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| Photo- NY Times |
DISCLAIMER:
There are many iterations of IBS. Men and women frequently experience different
symptoms. This is my story. FURTHER DISCLAIMER: I wrote this 2015. The number of quality, gluten-free food brands has skyrocketed since.
Whoever coined the name “Irritable Bowel Syndrome” clearly didn’t have it. I dealt with IBS for thirty years until I got it sorted. In that time, my bowels were angry, ballistic, caustic, furious, outraged, pissed off and wrathful. Only on good days were my bowels merely irritable.
The Mayo Clinic characterizes IBS by writing “Irritable bowel syndrome (IBS) is a common disorder that affects your large intestine (colon). Irritable bowel syndrome commonly causes cramping, abdominal pain, bloating gas, diarrhea and constipation.”
They further state “irritable bowel syndrome doesn't cause inflammation or changes in bowel tissue or increase your risk of colorectal cancer.”
Good to know. That’s the only upside to IBS. Before I share my life with IBS, it must be said what IBS is not.
IBS is not:
· Ulcerative colitis
· Crohn’s disease
· Celiac disease (sprue)
· Colon cancer
· Diverticular disease
These are seriously dangerous, possibly life threatening diseases. IBS, by comparison, is merely incapacitating, debilitating, and embarrassing. I was tested for every GI disorder for which a test exists. All negative. I had a colonoscopy (neither the prep or the exam were nearly so unpleasant as people would have you believe) which was also negative. With no evidence of any of the above disorders, I was placed on Lotronex. I was instantly improved by perhaps 80%. After six months of treatment and relief, Lotronex was taken off of the market.
The IBS Strikes Back
My IBS returned. It was again rare that I had a solid stool. In most instances, my feces sprayed around the toilet bowl. They often splashed up and around (Forest Gump accent here) “my but-tocks.”
My IBS turned my alimentary canal into a gas-passing machine. The weight room wasn’t so bad. Folks fart in the gym all the time. Whilst out training and racing, I learned to fart while sitting on my bicycle. (It’s tough-try it.) In my classroom, I learned to sneak farts out, or to wander into the doorway. On truly bad days, I produced so much gas I was forced to own a pair of trousers six inches bigger than my waist. There were days my abdominal distention was so rampant that my abdomen was rigid and painful to the touch. Pity my wife. There were evenings when the bed sheets behaved as if they were a sailboat’s spinnaker flapping about in a breeze.
My breath became an issue. My wife could smell a peculiar sour-sweet odor on my breath when I was having a bad IBS day. I became a habitual Tic-tac abuser. Tic-tacs gave me GERD (Gastroesophageal reflux disorder-an unpleasant form of heartburn). The GERD gave me water brash. Water brash is the regurgitation of acidic saliva from the stomach, up the esophagus, and back into the mouth. Ever touched the ends of a 9 volt battery to your tongue? That’s what my water brash tasted like.
My IBS made me late for everything. It was common for me to have three to six bowel movements in the morning before I left for work. I had to carry clean underwear in my briefcase. I frequently needed the clean underwear. On a few particularly unpleasant occasions at work, I wished I had a spare pair of trousers as well. Between the leakage and odor, I became hyper-vigilant of my perianal cleanliness. On notably bad days, I was reduced to MacGyvering, from toilet tissue, a sanitary napkin for my leaking anus.
I went nowhere without Pepto-Bismol. I mapped the quickest routes to the nearest restrooms. My bowels, and their needs, became the focal point of my life.
In my twenties, I raced bicycles on the semi-professional circuit throughout North America. I missed several races due to my IBS. Despite evacuating my bowels several times pre-race, the racers were called to the start line while I in was in the midst of another emergency visit to Port-a-potty.
In my thirties, I went to work in the financial services industry. We often attended off-site seminars sponsored by vendors. The office tradition was car-pooling to these events. My first event, we loaded into cars and as we pulled out of the parking lot, I had to have the car stop and let me out before we even got onto the access road. In my suit, dress shoes, and carrying my brief case, I sprinted, quite literally, back into the office men’s room. For the next ten years, whenever we had to attend an offsite, I always drove myself.
As a teacher, I became a very strong believer in teaching good behavior. I had to. Not only was this good pedagogy - this elevation of student self-efficacy, I needed well-behaved students so I could manage emergency runs to men’s room as needed.
During this time, IBS became more widely known to the public. I began to experiment with my diet. I went on a lactose-free diet for a month. No improvement. I tried the Jamie Lee Curtis approved yogurt. No improvement. Probiotic supplements? No improvement.
The Gluten Menace
As I entered my fifties, I was still a bike racer. As a science guy, I was always reading on physiology, anatomy, and health, in both the professional and lay press. In August, 2010, Allen Lim Ph.D., the team physiologist for the Garmin-Transitions professional cycling team, contributed to a piece in Men’s Journal titled "Winning Without Wheat; the Surprising New Diet for Athletes." Lim is a proponent of a gluten free diet for athletes. Gluten is a protein found in wheat which can cause people difficulty in digestion.
Dr. Lim ran down the typical symptoms of an athlete with gluten sensitivity:
1) Excessive gas
2) General difficulties in digestion
3) Frequent diarrhea or constipation
4) Abdominal bloating and stiffness
5) Unexplained muscle aches and joint pain
6) Difficulty in recovering from hard work-outs
As I read the article, I had a “Holy Moley!” moment the likes of which I’d never experienced. From a heavy reliance on high-gluten flour pasta (a mainstay in the Italian influenced culture of cycling) to every symptom, Lim described me right down to the ground. I decided to try a gluten-free diet for one week.
Three days later, I decided I would be gluten-free for the rest of my life. Nearly every symptom was gone. By the end of one week, all of my symptoms were gone. (Except for some gas. But I’m a guy. We fart.)
Once gluten-free, I was down to four bowel movements, or fewer, each day. My feces were firm and formed. They no longer ricocheted around the bowl like a kid given a garden hose and a sprayer on a hot summer day.
Leakage? Very rarely.
Bad breath? No More.
Abdominal distention? Done.
My fitness returned. When I did hard training days on the bike and in the weight room, I found I could recover in 1-2 days instead of the 2-4 days I experienced when eating wheat products.
A New Hope
It was an astounding discovery. The hard part lay ahead. Our family had to create a foodway that didn’t penalize everyone for my protein digestion shortcomings. There is a lot of hidden gluten in foods. BBQ sauces often include gluten. Soy sauce. Beer. Check the labels in your fridge and pantry and you’ll see “wheat gluten” listed in many products.
Fortunately, while I am gluten-sensitive, through trial and error, I have discovered that a small amount of gluten still leaves me symptom-free. I can eat about ½ of a small flour tortilla. Wheat beers- I can drink one. Our local pizzeria buys gluten free(GF) crusts from a certified vendor. I order the GF (this way, I can order anchovies) and the rest of the family orders regular crust.
We have found Schar's to be the best producer of gluten-free pasta. We eat more rice than before. We eat more potatoes, both sweet and otherwise. Corn and Rice Chex, and quality granola have become the work-day breakfast go-to. I often make real oatmeal the night before and reheat it in the a.m. Pamela's pancake mix for weekends is so good that the family prefers it to all others.
Bread is a problem. Every time I eat gluten free bread, I am reminded that it is bread in name only. I like hearty, crusty bread. I can eat a piece about 2 square inches without ill effects. So, I do. With lots of butter.
Dining out makes you feel like you are tiptoeing through a cow pasture. Creamy soups are out. They’re usually thickened with flour. I miss fried foods. The breadings are generally flour. I have had success in many restaurants just by asking the waitperson to ask the chef to flash the onion rings, calamari, etc. in a sauté pan sans breading. No chef has ever said “no.” Ditto for grilled sandwiches. “No bread, please. And ask the chef to run my sandwich under the salamander to melt the cheese.” Truly, most restaurants are happy to help.
My 20 YO son laughs his arse off when I must navigate a drive-through burger in the car. I rip off half of the top bun. I eat half of the burger, avoiding the bottom bun. Tear off the ‘empty’ half of the bottom bun and throw away the remaining top bun piece. Eat/slurp the burger using the bottom bun as a plate. A tucked-in napkin is required.
Time to Take Charge of Your Bowels?
Irritable Bowel Syndrome comes in many flavors. My experience, while not unique, is just one of many. Always, the first step in investigating your IBS symptoms is your physician. Truly life-threatening disorders must be ruled out. When I begin to understand my IBS, there were few options for support and knowledge, outside of my gastroenterologist. Today, I would most definitely become a part of the IBS support community, online and at my local hospital. As my GI guy put it, “This is a mouth to anus disorder. It’s like a parasite. It can halt your life, but it won’t kill you.” Everyone needs the support and wisdom of the group.
Gluten was, for me, the culprit. On a GF diet, I am nearly 100% symptom free. At first, gluten free is intimidating. Fear not. Read labels carefully (which we should all do, anyway) and put back everything that has wheat as an ingredient. Your need to read labels will help you make better food choices for all the members of your family. I have found that as I have eliminated processed foods which contain flour from our family’s diet, we have automatically eliminated many foods which also contain hidden sugars. Bonus-weight loss!
Nancy Clark, RD, MS is a great resource for well researched information. Click here for a sample of her work.
The Big Questions:
· Do you frequently have any of the IBS symptoms listed above?
· Have you consulted with your health care provider about them?
· Would you consider modifying your diet for a week as test? Would you report back?
· Please, share your story. We’re all in this together.
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