IBS and Bowel Health with Fibromyalgia

This post was previously published on The Zebra Pit

Fibromyalgia is a multi-faceted disease that affects far more than just your muscles. One of the common conditions that Fibromites experience is problems with their bowels. IBS or Irritable Bowel Syndrome can be a stand alone disease, but is often found in those with Fibromyalgia.

Symptoms

When you have IBS, you can experience some or all of the following symptoms:

  • Abdominal pain and cramping that is typically relieved or partially relieved by passing a bowel movement
  • Excess gas
  • Diarrhea or constipation — sometimes alternating between the two and occaisionally having both happen during the same bowel movement
  • Mucus in the stool
  • Bloating
  • Nausea
  • Back Pain (due to cramping)

The GI Society of Canada says the following:

“Symptoms occurring outside of the digestive tract that might be related to IBS include sleep disturbances, chronic pelvic pain, interstitial cystitis, temporomandibular joint disorder, post-traumatic stress disorder, and migraine headaches. Female patients who have IBS have also reported discomfort during sexual intercourse (dyspareunia). Our survey of 2,961 respondents showed 32% have some form of mood disorder, 27% have gastroesophageal reflux disease, and 27% have anxiety disorder.”

Common IBS Symptoms Graphic

It’s important to seek medical care when you experience bowel issues, to ensure that nothing more serious is going on. Don’t let embarrassment stop you. If you are experiencing any of the following, call and make an appointment:

  • Weight loss
  • Diarrhea at night
  • Rectal bleeding
  • Iron deficiency anemia
  • Unexplained vomiting
  • Difficulty swallowing
  • Persistent pain that isn’t relieved by passing gas or a bowel movement

Seeing The Doctor

When you seek medical care for your IBS symptoms, the following actions may occur:

Medical History: A physician reviews the patient’s medical history, considering bowel function pattern, the nature and onset of symptoms, the presence or absence of other symptoms, and warning signs that might indicate some other diagnosis.

Physical Examination: During a physical evaluation, the bowel may have involuntary jerky muscular contractions (spastic) and seem tender; although the patient’s physical health usually appears normal in other respects.

Investigative Testing: A physician might request tests to rule out other possible diseases. In performing a scope, physicians view the intestinal tract with an instrument that enters the body via the mouth (gastroscopy) or the anus (colonoscopy/sigmoidoscopy). The scope is made of a hollow, flexible tube with a tiny light and video camera.

Doctor Writing Notes

The physician may also request routine blood and stool tests to rule out known organic diseases. Some symptoms of celiac disease overlap those of IBS, so a family history of this disease might be a reason to test for it.

After other conditions have been ruled out, your doctor is likely to use one of these sets of diagnostic criteria for IBS:

  • Rome criteria. These criteria include abdominal pain and discomfort lasting on average at least one day a week in the last three months, associated with at least two of these factors: Pain and discomfort are related to defecation, the frequency of defecation is altered, or stool consistency is altered.
  • Manning criteria. These criteria focus on pain relieved by passing stool and on having incomplete bowel movements, mucus in the stool and changes in stool consistency. The more symptoms you have, the greater the likelihood of IBS.
  • Type of IBS. For the purpose of treatment, IBS can be divided into three types, based on your symptoms: constipation-predominant, diarrhea-predominant or mixed.

Treatment

Treatment of IBS focuses on relieving symptoms so that you can live as normally as possible. These suggestions below come from The Mayo Clinic:

Mild signs and symptoms can often be controlled by managing stress and by making changes in your diet and lifestyle. Try to:

  • Avoid foods that trigger your symptoms
  • Eat high-fiber foods
  • Drink plenty of fluids
  • Exercise regularly
  • Get enough sleep

Your doctor might suggest that you eliminate from your diet:

  • High-gas foods. If you experience bloating or gas, you might avoid items such as carbonated and alcoholic beverages, caffeine, raw fruit, and certain vegetables, such as cabbage, broccoli and cauliflower.
  • Gluten. Research shows that some people with IBS report improvement in diarrhea symptoms if they stop eating gluten (wheat, barley and rye) even if they don’t have celiac disease.
  • FODMAPs. Some people are sensitive to certain carbohydrates such as fructose, fructans, lactose and others, known as FODMAPs — fermentable oligo-, di-, and monosaccharides and polyols. FODMAPs are found in certain grains, vegetables, fruits and dairy products. Your IBS symptoms might ease if you follow a strict low-FODMAP diet and then reintroduce foods one at a time.

A dietitian can help you with these diet changes.

If your problems are moderate or severe, your doctor might suggest counseling — especially if you have depression or if stress tends to worsen your symptoms.

In addition, based on your symptoms your doctor might suggest medications such as:

  • Fiber supplements. Taking a supplement such as psyllium (Metamucil) with fluids may help control constipation.
  • Laxatives. If fiber doesn’t help symptoms, your doctor may prescribe magnesium hydroxide oral (Phillips’ Milk of Magnesia) or polyethylene glycol (Miralax).
  • Anti-diarrheal medications. Over-the-counter medications, such as loperamide (Imodium), can help control diarrhea. Your doctor might also prescribe a bile acid binder, such as cholestyramine (Prevalite), colestipol (Colestid) or colesevelam (Welchol). Bile acid binders can cause bloating.
  • Anticholinergic medications. Medications such as dicyclomine (Bentyl) can help relieve painful bowel spasms. They are sometimes prescribed for people who have bouts of diarrhea. These medications are generally safe but can cause constipation, dry mouth and blurred vision.
  • Tricyclic antidepressants. This type of medication can help relieve depression as well as inhibit the activity of neurons that control the intestines to help reduce pain. If you have diarrhea and abdominal pain without depression, your doctor may suggest a lower than normal dose of imipramine (Tofranil), desipramine (Norpramine) or nortriptyline (Pamelor). Side effects — which might be reduced if you take the medication at bedtime — can include drowsiness, blurred vision, dizziness and dry mouth.
  • SSRI antidepressants. Selective serotonin reuptake inhibitor (SSRI) antidepressants, such as fluoxetine (Prozac, Sarafem) or paroxetine (Paxil), may help if you’re depressed and have pain and constipation.
  • Pain medications. Pregabalin (Lyrica) or gabapentin (Neurontin) might ease severe pain or bloating.

Medications specifically for IBS

Medications approved for certain people with IBS include:

  • Alosetron (Lotronex). Alosetron is designed to relax the colon and slow the movement of waste through the lower bowel. Alosetron can be prescribed only by doctors enrolled in a special program, is intended for severe cases of diarrhea-predominant IBS in women who haven’t responded to other treatments, and isn’t approved for use by men. It has been linked to rare but important side effects, so it should only be considered when other treatments aren’t successful.
  • Eluxadoline (Viberzi). Eluxadoline can ease diarrhea by reducing muscle contractions and fluid secretion in the intestine, and increasing muscle tone in the rectum. Side effects can include nausea, abdominal pain and mild constipation. Eluxadoline has also been associated with pancreatitis, which can be serious and more common in certain individuals.
  • Rifaximin (Xifaxan). This antibiotic can decrease bacterial overgrowth and diarrhea.
  • Lubiprostone (Amitiza). Lubiprostone can increase fluid secretion in your small intestine to help with the passage of stool. It’s approved for women who have IBS with constipation, and is generally prescribed only for women with severe symptoms that haven’t responded to other treatments.
  • Linaclotide (Linzess). Linaclotide also can increase fluid secretion in your small intestine to help you pass stool. Linaclotide can cause diarrhea, but taking the medication 30 to 60 minutes before eating might help.

Potential Future Treatments

Researchers are investigating new treatments for IBS. Serum-derived bovine immunoglobulin/protein isolate (SBI), a nutritional therapy, has shown some promise as a treatment for IBS with diarrhea.

Studies also show that, in people who have IBS with diarrhea, a specially coated tablet that slowly releases peppermint oil in the small intestine (enteric-coated peppermint oil) eases bloating, urgency, abdominal pain and pain while passing stool. It isn’t clear how enteric-coated peppermint oil might affect IBS, so ask your doctor before using it.

Conclusion

Although Bowel related issues can be embarrassing, it’s important to acknowledge and treat your symptoms to give you the best health possible. Make time to reduce stress in your life, follow a proper diet and get a good nights sleep…these three things can make a huge difference in your gut health. If nothing changes, see your doctor. Your good health depends on it.

You Know What Omega-3s Are – But What About Omega-6s?

Today I’m featuring an article by Guest Author Nicole Ross Rollender. Her bio is at the bottom of the page. She’s written an excellent post about Omega-3s and Omega-6s and how important they are for our bodies. When you live with Chronic Pain, you know you need to do everything possible to maintain your overall health, and diet can play a part in that. Read on to see what Nicole has to say:

Positivity Quotes

No doubt you’ve gotten the skinny on good fats (hello, omega-3) from your primary care doctor or nutritionist.

You’ve probably heard this before: Omega-3 fatty acids like EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are found in fish oils from salmon, krill, tuna, trout, mackerel, and sardines, along with oysters and crabs.

Clinical evidence suggests omega-3s like EPA and DHA help reduce risk factors for heart disease, including high cholesterol and high blood pressure, according to the University of Maryland Medical Center.

You’ll find other omega-3s like alpha-linolenic acid (ALA) in flaxseed, oils like canola and soybean, and nuts and seeds such as walnuts and sunflower, according to the Mayo Clinic.

Omega 3 and Omega 6 For Your Good Health

Along with omega-3s, omega-6 fatty acids play a vital role in brain function, and our normal growth and development. 

Bottom line: Your body needs fatty acids to function, and they pack some major health benefits.

However, not as many people have heard of omega-6s. Here’s what you need to know to ensure you’re getting enough (but not too much) of this important fat in your diet.

What Are PUFAs?

Here’s a quick chemistry lesson: Like omega-3, omega-6 is a type of polyunsaturated fatty acid (PUFA), a fat molecule containing more than one unsaturated carbon bond. For example, oils (like olive oil) that contain polyunsaturated fats are liquid at room temperature, but start to turn solid when chilled, according to the American Heart Association.

“Omega-6s are essential for a whole host of things: proper brain function, stimulating hair and skin growth, maintaining bone health, promoting normal growth and development, regulating metabolism, and maintaining a healthy reproductive system,” says Laura Ligos, MBA, RDN, CSSD, a Real Food registered dietitian at Albany, NY-based The Sassy Dietitian & Designed to Fit Nutrition.

PUFAs offer heart-health benefits when you eat them in moderation and use them to replace unhealthy saturated and trans fats in your diet, according to the Mayo Clinic.

There are saturated fats in animal-based foods, such as meats, poultry, lard, egg yolks and whole-fat dairy products like butter and cheese. They’re also in cocoa butter, and coconut, palm and other tropical oils used in coffee creamers and other processed foods.

Trans fats, also called hydrogenated and vegetable oils, are in hardened vegetable fats like stick butter – and make their way into crackers, cookies, cakes, candies, snack foods and French fries.

A good rule of thumb is to reduce foods high in saturated and trans fats in your diet. Instead, choose foods that include plenty of PUFAs – but don’t go overboard.

All fats, even good ones, are high in calories – they’re nine calories per gram.

The Omega-6/Omega-3 Ratio

Humans evolved on a diet balanced in omega-6 and omega-3 (1:1 ratio) essential fatty acids, according to the journal Nutrients. Today, though, the ratio for many people is a staggering 20:1, contributing to weight gain and other health issues.

“The ratio between omega-6 and omega-3 in our bodies should stay between 2:1 and 3:1,” Ligos says. “You’re heading into dangerous territory when your omega-6/omega-3 ratio is greater than 4:1.”

Both a high omega-6/omega-3 ratio and a high omega-6 fatty acid intake contribute to weight gain, whereas a high omega-3 fatty acid intake decreases your risk for weight gain, according to Nutrients.

In addition, when your omega-6/omega-3 ratios are out of balance, you’re at higher risk for cardiac issues, according to the American Journal of Physiology-Heart and Circulatory Physiology

“When there isn’t enough omega-6 in your diet, essential fatty acid deficiency can occur, leading to excessive thirst and skin lesions, as well as more serious issues like stunted growth, skin lesions, a fatty liver, and reproductive issues or failure,” Ligos says.

Conversely, too much omega-6 (and not enough omega-3) can cause inflammatory conditions including heart disease, elevated blood pressure, diabetic neuropathy, autoimmune conditions and more, Ligos notes.

Not all omega-6 fatty acids promote inflammation though, according to the University of Maryland Medical Center.

Linolenic acid, often found in vegetable oils, is converted to gamma-linolenic acid (GLA) in the body. GLA is also found in plant-based oils like evening primrose oil, borage oil and black currant seed oil.

“There’s research to support taking a GLA supplement, an omega-6 fatty acid, to reduce inflammation, much unlike all other omega-6 fatty acids,” Ligos says.

The body converts GLA to DGLA, which fights inflammatory conditions, and having enough other nutrients like magnesium, zinc, and vitamins C, B3 and B6, promotes that conversion, the University of Maryland Medical Center says.

Where to Get Your Omega-6

The good news is most of us can get the right amount of omega-6 from a healthy diet alone.

“Omega-6 fatty acids are found primarily in vegetable and plant oils, including safflower, sunflower, grapeseed, corn, cottonseed, peanut, sesame, soybean and canola,” Ligos says.

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At one time, researchers believed omega-6 fatty acids metabolized in the body to then inflame and damage artery linings, which could lead to heart disease.

After reviewing the findings, the American Heart Association recommended people eat between 5% and 10% of their daily calories from omega-6 fatty acids.

It’s a good idea to replace saturated fats from foods like meat, butter, cheese and deserts with plant-based foods containing omega-6 fatty acids, including vegetables oils, nuts and seeds is a good first step.

Flaxseed and hempseed oil, nuts, borage oil, evening primrose oil and black currant seed oil, and acai are other healthy sources of omega-6.

About The Author:

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Nicole Rollender is a South New Jersey-based editor and writer. Her work has appeared in Good Housekeeping, Dr. Oz The Good Life, Woman’s Day and Cosmopolitan. She’s the author of the poetry collection Louder Than Everything You Love. Recently, she was named a Rising Star in FOLIO’s Top Women in Media awards and is a 2017 recipient of a New Jersey Council on the Arts poetry fellowship. Visit her online at www.strandwritingservices.com; on Facebook or Twitter.

Interview October – Jan

Interview October is almost over, but we have another guest to meet – Jan Collins

JanCollins

Introduce yourself and tell us a bit about you…  

I am Janet but prefer Jan and I am 60 years young. Recently divorced after 37 years of marriage I have 2 children, Zoe 35 and Nathan 26. Zoe has my only granddaughter Amerthyst who will be 7 in November and she is the light of my life

Chronic illness(es)/disabilities I have… 

I have among other things chronic brittle asthma, COPD, type 2 diabetes, osteoarthritis and the onset of osteoporosis in my left hip. For 15 years I was on steroids for my asthma which has caused me all sorts of digestive problems. I am pleased to say that I have recently come off the steroids and have already lost over a stone (14lbs) in weight

My symptoms/condition began… 

I have had asthma all my life, when I was 4 my parents were told it was infantile asthma and I would grow out of it. In the interim, I have had bad spells and good spells. About 16 or 17 years ago I collapsed at home and if it hadn’t been for my then 9 year old son who didn’t panic but kept his calm I could have died. For the next 6 months or more I was in and out of A and E, my mum and husband were on the phone every day trying to get me to see a specialist. We were told that as mine was asthma, not lung cancer I didn’t have priority. When I did see the specialist he put me on steroids and boy did that open a can of worms. Every time they found something else wrong it was due to the steroids. I put on loads of weight and lost all my self-esteem.

The hardest part of living with my illness/disabilities is… 

The worst point was being diagnosed with diabetes 3 years ago which restricted my already limited diet even more. My ex also has diabetes and could eat almost anything without it causing any problems. I quickly learnt I couldn’t and was put on insulin developed fat growths on my arm and in my eye and had problems with my feet. It was so frustrating, I lost my self-confidence and my controlling ex basically persuaded me I couldn’t do anything so I became housebound except when he took me out. Then he walked out, my son helped me do a food diary to work out what I could or couldn’t eat, yes it was limiting but at least I knew where I stood. I discovered an inner strength and regained some of my self-confidence. A haircut and losing weight with people telling me how good I looked did a lot for my self-esteem as well.

A typical day for me involves… 

At the moment a typical day for me starts when my alarm goes off at 5am. This gives me three-quarter’s of an hour to get up and get dressed before I wake my son. After the first of many cups of tea the dog and I go for an OK let’s get our bodies moving walk, we both suffer from arthritis. This is the first of at least 3 walks we do. Then it’s medicine time which can take up to an hour. 2 mornings a week the community transport bus picks me up from home and takes me into town (I can no longer drive due to my eye problems). My daughter comes over once a week and we go out for a coffee. Afternoons are given over to crafting and studying, I am doing an O. U. English literature and creative writing degree. After a late tea and my second lot of insulin and, my 3rd lots of nebules I do my son’s lunch box for the next day before sitting down for the evening. I usually catch up on social media and deal with anything that has cropped up, write to my numerous pen pals or read. Every day my intention is to be in bed by 10 but it rarely happens. For one thing, my evening routine of medicines, putting cream on my feet etc takes over an hour.

Being ill/disabled has taught me… 

Over the years I have adapted my lifestyle to suit my needs but despite what it sounds like my health doesn’t dominate my life I always say I am not disabled just less enabled in some fields but have learnt so many new things to more than compensate for those things. People feel sorry for me but I can’t understand why I have so much going for me and have learnt so much. These days I can’t imagine living without my health issues but that aside my Jack Russell Terrier Herbie is my lifeline, he is company, he gives me a reason to get up and walk him and thus exercise. As a result of watching my diet changes and walking Herbie, I have lost over a stone (14lbs) in weight. I am still overweight but every bit helps.

What advice would I give someone recently diagnosed… 

Pace yourself, set targets for yourself but don’t knock yourself up if you don’t achieve them.

One positive of having a chronic illness/disability is…

Being disabled has taught me so much it is difficult to remember them all. Tolerance, patience, understanding, empathy, compassion, I have become a better listener and learnt many new skills all as a direct result of my health problems

 To quote 2 sayings my grandad used to say

” count your blessings one by one every day.” These might be anything from the love of your family and friends, sunny days or just the fact that you are still breathing.

” Smile and the world smiles with you, cry and you cry alone”. People get fed up with you if you are always moaning.

Life is for living, enjoy.

My links are:

collinsjan20@gmail.com and people can private message me anytime.

Other than that I am a member of Disability Matters and I am an ambassador for the online group Carenity.com specialising in Respiratory Diseases, Chronic Pain, Depression and Diabetes.