Carrie Demers
Jennifer is an accomplished artist who is beginning to make a name for herself. She lives in the country on four acres of forested land and she spends her time painting, preparing for upcoming shows, marketing her prints, and taking care of her house and yard. She has a Siamese cat, but it is her cocker spaniel, Reilly, that is her constant companion. She is 56, single, and has many close friends. Even though her life is going well, Jennifer is anxious. She worries about money and the success of her next show. She frets about what would happen to her pets if anything were to happen to her. She is restless and sleeps lightly.
Jennifer’s time is unscheduled and her days often chaotic. She gets up whenever she feels like it, shops for groceries sporadically (often forgetting there is no food in the house), accidentally bounces checks, sometimes lets bills slide, and spontaneously takes the afternoon off and goes visiting whenever the mood strikes. Although she paints every day and tries to plan for her shows, she is often pushed at deadline time. When she is absorbed in her work, she will paint into the wee hours of the morning, forgetting both food and sleep (she would say these have never been important to her anyway). She doesn’t like to cook, so she eats mostly cold food that requires no preparation. A typical day’s diet is a bowl of cereal for breakfast with a cup of tea, rice cakes with peanut butter and an apple for lunch, fat-free strawberry yogurt for a snack, and grilled fish and a salad for supper.
Jennifer has never been especially athletic. She sometimes takes walks in the woods with her dog but has little motivation to do more. She rationalizes that her work is physical enough and that she goes folk dancing once a week. Her body is slender and agile, but she is beginning to notice that she feels stiff and achy after a long drive.
Her energy at the end of the day varies, especially when her digestive system is acting up, as it has been of late. She has gas, which causes pain, distention, and discomfort (and makes her pants too tight). Her stomach rumbles and grumbles and she feels heavy after eating—as if her food is just sitting in her stomach. Occasionally she has cramping and diarrhea, usually when she is under stress—transporting her paintings to a show, for example, or scurrying to meet a deadline—but more often she is constipated.
Jennifer has been diagnosed with irritable bowel syndrome (IBS). Her doctor also performed a series of diagnostic tests (blood tests, sigmoidoscopy, allergy testing), all of which were negative, although she did have a mild reaction to wheat and dairy products. Her doctor recommended a soluble fiber supplement (Metamusil) for the constipation and prescribed a variety of drugs to help manage her symptoms: an anti-gas medication, a laxative, an anti-diarrhea medication, and a drug that encourages gastric motility. Her doctor has told her that her condition is incurable, an opinion reinforced by the specialist she consulted for a second opinion.
WHAT IS IRRITABLE BOWEL SYNDROME?
Jennifer’s IBS symptoms are typical: constipation alternating with diarrhea, bloating, gas, and general indigestion.
Irritable bowel syndrome is the most common gastrointestinal disease in clinical practice. Approximately 35 million people in the U.S. are affected by IBS, usually young-to-middle-aged adults, and twice as many women as men. Jennifer’s symptoms are typical: constipation alternating with diarrhea, bloating, gas, and general indigestion. Some people have predominantly abdominal pain and constipation, others have diarrhea more frequently. Although it is not a serious health problem in the sense that it doesn’t progress to a more serious condition like colitis or cancer, IBS is uncomfortable and unnerving.
The Western medical approach to this disorder is to rule out a more serious problem with a battery of tests, and then treat the condition symptomatically, as was done in Jennifer’s case. Cure is not expected because the cause of irritable bowel syndrome is unknown, although it is clear that stress plays a role. Like Jennifer, patients are usually advised to learn to live with it.
