Perhaps I should only speak for myself, about the irritable part, I mean.  There are very few discomforts in life which are more painful, consistently aggravating and mess with your social life as much as Irritable Bowel Syndrome.  For many of us it has changed our eating habits, infringed on our good natures and forced us to know where every bathroom is located within a five mile radius.  Stores, restaurants, rest stops, we got it covered if you ever want to know.

When I was in nursing school one of the instructors referred to the gastrointestinal system as “the tube within the tube.”  I don’t know why that stuck with me all these years.  I guess I’d never been called a tube before. So, how’s your tube?  Mine is much better these last few years but for most of my adult life I have suffered from chronic constipation or diarrhea, abdominal pain, heartburn and general dyspepsia.  What a great old-fashioned word dyspepsia is.

I have “gone the route,” with the x-rays, the barium swallows, the CT scans, the ultrasounds, the lab work, etc. The results for me were always inconclusive except for some diverticulum in the gut, which is fairly common, especially as one gets older.  It is little annoying pouches in the gut which can trap non-soluble fiber. These pouches trap and hold certain indigestible food particles such as corn fiber and seeds, causing the bowel to become overactive in an attempt to expel its contents or “cough it up” so to speak. If these pouches become inflamed you have diverticulitis which can be very painful and in extreme cases require surgical intervention. In recent years there have been those who say small seeds do not harm you but I continue to have problems with seeds such as strawberry, all other berries with large seeds and nuts if not chewed thoroughly.

In my life and body, the problem has usually been diagnosed as Irritable Bowel Syndrome/disease.  Not to be confused with the more life-threatening Crohn’s disease.  Don’t misunderstand me, IBS all by itself can certainly ruin your day.  Until I read everything I could get my hands on and started a great many modalities on my own, it was not at all uncommon to double over with pain, be totally unable to have a bowel movement and a couple of times, faint while sitting on the toilet.  The “john” is certainly no fainting couch and I am somewhat embarrassed to admit it to you but, in the interest of knowledge…

Many of us with a form of auto-immune disease have lousy mucosal lining, starting at the mouth and going all the way through to the exit.  Some of us also have Sjogren’s Syndrome with its accompanying dryness of eyes, nose and mouth. (That we’ll save for another blog.) Sometimes the mucosa is reacting to NSAID’s which most of us know can play havoc with the lining of the gut.  Many pain meds can slow down the peristalsis in the gut.  It helps to think of the little conveyor belt which constantly moves food and fluid along in the gut as “the wave.”  It’s either that or think of the last nature film you saw where a large boa constrictor swallowed another animal and you saw the ripples. See?  “Wave” sounds better.  The list of drugs which attacks the lining of the gut is long which is why we should each be informed as to what we take and its possible side effects.

Antibiotics can cause increased peristalsis because they kill off all the good bacteria in the “tube” causing the “wave” to get overly active.  Many of us found that replacing the bacteria with good bacteria, found in acidophilus, i.e. yogurt with active cultures and buttermilk, or taking the acidophilus liquid or gelcaps, helped the “wave” to calm down.  I think we should talk about all of these things, don’t you?

Since this blog is intended to be personal, I am going to work very hard not to sound like a nurse and to talk to you as Sue, the patient.  I think she’s probably a lot more interesting anyway.  The only advice I ever got, after a multitude of tests was, “keep up the fiber” and “here are some antispasmodic medications.”  When I ran a fever with a bout, I was given specific antibiotics which are designed to stay in the intestines to work their magic. I wasn’t getting the answers I needed on prevention.  I surmised the doctors didn’t have anything to tell me, so I went on a quest of my own.  After all, it is my body and I am in charge of my own life. It started to feel an awful lot like my body was calling the shots.

For several years I read everything I could on “natural medicine” not to imply that regular medicine is in any way “unnatural.”  I was just very frustrated because my life was still intolerable. Abdominal cramps that made my eyes bug out, a painful sitter which wasn’t doing a thing for my social life as well as a problem every time I was exposed to sunlight for more than 5 or 10 minutes. I also had pain in several other joints, including my cervical spine. I was sleeping in a cervical collar.  I found a pediatric collar the most comfortable, by the way.

I subscribed to a natural health magazine with a credible reputation and continued to read everything I could by Dr. Andrew Weil.  As an RN I felt comfortable with him because he is an MD, a Harvard graduate, who had the courage to look at medicine in a new light.  I thought I could use a new light because I was still in the dark.  Dr. Weil also made a great deal of sense to me. Aided and abetted by every dietician’s book I could find I also began to take a long, hard look at what I was eating. A great deal of what I read about IBS didn’t seem to apply for me so I had to test almost everything I ate to see what did work or did not.  I knew from my years in nursing that my “tube” was in chronic trouble and rule number one is to keep the tube functioning and clear.  My “wave” was churning away almost daily demanding some attention and I knew it had to be calmed.  Each day I would face either constipation or if I treated it what I began to call “jet diarrhea.” I couldn’t and still can’t seem to find a middle ground.

Here is the regimen I developed for myself, which has worked quite effectively for me for the last ten years, with only a few exceptional bouts of “eyes bugging out” episodes.

1.     I try to eat soluble fiber, which includes foods such as oatmeal, pasta, rice, potatoes, soy and barley.  Grains, particularly in breads are okay, but if they need grinding or I can’t chew them into a mash then they probably aren’t going to travel well.  Nuts are okay if I chew well.  Beans, peas and lentils leave a bit of skin so I watch the amounts of those foods. I do well with chicken, fish and lean pork.  Red meat creates some digestive upset for me. Maybe it’s all those bovine hormones?  I have a love-hate relationship with Psyllium/Metamucil.  Doesn’t everyone?  If I ever meet anyone who says, “Yum, love that psyllium,” I’m going to drag them to a psychiatrist. It works well for me and it has also proven to help with high cholesterol so I stuck with it for many years but now find I can’t tolerate it.  It is the most disgusting “gunk” but worth the few seconds of gagging if you can get it down.  The secret to getting it down is to be prepared to swallow it as soon as it is mixed because it begins to set up, much like wallpaper paste.  It is also a little more palatable in fizzy water such as seltzer, club soda, etc.  In the case of psyllium, some of the generic brands are just too unpalatable to be endured. Also, you don’t want to mix it with juice if you ever want to like that juice again.  It’s called aversion therapy and it works.  I make one exception to that rule.  When I’m in extreme trouble with constipation I mix what I call a “kamikaze cocktail” which is psyllium mixed in prune juice or cherry juice. Very effective. Psyllium is available in capsules but you have to take many and if you have dry throat and dry esophagus, you must be very careful and drink a lot of water. If you’re not careful you can get a “traffic jam” in your esophagus that is very uncomfortable and dangerous.

2.     Daily exercise. I have all these memories of the surgical unit at the hospital when we dragged those poor surgical patients out of bed to parade up and down the hallway.  It’s a must to get the system back on line by moving the abdominal muscles. Unfortunately, the whole body is a package deal. You know, the old song, “The hip bone connected to the back bone, etc.” In this case, the abdominal muscles connected to the leg and hip muscles all help the little train we call the bowels to function. Chuga, chuga.

3.     Drink plenty of fluids. Just keep in mind that alcohol and coffee can overly stimulate the “wave.” They can cause cramping. Each of us reacts differently to caffeine.  My husband worked the night shift for years and could drink hospital coffee (think spoon standing alone thick and dark), come home in the morning and have another cup and go right to sleep.  I am extremely sensitive to caffeine.  I limit myself to one cup per day, in the a.m. I tried to kick the habit completely but found the mornings too joyless.  This includes regular teas, (therefore I look for the herbal varieties), chocolate and many soft drinks.  Read labels. I buy natural, zero calorie sparkling water by the case at Costco. I drink it all day long.  Have to keep the tube lubricated and moving.

4.     Dairy works for me.  I know there are many folk out there who cannot tolerate dairy.  Lactose intolerance is rampant.  There are tablets and special milks available.  There are drops to add to your milk. My gut, both the tube and the wave, seem to like yogurt, buttermilk, cream soups, cottage cheese and other cheeses. If your wave gets too much motility when faced with these items, there is always…drum roll…soy.  I know, manly folks cringe at the word but it is everywhere and some of it isn’t bad. The soy cheese and milks are quite good. Just be sure you are getting enough Vit. D3, Magnesium and calcium if you have no dairy in your diet. I have found, for me, that.three Colase each evening along with Magnesium keep things rolling along. In a pinch, I drink a mixture of white grape juice and cherry juice. One can only tolerate so much prune juice.

5.     There are a few herbs I have come to know and love. Slippery elm bark is my favorite.  It’s an old Indian remedy and for me, it does soothe the gut. It’s available in tea, capsules or a powder you mix with food. It does taste like you’re drinking the bark of a tree, because it is; that’s why I stick to the capsules. That’s not surprising. Good old-fashioned peppermint is another staple for me.  I drink the tea (be sure it’s caffeine free), chew on mints, and for those occasional fierce bouts of IBS, I get myself down to the health food store and buy enteric coated peppermint capsules.  They dissolve once they reach the gut. Be forewarned it does burn a bit on the way out.  I also like aloe vera gel.  The juice is acidic and too disgusting but there is a gel cap on the market. Be sure you don’t buy the latex and leaf variety because that works as a laxative, (quite well I might add and I have taken it for that purpose) but the gel caps are very soothing.  I had used aloe vera for years on burns, etc. and when I read the recommendation I thought, well, why not give it a try? Probiotics are a must for a healthy gut, especially those which contain Bifidum.

6.     Eat the right food.  I have to avoid too much of any extremes such as hot salsa, Chinese mustard, horseradish.  If it burns my mouth it is probably going to burn my gut. I try to keep it mild, natural and simple. We never know how the chemicals and additives in our food are going to affect us, so be careful and eat as if you’re on the farm.  If I do have a bout my personal favorites hark back to childhood.  They are homemade potato soup and my Mom’s recipe for homemade noodles cooked with boneless chicken breasts.  I also like boiled pasta, such as good Italian spaghetti prepared with a few herbs, olive oil with a touch of butter with a few mushroom slices and served after quickly being tossed with Parmesan cheese. I could live on all of those and sometimes do. I have decided I have to be kind to my gut and it will be kind to me.  I recommend to you that you test what works for you and what doesn’t, avoid. Happy tubing or should I say waving?

Please be reassured, if you are a fellow IBS patient, you are not the only one who carries extra pads and an extra pair of underwear in your purse, can make more noise than the horn section of the Marine Marching Band and always makes appointments in the afternoon in order to spend mornings at home, near the toilet. We adapt, yes, we adapt because we must.