Irritable Bowel Syndrome: The Poorly Understood Condition

Dr. Philip A. Pappas, Ph.D

Katie is a sales representative for a large corporation and travels long distances to see her clients.  About two years ago Katie starting having problems leaving the house in the morning because of bowel spasms and repeated bowel movements.  She was having as many as eight to ten bowel movements before lunch.  With each movement, she had more spasm and progressively loser stools.  Katie was afraid to leave the house until this had past.  She started losing more and more time from work and finally had to take a medical leave.  During this time, her physician put her through a variety of test and blood work.  After a colonoscopy, her physician told her she was fine, but she had Irritable Bowel Syndrome.  He suggested using a prescription anti-spasmodic and Metamucil.  She tried this for several weeks with no improvement.  Several doctor visits later Katie was frustrated and gave up trying to get better.  She resigned herself to a life centered on her bowel symptoms.  Katie felt much like a captive; unable to leave her home and do the things others take for granted.

Another client referred Katie to me.  She had not worked for several months and rarely felt well.  Her symptoms had left her tired and depressed.  Katie’s attitude was negative and she felt helpless.  I suggested that her condition (Irritable Bowel Syndrome), was not hopeless and there was much that could be done to make her feel better.  I developed an IBS program for Katie, using stress reduction, diet modification, exercise, and fiber supplementation.  After an evaluation and IBS counseling, Katei regained her spirit and hope.  Within two weeks, her symptoms were almost gone and she was starting to do things she had been avoiding.  In about one month, she was symptom free and back to work.  Although pleased, she wondered why no one had suggested an IBS program earlier.

Most people have never heard a story such as Katie’s, but it is much more common than you might think.  It is estimated that 15-17 percent of the population suffers from Irritable Bowel Syndrome (IBS).  Twice as many women suffer from IBS than do men.  Half of all patients develop symptoms before age thirty.  In America, IBS accounts for 3 million doctors visits each year.  The AMA estimates that IBS accounts for 50% of all referrals to gastroenterologists.  It has been ranked as the second leading cause of worker absenteeism in the United States, second only to the common cold.

The impact of IBS on our society is significant. Surveys of IBS patients point to a general dissatisfaction with medical care.  Studies have shown that if patients were counseled and put on an appropriate IBS program, outcomes would be significantly better.  Another reason that IBS patients do poorly is the embarrassing nature of the condition.  Many patients are simply not comfortable talking about this very personal problem. IBS is not a high profile condition by its very nature.  Who would want to be the poster child for IBS?

What is Irritable Bowel Syndrome?  Defining or describing IBS is itself a problem.  The literature usually defines IBS by symptoms such as, a cluster of symptoms, consisting mostly of abdominal pain, bloating, constipation, and diarrhea.  Some IBS patients experience alternating constipation and diarrhea.  IBS is not a disease and does not lead to illness that is more serious.  It will not cause cancer or any other fatal condition.  The confusion and lack of good information about IBS, cause patients to become weary and resign themselves to living with the condition.  Many patients manage but many others suffer discomfort, pain, and disability.

Diagnosing IBS is very difficult because there is no known test or diagnostic marker for this condition.  It is a diagnosis of elimination.  Much more serious conditions such as cancer or Crohn’s Disease can be tested for and eliminated but IBS is still an educated guess.  An incorrect diagnosis could be fatal.

What causes Irritable Bowel Syndrome?  There are many theories but no one really knows.  It has been associated with; stress, depression, chronic childhood constipation, anxiety, antibiotic use and food allergy.

Stress seems to be the most common issue for almost all IBS sufferers.  Simple stress reduction training helps most sufferers feel better.  The mind-gut connection involves a complex interaction of nerves that connect the brain and gut.  Emotional stress starts the muscles of the colon into spasms that create the churning and discomfort.  Until these emotions are addressed, little can be done to improve the condition.

The chronic nature of IBS and the impact it has on the patient, poses a challenge to all health care practitioners.  The standard medical model has failed to produce any significant improvement for a majority of chronic IBS patients.  Many alternative health practitioners can help IBS patients control and manage their symptoms.  It is important to find practitioners with an interest and experience in IBS care.  IBS is a condition of management that responds to stress reduction, biofeedback, and diet modifications. Counseling patients about these techniques of managing IBS is a more holistic approach.  Patients want to get better, and alternative treatment options often help.


Dr. Pappas is a certified nutritionist with 20 years of experience in natural health. He also has 25 years of experience in the health care industry.  To learn more about Dr. Pappas and his Natural Food Store in Bucks County, PA

Please visit his site at:

or call 1-215-794-5311

or email him at

Earth Foods is more than your regular natural food store, they offer a wide range of products and services not found in most natural and health food stores.

Copyright – Dr. Phil Pappas – used with permission.

This article was originally published in Progressive Health Magazine Winter 2000

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