By Dr. Mark Babyatsky
Both diabetes and IBS can affect the nerves supplying the gut and cause abdominal bloating and either diarrhea or constipation, making it a bit difficult to figure out which condition is causing your intestinal symptoms. If the main symptom of your IBS is episodes of diarrhea, then sorbitol or other alternative sweeteners may worsen your symptoms. However, if your IBS comes with constipation, these sweeteners may actually help. Also, medications used for abdominal pain and bloating, such as anti-spasmodics that relax the gut muscles (Levsin, Bentyl) and fiber products, would help both disorders.
In terms of diet, foods that are high in carbohydrates have not been proven to help IBS. Focus on adding complex carbohydrates and fiber to your diet. You
may also want to consider working with a dietitian or nutritionist to find the many foods that would be well tolerated by someone with both diabetes and IBS.
Although it seems to you that all foods are making you gassy, you should actually keep a strict food diary for a few weeks in an effort to spot any associations that may not be readily apparent. High-fiber foods and legumes tend to increase gas production in the intestine, so eating less of these foods may improve your symptoms. You may want to consult a nutritionist who is knowledgeable about IBS to help you design a diet consisting of smaller meals and a variety of foods that may reduce your bloating. There are also different types of probiotics - supplements that contain "friendly" bacteria and help maintain a healthy digestive system. Some probiotics have multiple strains of bacteria and may give you more relief. Finally, some patients feel better after taking charcoal products or Beano, which are designed to reduce intestinal gas. If these measures do not help, I recommend you see a gastroenterologist to find out whether any of the antispasmodic or serotonin pathway medications, which work in different ways to relax the smooth muscle in the gut, can help you with your IBS.
While there is clearly a connection between irritable bowel syndrome (IBS) and menopause, not enough studies have been done to explain it. When you have IBS, your nervous system releases substances known as neurotransmitters that can change the function of your colon (large intestine), leading to diarrhea, constipation, diarrhea alternating with constipation, and bloating. We also know that IBS is more common among women and that the female hormones responsible for menstrual periods frequently change IBS symptoms, often making them worse.
During menopause, your hormone levels change. Some studies have shown that IBS symptoms improve with menopause, while others have reported that IBS symptoms
worsen. Some studies have also reported that the onset of perimenopause can trigger the onset of IBS. Estrogen replacement therapy does not appear to improve
IBS symptoms, so I recommend using remedies that worked for you previously. Some newer agents that are effective in constipation-predominant IBS include
Miralax; probiotics work for some patients with other forms of IBS.
IBS, also known as irritable bowel syndrome, does not cause pancreatitis. Pancreatitis is an inflammation of the pancreas, an organ that secretes proteins that are important for the breakdown of nutrients and the metabolism of sugar. The most common causes of pancreatitis include gallstones, alcohol and certain specific medications. If gallstones are the cause, then the gallbladder should be removed by an operation called a cholecystectomy. If alcohol consumption is the cause, then alcohol should be completely avoided. Some patients have evidence of chronic pancreatitis with their first episode; such evidence includes calcifications of the pancreas on X-ray. Chronic pancreatitis is often much more difficult to treat than acute pancreatitis; episodes of pain take much longer to improve. In addition to a bland, low-fat diet, pancreatic enzymes taken before each meal often help the pain and bloating in pancreatitis and also aids in the digestion of food.
Many patients with irritable bowel syndrome (IBS) can tolerate cooked fruits and vegetables, so you can try selected items one at time, by trial and error, to see how your body responds. Also, fruits and vegetables contain different amounts of fiber, so it's worth trying those with lower fiber content first, such as bananas and tomatoes.
While most fats should be avoided to reduce the risk of heart disease, some fats are actually beneficial. For example, most fish oils lower the levels of
LDL, the "bad" cholesterol, while raising the levels of HDL, the "good" cholesterol. Try to increase the amount of fish you consume in your
diet. Most grains, including pasta, white rice, and potatoes, are well tolerated in IBS patients and do not raise cholesterol levels. Consult with a
nutritionist to help you establish guidelines to expand the variety of foods you can eat.
