Ask A Doctor: Do I Have Irritable Bowel Syndrome?

As one of the top hospitals in Pittsburgh, St. Clair has made it a priority to answer our patients’ questions. One such inquiry comes from individuals dealing with abdominal pain and indigestion. After struggling with these symptoms for a lengthy period of time, these individuals often begin to wonder: “Could I have irritable bowel syndrome? What is the treatment?”

 To answer these questions, we spoke with Jennifer A. Totten, M.D., who specializes in gastroenterology. According to Dr. Totten, irritable bowel syndrome (IBS) is the most common diagnosis delivered in gastroenterology practices. Up to 20 percent of Americans have symptoms consistent with IBS. Fortunately, experts such as St. Clair Hospital’s own Dr. Totten are able to recognize it ? and treat it.

Recognizing IBS

To help patients recognize the signs of IBS, we asked Dr. Totten to describe the symptoms of the disease.

“Patients with IBS often suffer from diarrhea, constipation, or alternating diarrhea and constipation,” she explained. “Abdominal pain must also accompany these bowel changes for a patient to be diagnosed with IBS. Other symptoms seen with IBS include bloating, gas and belching.”

Recognizing and reporting these symptoms is a patient’s greatest weapon in identifying IBS, as there is not one specific diagnostic test for the disease. Instead, doctors often rely on a two-part process to identify IBS. For starters, they can carry out certain tests to exclude other gastrointestinal conditions ? eventually allowing them to hone in on a final diagnosis. Ultimately, however, physicians must use a set of formal criteria to check for and confirm a diagnosis of IBS.

“In order to establish a diagnosis, patients must have recurrent abdominal pain and/or discomfort for at least three days per month during the last three months,” according to Dr. Totten. “The symptom onset must have been six months or more prior to the diagnosis, and patients must have at least two of the following three symptoms: symptom improvement with a bowel movement; onset associated with a change in stool frequency; or onset associated with a change in stool appearance or form.”

Treating IBS

Once doctors are able to successfully check off the criteria for this disease ? and eliminate any other gastrointestinal problems ? they can begin to look into what any sufferer wants: treatment. And although IBS is thought to be a chronic disorder, there are many options available for treatment, according to Dr. Totten.

For starters, “Patients must establish a good relationship with their doctor. By working with your physician, you can determine if you have specific symptom triggers, such as stress, lifestyle habits or specific foods that exacerbate your symptoms. Then, eliminate or attempt to minimize those triggers.”

Dr. Totten also emphasized that an evaluation of your diet is critical in addressing IBS. “Certain foods, such as milk-containing products, legumes and cruciferous vegetables, may aggravate IBS symptoms in certain patients by promoting gas and bloating. It is reasonable to eliminate these foods for two weeks to see if your symptoms improve.”

While lifestyle changes are helpful in addressing this condition, sometimes patients may require a little extra help in managing their illness. In these cases, there are several medications available to control IBS symptoms and specific therapies targeted to the individual symptoms. But even patients who are taking medications should take care to give their lifestyle the attention it deserves.

“It is also important to eat a balanced diet, drink plenty of water and to exercise regularly to help keep your digestive tract regulated,” she said. “The goal is to establish a lifestyle plan that gives you maximum control over your symptoms.”

Dr. Totten earned her medical degree at the University of Rochester School of Medicine. She completed her residency in internal medicine at  the University of Pittsburgh Medical Center, and a fellowship in gastroenterology at Allegheny General Hospital. Dr. Totten is just one of the outstanding clinicians who provide feedback and assistance to St. Clair Hospital patients. To browse through some of the feedback our physicians have provided in the past, you can visit our website and download past issues of HouseCall magazine.