that contain certain carbohydrates known as FODMAPs for a period of approximately four weeks. Once you are through this period, and hopefully feeling much better, you will then systematically add each FODMAP type back into your diet and assess for any continued reactivity.

Research shows that IBS symptoms are greatly improved for about 75% of people who are compliant with the diet. Your success on the diet will be greatly enhanced if you work with a qualified dietary professional. 

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4. Tweak Your Eating Habits

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Although IBS-D sufferers tend to spend a lot of time worrying about what to eat, it is also important to focus on how to eat. People who have IBS-D commonly skip meals, thinking that an empty stomach will result in an empty bowel. In this writer's experience, that is a mistake. If you think of the intestines as a conveyor belt, you would want your inner belt to carry an even, continual load so as to help it operate more smoothly.

Skipping meals also raises the risk of overeating, which in itself can strengthen intestinal contractions. You may find that eating small meals throughout the day actually helps reduce the reactivity of your system.

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5. Don't Try to Empty

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In my experience, many IBS-D sufferers mistakenly think that they will reduce the risk of experiencing diarrhea by making sure that their bowel is empty. The problem with this is that bowels are never truly empty! New stool is constantly being produced.

Encouraging the intestines to keep emptying results in evacuating stool that becomes looser and more watery with each bowel movement. Loose and watery stool is hard for the rectum to contain, so a focus on emptying may just make the problem worse.

It is much better to try to use strategies to calm your body and delay further movements so that the stool can undergo the process of forming. Think of it as building "tomorrow's stool".

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6. Use Relaxation Exercises to Keep Your System Calm

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IBS-D is like a Catch-22 situation. Stress can trigger diarrhea episodes, but diarrhea episodes are stressful! Your body's stress response is at play here. In response to a perceived threat, your body reacts in a variety of ways, one of which is to trigger intestinal movement. It is common for people who have IBS-D to scan their bodies for evidence that their systems will act up. Intestinal movement or noises become a perceived threat that then sets off the unwanted stress response.

What to do? Your best bet is to learn and use relaxation exercises to keep your body as calm as you can. You may also find it helpful to engage in activities that aim to reduce your body's baseline level of anxiety, such as yoga, meditation and tai chi.

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7. Try an At-Home Hypnotherapy Program

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Hypnotherapy has been shown to be an effective treatment for the symptoms of IBS-D. If you don't have access to a qualified hynotherapist locally, you can benefit from an at-home gut-directed program. Here are two good options:

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8. Sip Some Tea

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Although there are a variety of herbal teas for IBS, many of them are not appropriate for IBS-D. Luckily, there is one very notable exception - peppermint tea! Peppermint tea is not only good for soothing your digestive-ly frazzled nerves, the components found in peppermint can relax the muscles in your large intestine - resulting in less pain and improved motility.

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9. Head to the Drugstore

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There are three over-the-counter products that may be of help:

1. Peppermint Oil Capsules

There is research support for the effectiveness of peppermint oil in easing the abdominal pain and cramping of IBS-D. In fact, peppermint oil even has the blessing of the American College of Gastroenterology. You can click here to read more about peppermint oil...

2. Imodium

Imodium is an anti-diarrheal medication that has a good safety profile. You can ask your doctor how much imodium is safe for you to take to address your symptoms. Click here to read more about Imodium safety...

3. Calcium

Of the three products listed here, calcium as a recommendation is based solely on anecdotal reports, with no hard science regarding its effectiveness for IBS-D. However, it may be worth a try. Click here to learn more about calcium for IBS-D...

Source:

Ford, A., et.al. "American College of Gastroenterology Monograph on the Management of Irritable Bowel Syndrome and Chronic Idiopathic Constipation" American Journal of Gastroenterology 2014 109:S2-S26.

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