diagnosed with irritable bowel syndrome (ibs): overcoming barriers and finding treatment that works for you
7 minute read
the critical thing to remember when trying to find the proper treatment after a diagnosis of ibs is that there is no one-size-fits-all approach, and therapies and interventions are going to be highly personalized.
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when someone starts experiencing the telltale signs of irritable bowel syndrome (ibs), such as abdominal pain and discomfort, bloating and gas, or changes in bowel habits, it can be challenging to figure out why. because ibs mimics other gastrointestinal conditions, it isn’t easy to diagnose. on average, people with ibs tend to go through the symptoms and investigations to rule out other diseases for as long as seven years before they get their answer.
once diagnosed, finding treatment can be just as challenging because there is no real place for people to go. a gastroenterologist will work with patients with ibs, but because it’s often considered a less dangerous gastrointestinal condition, patients often “get lost in translation,” according to dr. jennifer tanner, co-owner of the tummy clinic, a collaborative clinic dedicated to helping people manage ibs.
primary care physicians can also be helpful, but many are not specialized in ibs, leading to a knowledge gap in the care and management of the syndrome, leaving people with ibs alone to figure things out.
dr. rahima hirji, a naturopathic doctor specializing in ibs, notes that the condition used to be a meaningless diagnosis, something doctors would throw out there if they couldn’t find anything wrong. but with new research, that’s becoming less accepted.
“that’s what makes it so hard for the diagnosis to be made,” she said. “that, and a lack of training to recognize it.”
after going through all the tests and finally reaching a diagnosis, the road to feeling better is a long one, but with the right resources and knowledge, people living with ibs can jump those hurdles to find a better quality of life while living with the syndrome.
understanding the mind-body connection and finding the right specialists
dr. hirji notes that most people will see a gastroenterologist at some point when experiencing symptoms because they are often called upon to rule out more severe diseases, such as crohn’s and colitis. however, once those more serious disorders are off the table, the gastroenterologist will likely fail to provide much direction.
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“they’re (ibs patients) not going to be on the priority list because they’ve (gastroenterologists) got more pressing patients that are a priority to take care of, and so that’s when they leave their doctors office or their gi’s office saying, ‘okay. well, now i have ibs. so, what am i supposed to do with it?’” said dr. hirji.
that’s when researching what ibs entails and finding the right specialists come into play.
understanding the connection between the mind and the gut is a great first step because it will allow you to investigate the right avenues for therapy and pin down cycles that may cause symptoms to flare.
“whatever’s happening in your head is going to impact your gut, and whatever’s happening in your gut is going to impact your brain,” said dr. hirji.
because ibs is largely associated with both the mind and the gut, it’s essential to look into various types of healthcare providers that can address all issues. for example, if a person has ibs that tends to flare up during times of stress or anxiety, they may want to add a mental health professional to their healthcare team.
if they notice that eating certain foods tends to cause the worst symptoms, a dietician can work with them to figure out their dietary triggers so they can remove them from their meal plan.
“i think that’s the area where people end up getting a bit lost and discombobulated in their care plan because it’s not always a family doctor that’s offering the treatment protocols for them,” said dr. tanner.
understanding treatment options
the typical treatment approaches in canada for ibs revolve around dietary changes, lifestyle changes, and psychological care. in some instances, a person may be given recommendations for supplements that can help with the symptoms or be prescribed medications.
“we’re looking at more of that overall picture,” she said. “we might use motility agents to get things moving, like osmotics, for example. or we might use bulking agents like fibres. those are some really common approaches. sometimes, we’re layering in probiotics.”
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dr. tanner notes that cognitive behavioural therapy is also a common treatment avenue for people living with ibs because it addresses the mind piece.
the critical thing to remember when trying to find the proper treatment after a diagnosis of ibs is that there is no one-size-fits-all approach, and therapies and interventions are going to be highly personalized.
“it might be looking at the person in particular and seeing what avenue in their life is most likely contributing to their symptoms,” said dr. tanner. “if we suspect diet might be part of it, then that would be a good place (to start), but if stress is really overwhelming for them, then maybe that’s the window they start with. there’s no rule that you have to start with one versus the other.”
when it comes to diet, the low fodmap diet (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) is often recommended.
“it’s definitely one of the only diets that’s been shown to help people with ibs,” said dr. hirji. “it’s a fairly restrictive diet, and that’s also why these patients need support because their doctor will say, ‘go do the low fodmap diet.’ it’s a hard diet to figure out on your own.”
dr. hirji suggests working with a dietician to handle the diet piece is the best approach because they’re often trained in specialized diets and can “walk through what the diet looks like” so that when a person recently diagnosed leaves, they’re ready to meal plan accordingly.
it’s also important to note that it’s a journey to finding the right ibs therapy, and it will take time. with various treatments available for those with ibs, none of which suit everybody, there’s a lot of “trial and error,” according to dr. hirji.
“it can be a really long process to get patients to the point where they feel like they are in control of this syndrome, and that’s what we emphasize,” she said.
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overcoming barriers by advocating for yourself
since ibs is often considered a mild disease, many healthcare professionals will give the diagnosis and follow it up with some recommendations before leaving the patient to their own devices.
“this is not a terminal illness, right? so, sometimes they’re just not taken seriously,” said dr. hirji. “maybe you miss work, and maybe you don’t leave the house, but it’s not going to kill you, so people don’t take it seriously, which i don’t think is right because it really impacts people’s quality of life.”
because of that, “advocating for oneself and trying to get those referrals into those specialists” is vital, according to dr. tanner.
she notes that other barriers people may face include a lack of time to plan out a highly restrictive diet or having to work around other dietary restrictions while eliminating many foods from the rotation.
“a lot of times when people are trying to self-guide through things like the fodmap diet, it’s pretty daunting,” she said. “it can be confusing … so i think that’s a big roadblock that people will often come up against.”
a lack of understanding amongst the healthcare community about ibs treatment is another barrier that people living with the condition will face, which makes it even more essential to find those who are knowledgeable and specialized in ibs specifically.
“because it’s a multifactorial illness, it’s hard to get all of the pieces working together,” said dr. hirji. “unfortunately, a lot of these patients end up trying to do the research on their own and trying to find the support on their own.”
it’s also essential for people to understand and accept their diagnosis. while the road ahead may be difficult, it’s worth it to find something that works to manage symptoms.
dr. hirji notes that while a person is going through the various therapy avenues, they should also be committed to living an overall healthy lifestyle. by doing so, they can improve their quality of life alongside their ability to stay with a treatment plan.
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“make sure you’re moving. make sure you’re walking. make sure you’re sleeping, managing your stress,” she said. “all of these things really apply.”
finding the right resources
to ensure that a person has access to the proper medical interventions, they must be able to find the right resources. typically, that will start in the primary care physician’s office because they do the referrals. however, other available resources give people a better chance of finding the right specialists for the best possible care.
for example, the tummy clinic, a virtual ibs care clinic, can be a great place to start when looking to get on the right path for ibs treatment.
“we’re not going to cure it. there’s not a cure for ibs,” she said. “but we want to empower patients, educate patients, give them a toolbox so that they can manage their symptoms and improve their quality of life.”
when it comes to the research side of things, sites that provide information regarding ibs and ibs care include:
“i think it would just be important for them to know that they’re not alone and that there is help out there for them,” said dr. tanner. “people are very grateful to have had the resources that are out there, to have somebody to talk to and to help feel that they’re not alone and that there are strategies they can start implementing right now to help them move forward and get some of their quality of life back.”
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