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Gastroenterology and Health

Irritable bowel syndrome

What You Should Know About I.B.S.

By Dr. W. Gifford Jones

December 26, 2000

Napoleon Bonaparte at one time needed a soldier for a particularly hazardous mission. The story goes that he ordered several soldiers to face a firing squad. He picked the stoic who showed no tendency to move his bowels. Napoleon might also have concluded that this soldier did not suffer from "the irritable bowel syndrome" (IBS).

A recent report in the Canadian Medical Association Journal says that 15 percent of adults in North America suffer from IBS. And that it's notoriously hard to diagnose and treat.

I'd say "amen" to that. In fact, any physician reading about IBS usually ends up by saying "What in the devil is IBS and what causes it?" The fact, is that no one really knows.

Symptoms vary from patient to patient.Some complain of chronic abdominal pain, bloating and gas. Others suffer from stomach cramps, constipation, diarrhea. And the greater the number of symptoms the greater the likelihood the diagnosis is IBS.

But what causes IBS if you're not facing a firing squad? We know historically that emotions play a major role in bowel function. Early Egyptian sculpture shows a bull defecating while being attacked by a lion.

William Shakespeare in the play Othello wrote, "The thought whereof doth like a poisonous mineral gnaw my inwards." Anyone about to give an important speech knows the immortal bard was right.

Today too many people are living what Thoreau called "Lives of quiet desperation." And evidence suggests that chronic anxiety causes unusual patterns of intestinal movement which may either speed up or slow down bowel contractions.

I'm convinced that lifestyle also plays a major role in this problem. Patients tell me time and time again that they often put off having a bowel movement. There are dozens of reasons for the delay. They may be at an important meeting. Or simply decide they'll wait until they arrive home. Or whatever.

Usually I know this is their habit without them telling me about it. Rectal examination often reveals small hard lumps of stool in the lower large bowel that have remained there a long time. This is the start of chronic constipation.

A few years ago a remark of mine caused a stir. I stated that if your stools don't float you're not eating enough fiber.

I admit that remark isn't 100 percent true. But stools do float when sufficient fiber is eaten. And good sense tells you that soft floating stools are easier on the bowel than hard rocks. The strain of trying to move along and pass rocky stools causes abdominal cramps.

Mothers are often right in some things. Studies at Harvard Medical School show she was right when she advised cranberry juice to decrease the risk of urinary infection.

But "Wow" was she wrong when she advised the weekly bowel purge with castor oil. She condemned some children to a lifelong habit of laxative use.

I doubt that anything has caused more cases of IBS than the excessive use of laxatives. The chronic use of laxatives slowly but surely impairs normal bowel function.

Studies in mice show that when they're given laxatives for four months, degeneration of the intestinal nerves takes place.

Laxative use is an immense problem around the world. An English study revealed that 38 percent of the male population of Edinburgh used laxatives. And 50 percent of women in the same group.

More frightening, another study showed 20 percent of those having two or more bowel movements a day still used laxatives! It's hard to forget Mother's advice. Or the constant reminder on T.V about the use of laxatives to ensure a healthy life.

My advice to patients is to eat a healthy diet including large amounts of fiber. And to establish a good bowel routine. This means getting up half and hour earlier to have a decent breakfast along with a hot cup of coffee or tea. A full stomach and a hot drink help to trigger the gastro�colic reflex that triggers a bowel movement.

I also advise patients to sit on the toilet following breakfast even if they don't believe they need a bowel movement. Often they find they do and it also establishes a good bowel routine.

But remember these "red flags". Rectal bleeding is not associated with IBS. And if you have a sudden change in bowel habits such as alternating constipation and diarrhea this may be due to serious disease. These symptoms always demand an examination of the bowel. Never, never delay seeking medical attention.


W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com

My book, �90 + How I Got There� can be obtained by sending $19.95 to:

Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1

Pre-2008 articles by Gifford Jones
Canada Free Press, CFP Editor Judi McLeod