What exactly is IBS?
Irritable Bowel Syndrome is the most prevalent chronic disorder
in the United States.
This disorder is thought to affect as many as 1 in 5 individuals, or 35-50 million Americans. In fact, it affects more people than asthma, depression and diabetes combined!
Irritable Bowel Syndrome (IBS) is a digestive health condition in which the patient experiences diarrhea, and/or constipation, and abdominal pain or discomfort. There is no test for IBS. IBS is essentially a diagnosis in the absence of finding a specific cause or causes. This is often confusing or frustrating to people, and rather than a specific pathology, the definition of IBS has become a group of symptoms.
A patient can be diagnosed with IBS if they have the symptoms outlined in the Diagnosis section and lack certain 'red flag' indicators - like being awakened by abdominal pain, fever, significant weight loss, among others. But according to the official publication of the ROME III conference: "Few tests are required for patients who have typical IBS symptoms and no alarm features." Patients may also have a variety of other symptoms, such as gas, bloating, feelings of incomplete evacuation, and others.
What this means is that if your doctor diagnoses you with IBS according to the outlined guidelines, he/she is correct. However, it does not entirely rule out other treatable conditions that are not found without additional testing.
We recommend additional testing not commonly done by most gastroenterologists or internists.
There are many identifiable and diagnosable conditions that can cause IBS symptoms, but are not regularly performed. Some causes of IBS symptoms include celiac disease, food allergies, microbial infections and imbalances, parasites, certain types of cancer, yeast overgrowth or candida, and many other conditions. Diagnosis by a physician is important to rule out potentially fatal conditions.
Nutrition is a critical part of successful treatment for IBS. When food allergies are involved, identification through testing is important to ensure that the right foods, additives, and food ingredients are eliminated from the diet and healthy foods to which the patient is not allergic are kept in the diet. But there are many causes of IBS symptoms and the right diet and medications/supplements can make a big difference for many of them.
Diagnosis and Who Diagnoses Me?
Although there is no single test for IBS, the medical community uses the distinct diagnostic criteria for IBS. The Rome III criteria for irritable bowel syndrome are as follows:
Recurrent abdominal pain or discomfort** at least 3 days per month in the last 3 months associated with 2 or more of the following:
1. Improvement with defecation
2. Onset associated with a change in frequency of stool
3. Onset associated with a change in form (appearance) of stool
*Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis.
**Discomfort means an uncomfortable sensation not described as pain. In pathophysiology research and clinical trials, a pain/discomfort frequency of at least 2 days a week during screening evaluation for subject eligibility.
Do not self-diagnose! You should be diagnosed by a physician, such as a board certified gastroenterologist or other GI specialist*. The following is a partial list of several other possible diagnoses that your doctor should rule out:
However, this list has proven to miss several important and increasingly prevalent conditions. You may have had all of these tests and still have symptoms.
Treatment
One of the biggest gaps in medicine is between the research now available on IBS and doctors and other health care professionals who are supposed to treat patients with IBS. This information has not necessarily found its way to your family doctor or the local registered dietitian or nutritionist.
One of the primary ways to treat and manage IBS is through dietary changes, including food, beverages and dietary supplements.
Are there other approaches to IBS besides Medical Nutrition Therapy?
Yes. Treatment is most effective when the underlying cause of your IBS has been identified. Though there are many recommendations that may help reduce symptoms, the best treatment is one that addresses the cause or causes of your IBS.
How can Julie Starkel, MS, MBA, RD help you with your IBS?
If you have symptoms as described above, but have not been diagnosed by a physician, go to your internist or gastroenterologist* and have him/her perform the many tests listed above so that you can begin to rule out other diagnoses. In the meantime, Julie and the nutritionists at Green Lake Nutrition can help you cope with the symptoms until the cause of the problem is found. We do this through diet and some "diet aids" which can soothe your intestinal lining and reduce inflammation. Most people find the underlying issues to their problems in the first wave of testing. However, there are many who do not. At this point, we recommend very specific clinics or practitioners who work with a wider array of tests and, in a sense, dig deeper to uncover the cause of your IBS. Most cases of IBS have a root cause. We often act as a medical advocates to help guide you through this discovery process while offering dietary support along the way.
If your diagnosis reveals a GI disorder, we work with you to create the best personalized dietary treatment and plan for you.
Food and supplements can modulate the muscle contractions of the gut by regulating water content, reducing irritation to the intestinal wall, and blunting the gastrocolic reflex. This can help those with diarrhea, constipation, gas, bloating and pain.
Our goal is to educate you on an eating pattern that reduces your IBS symptoms and may even allow you to live symptom-free over time.
In our sessions, we review your current diet, medical background, your specific symptoms of IBS, and your test results. We then create a customized eating plan for you that sets you on the path to recovery. We use professional line supplements that are proven to work with IBS patients in calming irritation, repairing intestinal mucosa (lining) and relieving symptoms of pain, gas, bloating, diarrhea and constipation. We act as the partner you can rely on in this 6-month to a year process.
Julie works with patients both in person in her office in Seattle, Washington and by phone for those out of area. Special IBS packages are available, and she also accepts insurance for Washington residents.
* If you are located in Seattle, we can recommend an appropriate physician for these tests.
Let us help you get started now.
Julie L. Starkel, MS, MBA, RD
Insurance accepted (Regence Blue Shield, Premera
(206) 729-5111Uniform and First Choice)
