Soothing the Symptoms of
Irritable Bowel Syndrome

Recognizing Symptoms
Relieving Discomfort

One in five Americans may have it, but doctors know little about its exact causes. It is cited as the second-leading cause of absenteeism in the American workplace. It's not life-threatening, but its symptoms can be painful and embarrassing, and they may occasionally mimic something more serious. The condition is Irritable Bowel Syndrome (IBS), formerly known as Spastic Colon.

A syndrome is a cluster of symptoms that appear together. Although the exact triggers of IBS can't always be identified, the good news is that a few simple steps, outlined in this booklet, may help manage this condition and decrease the symptoms of IBS.

Symptoms
If you experience lower abdominal pain relieved by moving your bowels... or if you experience changes in the frequency and consistency of bowel movements, it may be a sign of IBS. Signs of IBS can often show up shortly after a meal. In some cases, constipation can alternate with diarrhea. Everyone experiences one or more of these symptoms from time to time. But if you suffer from them frequently over a period of time, consult with your physician.

Irritable Bowel Syndrome and Your Digestive System
To help understand the symptoms of IBS, let's take a quick tour of your digestive system. A little information can go a long way in preventing difficulties.

The digestive process begins in your mouth. Your teeth break up the food into small pieces and your saliva mixes with the food, allowing it to pass through the esophagus into the stomach. Using muscular contractions, the esophagus sends food from the mouth to the stomach.

Like a giant processing center, the stomach churns the food into smaller pieces, preparing it to travel on to the lower part of the digestive tract.

After leaving the stomach, the food passes into the small intestine, where the food's nutrients are further broken down and absorbed into the bloodstream. By the time food passes through all 21 feet of the small intestine and reaches the colon, only water and waste products remain.

Now the colon begins the process of removing waste from the body. Under normal conditions, the colon is very efficient at absorbing excess water from the waste. However, if your colon's ability to remove waste efficiently is affected, then symptoms of IBS can occur. If transit through the colon is sped up, your waste doesn't have time to solidify and you experience diarrhea. If it's slowed down, waste hardens and isn't passed in a timely fashion; that's constipation.

Here's a closer look at some common factors that can aggravate Irritable Bowel Syndrome:

FOOD -- Each of us reacts differently to various foods. It's not just spicy or hard-to-digest foods (greasy, fatty stuff) that can irritate our bowel. Cabbage or beans usually produce gas and, in some of us, that's more disruptive. But occasional constipation, a frequent symptom of IBS, is often relieved by increasing fiber in the daily diet.

STRESS -- The rigors of everyday life may cause headaches, high blood pressure, and insomnia. Doctors do agree that stress is one of the most common triggers of IBS. No matter what you eat, if your mind is preoccupied with pressure, the effects of stress can show up in your digestive tract.

CAFFEINE -- Coffee, cola, chocolate, and other foods containing caffeine can stimulate muscles and upset their normal rhythm throwing you off your normal routine.

Diagnosis
Should you experience symptoms consistent with IBS, see a doctor. He or she can better determine if you have IBS or something more serious.

You'll be asked about your medical history ... about bowel habits, about your diet, about the stresses and strains on your daily life. The doctor may request a sample of your stool, ask you to undergo a barium enema (or barium X-ray), or suggest a sigmoidoscopy or colonoscopy to get a better look at your colon and rule out more serious disorders. Based on your medical history and the results of any additional tests, your doctor can determine whether you have IBS.

Treatment
Many people who suffer from IBS try to ignore its symptoms, or they treat it by taking remedies that only temporarily relieve their discomfort. They would be surprised to learn that, for the most part, they can more successfully manage their symptoms.

DIET -- If you and your doctor have determined that certain foods you eat aggravate the symptoms of IBS, he or she may suggest that you eliminate those foods. You may also be eating too much, too fast. Try slowing down at mealtimes; take time to enjoy your food. Eat smaller portions; perhaps break down your eating into segments during the day instead of three huge meals. Whatever change you make in your diet, make it gradually so that your body has time to adjust.

STRESS -- Recognizing stress is the first step toward dealing with it. Make a checklist of the things that bother you-whether it's work, money, or domestic tensions. Often just talking about your problems with a friend, a counselor, or clergyman will help relieve them. Exercise can relieve tension by stretching muscles that store stress. You don't have to join a health club or buy a home gym; try walking, dancing, or calisthenics. Some people relieve stress through meditation or yoga, relaxation therapy or biofeedback. Talk to your doctor about these methods for some informed input.

MEDICATIONS -- Doctors often recommend over-the-counter bulk fiber laxatives or stool softeners for relief of constipation associated with IBS. Research on this symptom suggests that soluble fiber (such as "psyllium") is preferable to insoluble fiber (such as "wheat bran"). Doctors sometimes will prescribe an anti-spasm medicine, but this is only for short-term usage.

MEDICAL CHECKUPS -- Once you seek a physician's help for IBS, make sure you follow up to monitor your situation.

The High-Fiber Diet
Fiber is probably the most misunderstood part of our diet. It furnishes no nutrients, vitamins, or minerals. It isn't even absorbed into our bodies. So why do we need it? Fiber adds bulk to keep other foods moving along the digestive tract, and it holds water, which in turn, softens the stool for easy elimination. Right now, most people could double or even triple their fiber intake just to reach suggested levels. The average American takes in 10-15 grams of fiber a day, but experts recommend taking in 20-35 grams.

Fiber comes in two different forms: soluble and insoluble. While they work differently, both are needed for proper bowel function. All fiber sources contain both kinds of fiber in varying amounts. Don't think you have to totally rearrange your diet to accommodate more fiber. One way to start is to substitute high-fiber foods for low-fiber ones. Switch your bakery habits from white bread and rolls to whole-grain breads. Try brown instead of white rice. Eat "whole grain" cereal. And most easily of all, add fruits and vegetables to your diet.

Your general rule of thumb should be at least one serving of whole grain in every meal. Try this sample menu:

Breakfast -- Cereal and/or toast. Make sure the first name on your cereals and breads is Whole Grain. Add banana slices to cereal.

Lunch -- Sandwich on whole-grain bread. Carrot sticks. Snack -- Apple or raisins. Skip the candy bar, or at least cut back.

Dinner -- Broiled chicken and steamed broccoli. Wheat rolls. Salad.

Also, increase your intake of vegetables and fruit. You should be getting three servings of each every day. Try a sliced banana on your cereal, substitute carrot sticks for chips as a lunch side, and crunch on a salad for dinner. Wherever possible, eat the peels (you're off the hook with bananas and oranges).

There are possible downsides to increasing fiber. Some high-fiber foods, like beans, can produce excessive gas or bloating. Take in too much fiber too soon and you could suffer from bloating or abdominal cramps.

Remember, whenever you change your diet, for whatever reason, do it gradually. Let your body adjust. And check in with your doctor if you experience any discomfort.

A Fiber Solution: METAMUCIL®
If your physician has recommended increasing your fiber intake in order to treat constipation, he or she may suggest the convenience and effectiveness of Metamucil.

What does METAMUCIL add?
METAMUCIL contains psyllium, a 100%-natural fiber that helps you restore regularity, increase your fiber intake, and maintain regularity when recommended by your physician.

How much fiber can METAMUCIL add?
At 3.4 grams per dose, taken up to three times per day, you can add as much as 10.2 grams of psyllium fiber. That's about half of the minimum amount of fiber recommended for your daily consumption. And it's one of the most concentrated sources of soluble fiber. In fact, METAMUCIL's fiber contains more than eight times the amount of soluble fiber found in oat bran, gram for gram.

When can I take METAMUCIL?
You can take METAMUCIL in the morning, at noon or in the evening, with or without food with at least 8 ounces of liquid (one to three times a day). Laxatives, including bulk fibers, may affect how well other medicines work. If you are taking a prescription medicine by mouth, take this product at least 2 hours before or 2 hours after the prescribed medicine.

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