Cybill Shepherd has revealed that she suffers from irritable bowel syndrome (IBS). The star of Moonlighting and Taxi Driver says that she has struggled with her symptoms for many years, and is now hoping to raise awareness of IBS and encourage sufferers to talk more openly with their doctors.

She says: “For years I have been battling recurring constipation, abdominal pain and bloating. Go ahead and laugh. We laugh because we’re embarrassed. In order for us to get relief, we have to talk about our symptoms and stop suffering in silence.

“I have tried nearly everything: changing my diet and watching what I ate. I exercised regularly. I even tried taking fiber supplements and over-the-counter laxatives, but nothing helped with all of my symptoms.

“My doctor used to tell me it was all emotional and psychological. So I got a new doctor. And a year and a half ago, I was diagnosed with irritable bowel syndrome with constipation. It was a huge relief to find out that my IBS with constipation was not all in my head and that it was a treatable medical condition. My doctor prescribed Zelnorm and it has provided me with relief for all my symptoms. In a lot of ways, I feel like my old self again.”

And good for her! I think that many IBS sufferers will identify with what she says: from embarrassing, unmentionable symptoms to doctors who insist that our bowel problems are really in our heads.

We may identify less with her relief from one drug alone (although the new drugs Zelnorm and Lotronex have had a good success rate in America), but we could all benefit from talking more openly with our doctors and looking for more solutions rather than accepting that IBS will rule our lives.

What Cybill Shepherd has done, though, is more than just draw attention to the fact that IBS sufferers need more help. Just by revealing that she is an IBS sufferer she has shown that IBS can affect anyone. Here is a glamorous, successful actress, someone who has kissed Bruce Willis and won three Golden Globes, saying that she has trouble with her bowels.

The power of celebrity

In these celebrity-soaked times it can be easy to forget that famous people sometimes achieve genuinely selfless and compassionate things just by using their fame. The greatest power that they have is the ability to shine the light of their stardom on an issue which would otherwise have been ignored.

And yes, the issue may sometimes be whatever cause is most fashionable at the time - “Gay whales against racism” as one satirist put it ? or the one which helps the star more than the people (or whales) who are suffering. But sometimes there is no doubt that the celeb has really stuck their neck out to help others who are dealing with an issue that is considered untouchable.

And I can’t thing of a more untouchable issue than IBS, something that no-one in the public eye would readily admit to. Can you imagine Julia Roberts standing up and saying “Diarrhea is the blight of my life and hemorrhoids have driven me to drink”? No, of course not, because anything remotely digestive is considered highly embarrassing and distinctly unglamorous. Cybill Shepherd’s admission, therefore, is to be applauded.

Dare not speak its name

Before Cybill Shepherd ‘came out’, the only famous person I knew of who had IBS was Kelsey Grammar’s wife (Kelsey Grammar used to play Frasier in the eponymous sitcom and Cheers). Whoever you are, whatever your gender or problems or pain, it is vital that you find someone with whom you can identify. If you watch TV and never see a reflection of yourself, if you are a black man and only ever see white faces on screen, then you will start to feel alienated ? and the same goes for people who are ill.

If you constantly hear about diabetes sufferers and asthma sufferers but never hear a word about bowels then you begin to learn that your illness is far less important than these other worthy causes.

We need more people in the public eye standing up and saying “Me too”, so that everyone can start to realise just how widespread a problem this is.

Don’t suffer in silence

But it’s not just about how other people perceive us, and how we perceive ourselves. It’s also about making sure that anyone who has bowel symptoms seeks help, and at the moment that just doesn’t happen.

There are still many people with bowel problems who are too ashamed or embarrassed to go to the doctor, and just soldier on through their lives when they could be receiving treatment. And there’s always the risk, of course, that their symptoms could actually be the result of something other than IBS that may get progressively worse if it is left alone.

IBS often goes undiagnosed for years, and even when we pluck up the courage to visit the doctor we can be so tongue-tied that we don’t properly describe our symptoms. If we could leave our embarrassment in the waiting room it would be so much better for our health.

Cybill Shepherd says: “My goal is to urge all women to get over their embarrassment, to stop suffering in silence the way I did, and to talk to their doctors. Although it may be uncomfortable, it is very important for you to be open and honest with your doctor about all your symptoms”.

And things can change. Just think about breast cancer, which is now regularly discussed on TV and radio, but 20 years ago was stuck behind a wall of silence where breasts were not to be mentioned, cancerous or not.

Irritable bowel syndrome is a debilitating and distressing condition, which affects 10-20% of the population. IBS is characterized by abdominal pain and altered bowel function such as constipation, diarrhea or alternating diarrhea and constipation. Some people have occasional symptoms, which can be aggravated by stress or food intolerances. Others experience crippling symptoms, and struggle to maintain their quality of life in the absence of any targeted, effective pharmaceutical treatments.

This disorder affects people of all ages and backgrounds, including children, although women are predominantly affected. Severe IBS can dramatically restrict mobility, through loss of control of bowel function and severe abdominal pain. These symptoms contribute to IBS being second only to the common cold as the most frequent cause of absenteeism from work and school.

Despite the significant impact on individuals and the population at large, there is no clear established cause for IBS. Whilst medical investigations are important to eliminate the possibility of an over-lapping pathology such as parasites, candida, inflammatory bowel disease, cealiacs or Crohn’s disease, there is no specific investigation which patients can test positive for in order to confirm a diagnosis of Irritable Bowel Syndrome. A diagnosis of IBS is more often a diagnosis of exclusion ? if its not another gastrointestinal condition, and it fits the symptom picture of IBS, then it is IBS.

The current accepted criteria for diagnosing IBS is the Rome criteria (adopted in medical texts and by the American Gastroenterological Association). Their definition of IBS consists of:

At least 12 weeks, which need not be consecutive, in the preceding 12 months of abdominal discomfort or pain that has two of three features:

• Relieved with defecation and/or
• Onset associated with a change in frequency of stool and/or
• Onset associated with a change in form (appearance) of stool.

The following symptoms support the diagnosis of IBS:

• Abnormal bowel movement frequency (more than three per day or less than three per week),
• Abnormal stool form (lumpy/hard or loose/water),
• Abnormal stool passage (straining, urgency, or feeling of incomplete evacuation),
• Mucous passed with stools,
• Abdominal bloating or distension.

There are few effective treatments for IBS. Pharmaceutical medications include anti-diarrheal agents and laxatives, some of which can be harmful if used repeatedly. Significant improvements can be made through dietary changes which can therefore reducing some trigger factors for IBS. It is also important to practice some stress reduction techniques such as breathing techniques, and positive psychology, as there is a direct link between stress and an aggravation of IBS symptoms.

The most promising, long-lasting and side-effect free results in the treatment of IBS were based on a large clinical trial conducted at an Australian university, and published in the Journal of the American Medical Association in 1998.

These results demonstrated a 64-76% improvement rate on all measures of IBS such as abdominal pain, distention and bowel habits. These results were achieved in a double-blind, placebo controlled clinical trial conducted by gastroenterologists and doctors. The remarkable positive results were achieved in the treatment group that received Chinese herbal treatments. This same formula can be purchased as pre-made capsules from select retailers, and it offers great hope for those struggling with IBS.

Dr. Maia Dodds is the author of ‘The Irritable Bowel Syndrome Improvement Program’

Irritable bowel syndrome (IBS) is a very common condition, but in some ways it is still a mystery. There are many different theories about what causes the syndrome, and different doctors will give you different reasons for your illness ? anything from stress to bad bacteria to food intolerance. And once you have been diagnosed, there is no set form of treatment ? instead, sufferers tend to try two or three supplements or therapies to find a combination that works for them.

IBS is clearly a complicated issue, so here is a basic overview of the symptoms, diagnosis and treatment of this disorder.

The symptoms

Although the symptoms of IBS vary from person to person, there are several symptoms which are typical of the illness. The most common symptom is either recurring diarrhea or recurring constipation (although some patients also have alternating diarrhea and constipation).

Additional symptoms can include stomach pain (sometimes relieved by a bowel movement), bloating, nausea and a lot of gas. These symptoms generally go away for a short time before returning again, as IBS can work in cycles. Sufferers may experience a few weeks or even a few months of good health before the symptoms come back.

Sufferers sometimes find that their symptoms begin after a bout of food poisoning or an operation. Others date their symptoms back to a very stressful period in their lives, and some patients can see no clear reason for why their symptoms began.

The diagnosis

There is no set test for IBS, and it is often called a diagnosis of ‘exclusion’. This means that a doctor may rule out other bowel and stomach complaints such as celiac disease or inflammatory bowel disease before giving you a diagnosis of IBS.

Sometimes patients are given a colonoscopy, where a tiny camera is inserted into the intestines to look for abnormalities. In an IBS sufferer the colonoscopy won’t detect any physical signs of disease ? IBS is often called a ‘functional’ disorder, because it seems to be caused by an alteration in the way the body functions rather than an identifiable cause such as inflammation.

However, this does not mean it is any less real than, say, inflammatory bowel disease, it just means that doctors haven’t come up with a proper test for it yet!

It is very important that you receive a diagnosis of IBS from a medical professional rather than self-diagnosing, as bowel symptoms can be present in many other health conditions.

The treatment

The first stage of treatment may involve any medications your doctor has given you to try. This could be an anti-spasmodic, which will relax the muscles in the gut walls, or perhaps a low dose of an anti-depressant, which can help to reduce the pain.

You may also be given one of the new drugs specifically developed for IBS ? Lotronex for diarrhea sufferers and Zelnorm for constipation sufferers.

If the drugs do not help you then you could try using a fiber supplement such as Citrucel to add bulk to your stool ? this can be helpful for both diarrhea and constipation. Also, there are other supplements such as Caltrate Plus which may be useful (Caltrate Plus contains calcium carbonate which can reduce diarrhea).

It may also be worth looking at your diet. A nutritionist can advise on ways to identify any particular food ‘triggers’ which may be setting off your symptoms, and also on whether you might have a food intolerance to something like gluten or lactose.

Finally, there are several alternative therapies which can be effective for IBS. Hypnotherapy has proved very effective, and a special form called gut-directed hypnotherapy has been developed just for digestive problems. Acupuncture may also be worth looking into.

Irritable bowel syndrome sufferers often find that they have to deal with two sets of symptoms. The physical symptoms of diarrhea, constipation and pain form the main part of IBS, but sufferers may also develop emotional problems such as mild or moderate depression and anxiety because of the strain that IBS places on their lives.

There’s no doubt that IBS can have a huge impact on your mental and emotional health. One of the reasons why people assume that IBS is caused by stress is that IBS sufferers can appear so stressed and unhappy. But is this really surprising? If you had explosive diarrhea, never-ending constipation or stabbing stomach cramps you’d be a bit stressed too!

The nature of IBS symptoms can mean that they are very difficult to deal with, both practically, in terms of being afraid to go out because of fear of diarrhea, and emotionally, because of embarrassment and the sometimes unsympathetic reactions of others.

Sufferers find that their social lives quickly diminish to nothing, or that they can no longer eat the food at restaurants or dinner parties without ending up in pain. Work or school can become a chronic struggle as you drag yourself in on days when you feel ill, knowing that if you didn’t you’d get fired or kicked off your course.

You may also feel that you have to pretend to be healthy most of the time in spite of how you really feel, because people get tired of hearing about your condition or begin to say things like “Well why don’t you go to the doctor” or “My mum had that and ate lots of bran and now she’s fine. That’s what you should do.”

It can be very hard to bite your tongue and stop yourself answering back. “Oh, go to the DOCTOR, I see, that’s where I’ve going wrong all this time, I thought you had to go to the hardware store. I shall now be cured.”

What is important to remember is that anyone who is battling with IBS is going through a very difficult time, and deserves some genuine support, as does anyone with a chronic, long-term condition.

Hopefully, if you explain your condition to family and friends, support will be forthcoming, but if not you should ask yourself how much misunderstanding you are willing to put up with, and whether it is hazardous to your health.

This is what Heather Van Vorous says in The First Year - IBS: “You may even have friends or family dismiss your problem as ‘all in your head.’ It’s up to you to educate these people, and then dump them if they persist in their ignorance at the expense of your health.”

If they are truly your friends then they will want to learn about the condition and be ready to accept that their views are based on prejudice and assumption rather than fact.

But if they still believe that you’re exaggerating then ask them to explain exactly why they believe that IBS is psychosomatic or ‘all in your head’, what scientific studies they are basing their views on, and how they explain the success of new drugs such as the selective 5-HT3 antagonist Lotronex. That should keep them quiet.

If you have been diagnosed with irritable bowel syndrome (IBS), you will know how difficult it is to treat. Doctors can be dismissive of IBS symptoms such as diarrhea, constipation and bloating, and when treatment is offered it may only help for a short while before the distressing symptoms return.

Sufferers often find that they have to deal with the symptoms themselves, through self-help methods and supplements, rather than by using conventional medicines. However, this does not mean that there is no hope of improvement. By sharing their experiences, sufferers can learn a lot about what really helps to ease IBS.

All the self-help tips in this article have come from IBS sufferers who have found a way to control their irritable bowels. Before trying any form of self-help, please make sure that you have your doctor’s approval, and do check that anything you try will not interfere with any medication you are taking.

Calcium tablets

Linda, who suffers from severe diarrhea, says: “What has helped me for more than two years is calcium carbonate, an over-the-counter supplement. I take three tablets a day, one at each meal. The most success has come from using any formula of calcium supplement that is like Caltrate 600 Plus with vitamin D and minerals. The only side effect is at the beginning of taking the calcium you may have some gas or indigestion, but this usually goes away after taking a regular dose for a few days.”

If you suffer from constipation rather than diarrhea, you could try magnesium supplements instead, as these can have a slight laxative effect.

Digestive enzymes and probiotics

Kim, who also suffers from bad diarrhea, says: “I tried taking digestive enzymes with acidophilus and found significant relief within three days. I am not afraid to eat now, but find that I still cannot eat very much refined sugar or high fibre vegetables. I have also added a cup or two per day of peppermint and chamomile tea. When I do have an episode it occurs late in the day and by the next morning I am feeling back to normal.”

Looking at your diet

Laura describes how a close examination of her diet helped her IBS: “I was placed on every kind of medication, and sometimes they worked in the short term, sometimes they didn’t work at all. The doctor finally suggested trying to alter my diet in cycles, and we discovered that eating meat was my problem. I became a vegetarian and no longer have constant problems. Sometimes I even go years without any pain at all. It’s worth all the effort you put into it when you finally feel better.”

Mina also found that dietary change helped control her symptoms, alongside traditional medication: “I’ve made a number of changes to my diet. I’ve eliminated milk and mostly any dairy, fried foods, sugar for the most part, pop, alcohol, potato chips, spicy food, rice, pasta and bread. Most recently I’m eliminating flour. But my best friend for the last couple of years has been Imodium Quick Dissolve tablets. I don’t ever leave home without them. I just have to make sure I don’t overdo it. If I ever become immune to the wonder drug I am gonna be a real mess!”

Flaxseed

Watching your diet is sometimes not enough to completely control the symptoms, and natural or herbal supplements can help, as Marion discovered: “After about six months of a horrendously restrictive diet (ultra low-fat vegan with no raw veggies or fruit except banana) and a lot of Metamucil, I managed to get it sort of under control. But if I deviated from the diet, the chronic diarrhea would come back. Someone I met told me that she had helped her IBS by taking a tablespoon of freshly ground flaxseed with a glass of water or juice every morning.

I thought it was another crackpot cure, but eventually I decided to try it. She had told me that pre-ground flaxseed didn’t work because flax seed starts to oxidize as soon as you grind it and that whole flax seeds are no good either, because they cannot be digested properly. After years of IBS, in about two weeks it just went away. I cannot believe that I now have perfectly normal, regular bowel movements.”

Fiber, water and yoga

Pam, who struggles with constipation, has developed a combination of things which work for her: “I drink Metamucil (psyllium fibre) every day and try to relax, pray or meditate, even do a little yoga. The more I make myself relax and take time to de-stress the better I can manage my problem. I know time for yourself is very hard to come by sometimes but I have to if I’m going to manage this. I try to drink at least three bottles of water a day. This is also hard sometimes but I have to take care of me the best I can. I also take a mild anti-depressant. This has helped a bunch in my stress department and in turn has helped my IBS.”

Stress and IBS

Daniel believes that his symptoms are related to his emotions and stress: “I thought that when I was stuck on the toilet, experiencing the most severe cramps, thinking I was about to pass out from the pain, feeling like I was about to throw up, I was the only one. I’m still trying to work it out but I believe it has a lot to do with my psychological state. I say this because although I don’t get too stressed out at any one moment, I do have general worries about money and life. I tend to find when I’m not worrying about these things I don’t get the pain as much, if at all.

It’s easier said than done of course, I can’t just stop worrying about money or my future, but being aware of these things seems to help - being optimistic and knowing that everything is only temporary. I have been taking Colpermin (peppermint capsules) as a preventative which often helps and for a while I took painkillers which I think helped.”

Soluble versus insoluble fiber

Some nutritionists believe that IBS sufferers’ intestines react differently to soluble and insoluble fiber, and this has been Stu’s experience: “After trying all kinds of drugs and healthy eating, my pains were still there. I found by accident that it wasn’t so much what I ate but whether I ate it on a full stomach or not. My failsafe is pasta on an empty stomach, I get no reaction - it is soluble fibre that settles the colon apparently. I quickly searched on the internet for recipes high in soluble fibre and I have improved.

Most significantly though I am on no medication and this puts me in control of the IBS, not the other way around. I think this is important as stress certainly can trigger the symptoms off. I don’t avoid insoluble fibre as it is essential for the body, but I recommend that you eat it on a full stomach.”