In the United States and other western countries, twice as many women as men seek treatment for Irritable Bowel Syndrome (IBS). In fact, IBS is largely perceived as a women’s health issue even though there are men who suffer from it as well. Why are more women diagnosed as men? Does the answer lie in the physical, chemical, social or emotional differences between the genders?

Physical differences. Some research indicates that the large discrepency between men and women with IBS may lie in physiological differences, such as response to pain. In general, women have been shown to be more sensitive to certain types of pain (such as pain from internal organs) than men. Therefore, IBS pain that might be considered debilitating to a woman may be only an annoyance to a man.

Chemical differences. Many women report that their IBS symptoms are worse during certain phases of their menstrual cycle (such as pre-menstrual or ovulation periods). This association led researchers to speculate that if female hormones exacerbate IBS, male hormones may be responsible for “protecting” men from IBS. In one study, men with IBS were found to have lower hormone levels than men without IBS. This could mean that higher levels of male hormones in the body somehow prevent IBS symptoms, but researchers are unsure why. Additionally, another study showed that men who had a lower testosterone level in particular experienced worse IBS symptoms.

Social differences. Another reason for the low amount of men reporting IBS symptoms is that they may not seek medical treatment as readily as women. Men tend to have a higher pain threshold and might not consider seeing a medical professional for the pain experienced from IBS.

Women may also seek treatment for IBS more often because they are already accustomed to seeing a doctor (usually a gynecologist) for a Pap screen on a yearly basis. Reporting abdominal pain or changes in bowel habits on these visits might lead to a referral for a follow-up with a general practitioner or a gastroenterologist. Younger and otherwise healthy men may not see a physician on a regular basis, and would therefore not be in a position to report pain or changes in bowel habits.

Emotional differences. There appears to be a connection between psychological conditions and IBS, though researchers are still unsure about what causes the link. Depression and anxiety are generally more common in women than men which may partly explain the prevalence of IBS in women. Women with IBS are also more likely to have a history of sexual abuse.

It appears that all these factors play a role in explaining the low rate of reported IBS in men when compared to women. Studies about IBS have increased in recent years, and researchers conclude that more are needed to understand the gender differences in IBS.

What are the foods that cause constipation?

People who have irritable bowel syndrome (IBS), have the nerves in the lining of the bowel react to lectins, or identifying proteins, in certain foods. These lectins make the foods have the same effect on the bowel as a medication containing opium, such as paregoric. Commonly constipating foods in IBS include wheat, dairy products, beef, pork, and lamb. Constipation is a problem with low carb diets that allow large intake of meat and protein

People with a sensitivity to the gliadin or gluten protein in wheat, barley, and rye can experience alternating constipation and diarrhea, along with varying degrees of intestinal inflammation, weakened immunity, and chronic headaches. These IBS symptoms can be relatively mild but still caused by celiac disease.

When the problem is celiac disease, the answer is eliminating ALL gluten protein from the diet. Other foods do not aggravate condition.

What about the rest of us? For most people, constipation has more to do with not drinking enough water or not getting enough exercise. Taking too many laxatives or avoiding trips to the bathroom can aggrevate the situation also. There are, foods that can cause constipation, as well as foods that relieve constipation, in nearly anyone. It helps if you pay attention to your diet and note what food groups you may be overdoing it in.

Some foods cause constipation if you don’t drink enough water with them, but ironically are foods that relieve constipation if you do drink plenty of water with them. Foods containing inulin (a starch, don’t confuse it with insulin) such as bananas, chicory, leeks, and onions, provide food for the helpful bacteria that live in the gut.

These bacteria form a mass that makes the stool easier to move, provided there is enough water available to soften it. The value of that old adage about drinking plenty of water becomes apparent here. When there is adequate hydration, inulin helps the lining of the colon absorb calcium. And when the colon absorbs calcium, the risk of colon cancer is reduced.

Fiber supplements that many people use to treat constipation, can actually cause constipation if you don’t drink the recommended eight glasses of water a day.

What are the foods that relieve constipation?

The best-known of the foods that relieve constipation is that old standby for relief of irregularity is the prune. Prunes are dried plums. Dried prunes are approximately 6 percent fiber, but prune juice (which is made from dried prunes) contains no fiber at all.

Prunes promote regularity by providing simple sugars that draw fluid into the intestine. The additional fluid makes stool softer and easier to expel. Prunes do not cause spikes in blood sugar, because their natural sweetening agents are fructose and sorbitol rather than sucrose, better known as white sugar. Too much sorbitol, of course, can cause diarrhea. If prunes are too much of a good thing for you, consider this list of high-fiber foods.

Soluble fiber is found in barley, beans and peas, apples and oranges, carrots, flax seed, oatmeal and oat bran, and psyllium (the fiber source used in Metamucil).

Insoluble fiber is found in peels and skins of fruits and vegetables, corn bran, flax seed, vegetables such as green beans and cauliflower, and whole-wheat products.

Fiber from fruits and vegetables is always more beneficial than any fiber supplements. That’s because fruits and vegetables offer fiber in small doses. There’s enough fiber to contribute to regularity but not so much fiber as to create its own clogs and road jams in your colon.

Wheat bran is considered a popular food that relieves constipation in adults, but it may not be best. Many people suffer mild sensitivity to gluten that can cause alternating constipation and diarrhea. For people with this condition, called celiac disease, wheat products aren’t the solution, they’re the problem.

Even if you aren’t sensitive to wheat, the fiber in wheat bran is only effective if you eat the bran by itself, not if you eat it with other foods. Eating any bran food by itself can aggravate constipation. Better than wheat bran are psyllium, citrus fiber, or slippery elm.

Here are a few things I’d recommend trying to improve your IBS. I eat lots of fiber and drink plenty of water and my symptoms have improved.

Tips on controlling IBS

• Eat a varied healthy diet and avoid foods high in fat.
• Drink plenty of water.
• Try eating 6 small meals a day rather than 3 larger ones.
• Learn new and better ways to deal with your stress.
• Avoid using laxatives. They may weaken your intestines and cause you to be dependent on them.

1. Acknowledge the pain of IBS

2. Hold an empathetic and non-judgmental point of view

3. Educate and reassure you

4. Set reasonable goals for managing your IBS symptoms

5. Help you, the patient, take responsibility

6. Know his or her limitations and refer you to specialists if necessary

What you cannot expect from your doctor is a cure. Currently there isn’t one.

What to ask your doctor about Irritable Bowel Syndrome
1. Do my symptoms truly match those of IBS and the Rome II Guidelines?

2. Have you run the diagnostic tests necessary to rule out:

• Colon cancer
• Inflammatory bowel diseases (Crohn’s and Ulcerative Colitis)
• Bowel obstructions
• Diverticulosis
• Gallstones
• Food allergies
• Celiac (a genetic, autoimmune disorder resulting in gluten intolerance)
• Bacterial infections
• Intestinal parasites
• Endometriosis
• Ovarian cancer

3. What prescription drugs do you recommend for me, and why? What if they don’t work? What about side effects?

4. Are there any new medical options for Irritable Bowel Syndrome on the horizon?

5. How should I keep myself informed about current IBS research?
 
6. Should I schedule a follow-up visit with you? When?

7. What about diet?

8. What about stress management?

9. What about alternative therapies?

10. What types of supplements, fiber or otherwise, do you recommend?

11. Do you know of any Irritable Bowel Syndrome support groups in my area?

12. Can you recommend any good books or literature on the subject?

13. What do you think is the best way to comprehensively manage my symptoms?

Help for Irritable Bowel Syndrome

Once you’re confident that your physician has properly diagnosed you with IBS, there are several key strategies to successfully managing the disorder: follow the explicit IBS diet guidelines and IBS safe recipes; learn stress management through hypnotherapy for IBS or yoga practice for IBS; inform yourself with the best-selling and best-reviewed IBS books available; find the most helpful IBS supplements for specific symptoms and overall digestive health.

No particular test is specific for Irritable Bowel Syndrome. However, diagnostic tests may be performed to rule out other diseases. These tests may include stool or blood tests, x rays, or endoscopy (viewing the colon through a flexible tube inserted through the anus). If these tests are all negative, the doctor may diagnose Irritable Bowel Syndrome based on your symptoms: that is, how often you have had abdominal pain or discomfort during the past year, when the pain starts and stops in relation to bowel function, and how your bowel frequency and stool consistency are altered.

Criteria for Diagnosis
Abdominal pain or discomfort for at least 12 weeks out of the previous 12 months. These 12 weeks do not have to be consecutive.

The abdominal pain or discomfort has two of the following three features:

• It is relieved by having a bowel movement.
• When it starts, there is a change in how often you have a bowel movement.
• When it starts, there is a change in the form of the stool or the way it looks.