The F word...

If you have been diagnosed with IBS you have likely talked a lot about the “F” word – F.I.B.R.E.  I feel confident enough to say that you were likely told to increase your fibre consumption, no matter the type of IBS you happen to have.  Fibre appears to be the centre of the IBS universe and at the forefront of the minds of our medical professionals.  It is often touted as the cure-all for IBS.  I am about to tell you how fibre is quite literally a pain in my ass; it is both friend and foe.  Fibre is like that person that you walk on eggshells around, too much one way or the other and this fickle friend will make your life miserable. 

It took me a long time to figure out fibre and it required a lot of help along the way.  It took specialists, a surgeon and one amazing dietitian to help me understand how fibre affects my body.  This journey also included extensive food journaling, diligence and patience to gain the understanding I now have today.  

How much fibre do I eat in one day?  Fifteen to nineteen grams (15-19g), however, I prefer to hover in around 15g.  How much should you be consuming?  According to the Dietitians of Canada, adult men should consume 38g per day and women are recommended 25g.  For those of you without IBS, you will likely be shocked at my daily intake, and some of you will likely deem it to be unhealthy…  this would not be the first time that I have heard this, and it will certainly not be the last. 

A low intake of fibre allows me to manage my symptoms and maintain a routine of three to four “movements” daily.  However, this does not mean that I do not have flare-ups at this level.  I think I hit six, seven and eight washroom trips on three consecutive days last week at my normal intake level.  So, what I am telling you is, often, IBS is kind of like gambling.  Sometimes you are cautious and win big, sometimes you throw caution to the wind and you win big, and sometimes, no matter what you do, shit happens.  What I do know for sure is that if I go above this threshold I might as well pitch a tent right beside the toilet.  

One extremely important fact to keep in mind is that everybody is different.  My fibre RDI may be the same, lower, or higher than yours, and that is okay.  Everyone reacts differently to different foods and that also applies to those who do not have IBS.  So, when it appears as though someone is judging you for eating things like gasp – white bread – keep in mind that, if it is easier for you to digest than whole wheat bread, then eat the white bread.  Eating things like whole grains can be just as unhealthy for someone with IBS as for someone else who shuns white bread.  If it makes you use the washroom all the time, forces you to take medication and/or causes weight loss and additional stress, then, this choice is unhealthy for you.   

• Never be ashamed of the choices you have to make in order to lead a healthy life. 

• Never forget that healthy is not a static definition; it is just as unique as you are.   

Be sure to talk these things over with your doctor, or, get referred to a dietitian.  If you do not gel with your dietitian, ask to be referred to a different one.  That is what I did, and we ended up meshing really well and I was able to learn a lot from her. 

Fibre is a beast of its own and a bit cumbersome to tackle in one post, so, I will begin a series of posts relating to fibre so that we can work through this issue together.  If you have specific questions relating to the f word, contact me and I will ensure I cover it at some point throughout the series.  In addition, feel free to share your experiences about keeping it regular!

Be prepared - your journey to a diagnosis...

WARNING:  This is an IBS-specific post, and may contain TMI - Too Much Information. 

Here is a post specifically for those of you with IBS or for those of you with questions relating to IBS.  Keep in mind that what I write in relation to IBS is what I experienced and that some of my opinions are not that same as some of the medical practitioners that I have encountered.  Over time I will cover a series of topics such as: fibre, stress, food, exercise, relief through products, various resources etc. Please feel free to send along any requests regarding topics you would like me to cover. 

My journey…

My road to an IBS diagnosis was a long one that required many doctor visits and a heavy amount of convincing to get anyone to listen.  It all started to go downhill after having jaw surgery in October 2001.  I am convinced that the medication and stress associated with getting my jaw broken was what triggered my first “episode” of IBS.  It took about a year to get to a specialist and then to finally have my first colonoscopy – on my first day of university – and of course, in true IBS style, there is nothing physically wrong with me that can be found in stool samples or any type of scope; I have a collection of symptoms that medical practitioners group under the umbrella of IBS.  Or, as I like to call it: “we don’t know what’s wrong with you, but you have poop problems”.  Over the years I have become very frustrated with the medical system in Canada.  I quickly discovered that unless you are bleeding from your bum, and even then, medical practitioners are very reluctant to spend the time to assess your illness or to attempt to treat you.  I attribute several of my worst episodes to this casual attitude and fully attribute the surgery that I underwent to the gaps in our medical system.  Unfortunately, butt issues do not appear to be a priority in Canada, and I have been told as much by a doctor in one of our emergency rooms, some practitioners appear to believe that these problems are (and I quote) “just a nuisance”.  For this reason, I avoid going to the doctor when having an episode, I trust my own judgment and know enough to be able to tell when something requires medical attention.  Keep in mind there are some specialists out there who are wonderful and helpful, but the trouble seems to be making your way up the referral chain to see one of these doctors. 

When you are initially diagnosed with IBS many doctors immediately suggest reading some books so that you can arm yourself with a bit of knowledge.  This is often coupled with a suggestion to see a psychologist.  At first, I was extremely insulted by what I felt this insinuated, and contrary to what many doctors make you feel – IBS is not in your head.  There are very real symptoms that present themselves on a daily basis.  However, it is triggered by stress; some of my worst IBS episodes were triggered by a stressful life event.  Stress is the number one trigger of my more serious episodes. 

My advice to anyone with IBS would be to summon all of your patience to travel the long road to any sort of diagnosis or treatment, most especially in Canada.  If you think something is wrong, it probably is.  Believe your gut and keep on top of the doctors until you have exhausted your options and arrived at a specialist.  It is imperative that you be persistent because once you are armed with a diagnosis, you at least know what you are up against.  The important thing with bowel problems is to rule out anything more serious such as Crohn’s or Colitis.  

Be prepared…

1. Be prepared to describe your poop: green, brown, yellow, hard, rabbit-like, soft, liquid, bloody, mucousy, gassy, frequent, difficult, easy, etc;
2. Be prepared to poop in an ice cream container (ie. stool collection);
3. Be prepared for blood work;
4. Be prepared for laxatives, enemas, swallowing barium, barium enemas and colonoscopies; 
5. Be prepared and willing to see many types of medical practitioners: specialists, naturopaths, dietitians;
6. Be prepared for varied and strange diets in an effort to identify your trigger foods; 
7. Be prepared to journal; and
8. Be prepared for many fingers up your butt.

Finally, know that very soon you will have no problem dropping your pants for any doctor (male, female, hot intern, nurse, group of doctors), in any state of mind or position: conscious, unconscious, drugged, standing up, bent over, in the fetal position – or, my personal favourite – rotated forward and up in the air (ie. semi-handstand on what you initially thought was a kneeling station, but in fact is the medical community’s last laugh as they propel you into the air and look up your butt-hole). 

Know that you are not alone, know that many, many others suffer as you do and all you have to do is look around on the internet and you will find someone to talk to whether it be me or IBS Forums.  My final and most important piece of advice would be to have a sense of humour, because, if you can’t joke about butts and poop then this will be a very miserable experience indeed. 

Glamour Guts

As a quick recommendation for any of you out there who suffer from IBS, Crohn's or other bowel problems, please check out this video.  It is a fabulous depiction of what life can be like while living with these issues and I am sure we can all see a little bit of ourselves in this video.  Jasmine Oore manages to make an embarrassing topic hilarious and relevant.  This just goes to show that we are not suffering alone.