IBS and Other Symptoms

Extra-Intestinal Symptoms and IBS

Many IBS sufferers often report other associated symptoms not directly related to the bowel -- symptoms doctors call extra-intestinal symptoms. These symptoms can be experienced in other parts of the digestive system or throughout the whole body. Their link to IBS can be quite puzzling and a great source of frustration for those IBS sufferers who find themselves coping with chronic, uncomfortable and unexplained physical problems.

Common Gastrointestinal Symptoms

Many IBS sufferers experience common symptoms related to their digestive system, including diarrhea, constipation and abdominal pain. They may also experience other symptoms elsewhere in the body.

These are the most common:

• Nausea
• Heartburn and reflux

Non-GI Symptoms

More puzzling than the experience of non-intestinal digestive symptoms is the fact that IBS sufferers appear to suffer a wide variety of physical problems at a greater rate than non-IBS patients. According to University of North Carolina at Chapel Hill School of Medicine researchers Olafur S. Palsson and William Whitehead, the most commonly reported non-gastrointestinal symptoms that are seen more often in IBS patients than others are:

• Headache
• Back pain
• Frequent urination
• Fatigue
• Bad breath and/or bad taste in mouth

Other reported symptoms include:

• Sleep difficulties
• Muscle aches
• Cold, clammy or trembling hands
• Heart palpitations
• Dizziness
• Pain during menstruation or intercourse

Palsson and Whitehead's full list of 26 symptoms shown to be more common in IBS patients by at least one study: [Download PDF]

Effect on Patients

Unfortunately, IBS patients often find that their extra-intestinal symptoms are frequently minimized or dismissed by their doctors, other health professionals, friends and family members. Here are examples of what some IBS patients may be told in regard to their extra-intestinal symptoms:
(Thanks to a brave reader for sharing these examples, which come from personal experience.)

When speaking to a health professional:

• "That's not supposed to happen. Other people don't have X symptom [or] are worried about Y."
• "It's not cancer. It won't kill you."
• "It's in your head."

From therapists who claimed to know about IBS:

• "If you're not responding to medical treatment, you must be misdiagnosed."
• "If you don't have preexisting mental health issues, [your problem] isn't psychological. See a doctor."

From relatives and acquaintances:

• "You must be doing something wrong."
• "You must be misdiagnosed."
• "Live with it."

Why Does This Happen?

Theories abound as to why IBS patients are at higher risk for the experience of extra-intestinal symptoms. The wide variety of reported physical problems makes it challenging to find a common, underlying explanation. It may be that it is a combination of factors, some of which have yet to be uncovered, that contributes to the problem of extra-intestinal symptoms and IBS. The debate on this subject is ongoing and includes two main areas of inquiry:

Underlying Biological Cause:
In the search for a unifying biological factor, researchers are looking at the nervous system, including the role of neurotransmitters, or dysfunction in the body's innate pain regulation systems. The immune system is also being looked at as a possible contributor.

Psychological Factors:
Research into the role of psychological factors as contributing to the experience of extra-intestinal system has pinpointed two possibilities: IBS patients may be more likely to experience emotions as physical symptoms or to have a tendency to be hyper-aware of bodily sensations.

What Can Be Done?

The high frequency of extra-intestinal symptoms experienced by some IBS patients suggests that this is a problem that needs to receive proper attention from the medical establishment. The strength of the doctor-patient relationship appears to have a beneficial effect on patient outcome, particularly in IBS.

Your doctor needs to take your health concerns seriously and work to develop an effective treatment plan that addresses all of your physical complaints. A focus on interventions that address the body as a whole might prove helpful. This includes dietary modifications, herbal supplements, and brain/gut interventions such as cognitive-behavioral therapy (CBT) or hypnotherapy.

You can educate yourself about red-flag digestive symptoms to ease anxiety that something more serious is being missed.

Anyone touched by IBS, including health professionals, patients and their loved ones, should consider advocating for and donating to research aimed at uncovering better information about the possible underlying causes of and effective treatment for these puzzling extra-intestinal physical complaints.

_Sources:

_{Farhadi, A. "I Have IBS…Now What?!!!" Shafagh Press 2007.}

_{Palsson, O. & Whitehead, W. Beyond the Bowel: The Meaning of Co-Existing Medical Problems UNC Center for Functional GI & Motility Disorders.}

Essential Reading:

• IBS and Other Health Problems