How I got my confidence back in long battle with IBS
For nearly two decades Irritable Bowel Syndrome sufferer Joan Horgan could barely travel, go on a night out with friends or feel comfortable sharing a room until a chance conversation led her to some new research..
Published 13/05/2014 | 02:30
Car journeys or airplane trips were a nightmare; the condition affected her social life and how she dressed, caused pain and depression and damaged her confidence.
For 20 years Joan Horgan endured the discomfort and pain of Irritable Bowel Syndrome, which struck without warning or any apparent cause.
"I have no idea what started it, but it began with bloating in my stomach and a lot of flatulence," says the Cork woman (63). "After a few months it progressed to difficult bowel movements with diarrhoea and constipation, but there had been no change in my diet," says Joan, a widow who lives in Douglas.
Like many sufferers of the condition, commonly known as IBS, Joan was reluctant to discuss her condition. Research shows that 75pc of women won't talk about digestive problems because of embarrassment and that 73pc avoid seeking help for digestive troubles because of it: "I was embarrassed about it and kept it to myself in the beginning," she recalls.
"I thought perhaps I might have been eating the wrong food, but looking back now I think my mother had IBS as well because I remember she suffered with a bloated stomach and constant pain in her tummy for many years."
But while it embarrassed her, the condition didn't discourage Joan, the mother of an adult son, from seeking medical help.
She says: "I went to my GP on numerous occasions, saw a number of consultants and had seven or eight colonoscopies and gastroscopies over a period of about 14 years but they just put it down to IBS."
Joan tried everything, including the exclusion of foods such as milk, bread, beer and tomatoes from her diet, but to no avail.
IBS, which affects about 10pc to 15pc of the general population, is about one-and-a-half-times more common in women than men and usually affects the 18-35 age group – often quite significantly, according to Dr Eileen Murphy, Research Director and Nutritionist at Cork company Alimentary Health.
"Your life revolves around your bowel habits because the main symptom of IBS is abdominal pain, as well as diarrhoea, constipation and gas," she explains. "We know of people who cannot wear the same clothes in the evening that they wore in the morning," she says.
So it was for Joan, who found the bloating became so bad it even changed the way she dressed.
"My stomach would be flat in the morning but would start to bloat during the day to such an extent that the clothes I had on in the morning were too tight by evening," she recalls.
"I started buying loose, flowing clothes to hide it. I became embarrassed and in a sense almost retreated into my home.
"Socially it was very difficult.
"You'd be out for a meal and you'd have to rush to the loo. You were always afraid of having an accident. It knocked my confidence and I think it caused an element of depression."
This, it appears, is a common problem with IBS – three-quarters of the 480 Irish women surveyed in a new nationwide study, She's Got Guts, said their digestive problems affected their self-confidence.
One in four admitted that digestive problems prevented them from leading a productive, fulfilling social life and participating in sports or recreation and gatherings with friends or family.
This month is IBS Awareness Month, and the survey, launched by Alflorex, a precision biotic made in Cork, aims to highlight the condition and shed light on the scale and impact of digestive problems amongst Irish women.
IBS has a major impact on lifestyle, according to Joan, who found that she also began to dread long journeys – air travel in particular was a nightmare.
"On a long flight I'd get very stressed once they said put on your seatbelts and don't leave your seat," she recalls.
She would also become nervous on long road journeys – particularly if she wasn't driving and couldn't just stop the car and get out whenever she needed to.
On one occasion a bus journey from Cork to Dublin airport was hugely stressful she recalls, because the bus did not have an on-board toilet and made no stops during the journey.
Breaks or holidays with friends were also difficult: "I found it very difficult to go away with my friends because sharing a bathroom was a major problem to me."
Then about two years ago, things took a turn for the worse: "I started to get terrible pains in my lower stomach in the mornings. It would wake me up at about 5 am," she says. The pain was extremely intense and could last for hours.
Yet although it's extremely common, and can clearly be very debilitating, a clear cause of IBS has still not been isolated, says Professor Eamon Quigley, Chief of Gastroenterology at the Methodist Hospital in Houston, Texas and a world authority on IBS and gastrointestinal motility disorders.
More recently, he says, scientific research has linked it with an abnormality in the composition of the bacteria in the bowel:
"Over the last three years or so research has indicated that it is specific bacteria in the bowel that are linked to IBS," says Professor Quigley, a former Dean of the Medical School at UCC and principal investigator at the university's Alimentary Pharmabiotic Centre.
"New research has shown that some strains of probiotic bacteria seem to be effective in eliminating one or two symptoms of IBS," he says, adding that research has shown that certain strains could potentially help eliminate all symptoms. "How the probiotics work is complex, but we have some idea. It will tend to normalise the bacterial composition of the gut." Certain probiotics, he adds, will also tend to tone down the immune response of the gut to the bacteria. "We still don't know what causes it in every person who is affected by it, but for some people an approach which modifies the bacteria in the gut is effective."
Professor Fergus Shanahan, Director of the Alimentary Pharmabiotic Centre, University College Cork and Consultant Gastroenterologist at Cork University Hospital explains: "While everyone's gut microbiota is different, research has shown that IBS is associated with a bacterial imbalance in the gut.
"Common issues such as change in routine, travel, stress, antibiotics and diet can alter your intestinal bacteria.
"It is important to establish a regular eating pattern and healthy eating lifestyle.
"Also, taking the right precision biotic with clinical support in IBS is helpful."
And, as it turned out, this was to be the key for Joan – quite by chance last January she was discussing the problem with an acquaintance who suggested that she try precision biotic.
Desperate for relief, she gave it a go.
"For the first three weeks there was no improvement but in the fourth week there was a sudden significant improvement."
The morning pains vanished and her bowel movements returned to normal for the first time in nearly 20 years.
"My confidence is back, the same clothes fit all day and I am going back out into the world! I no longer worry when I am in a social situation and I'm far more comfortable going out for lunch and dinner with my friends."
For many years, says Professor Quigley, IBS was not viewed as a particularly significant condition – but that has changed. In recent years, he says, it has been acknowledged as a potentially very debilitating condition.
He says: "The medical profession is now much better educated and much more aware of IBS. There's a lot of research going on that was not going on 10 years ago.
"The good news is that IBS is being taken seriously and we appreciate how serious a condition it can be, that good research is going on and that new treatments are being developed. I have high hopes that we will find the causes of IBS."
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