Digestive dilemmas: irritable bowel syndrome can disrupt your workout — not to mention your day. Here's how to get relief - Healthy Woman

You're at the gym, right in the middle of your glute routine, when a sudden urge sends you dashing for the ladies' room--you've got diarrhea. The next morning, you're constipated. What the heck is going on? It could be that you're suffering from irritable bowel syndrome (IBS), an intestinal condition that affects an estimated 50 million people, with twice as many women diagnosed as men. Symptoms can range from mildly annoying to completely debilitating. Doctors refer to IBS as a functional disorder, since there's no specific sign of disease when a patient's colon is examined. Yet that doesn't mean that IBS--and the physical distress its sufferers experience--isn't the real deal.

Diet, poor muscular function, stress and hormones can play major roles in the occurrence of IBS symptoms, which can include diarrhea, constipation, bloating, flatulence, heartburn, cramps, pain when eating or defecating, and stools with mucus. A proper diagnosis is key. Your doctor should ask you a series of questions relating to nutrition, exercise and stress, and may also test for IBS using stool samples, endoscopy and X-rays.

Cause for Concern

Let's begin with a basic lesson on how your colon functions. Its primary purpose is to absorb water and salts from digestive matter that enters from the small intestine. Once your body absorbs the water and salts, stool will then move through your colon due to the contraction of your intestinal muscles and the colon muscle itself. Normally, some of these muscular functions will result in a bowel movement. Normal bowel movement frequency ranges from as many as three per day to as few as three per week. They're characterized as formed but not hard, and are passed without cramps or pain. They should also be free of blood or mucus.

In an IBS sufferer's experience, however, the colon muscle is so sensitive, it spasms at the slightest contraction. This type of overreaction can stop stool from being passed out of your body, causing--you guessed it--constipation. Alternately, since the act of eating naturally causes the colon to contract, IBS sufferers may find this contraction can also cause diarrhea and stomach pain.

As you might expect, what you eat may be the biggest factor. "The standard 'mindless' low-fiber, high-sugar, high-fat and low-nutrient diet typical of the West appears to aggravate the symptoms of IBS," says Raphael Kellman, MD, director of the Kellman Center for Progressive Health in New York City. He's also the author of Gut Reactions: A Radical New 4-Step Program for Treating Chronic Stomach Distress and Unlocking the Secret to Total Body Wellness (Broadway Books, 2002). Alcohol, caffeine, grains, corn, citrus fruits, chocolate and milk can all exacerbate IBS, he notes. In fact, when determining whether a patient has IBS, "One thing [that needs to be done is] to differentiate it from lactose intolerance," explains Lin Chang, MD, of the UCLA-CURE Neuroentetic Disease Program in Los Angeles.

While previous research has examined the effect of stress on IBS, Kellman believes acute stress may worsen symptoms without being the primary cause. "Even so, you can't overlook the mind component," he adds. "Subtle stressors lurking and nagging, something unresolved--these issues must come to the surface." Chang agrees: "I think a lot of people aren't ready to face their stressors. A legal case at work, abuse, divorce--these types of things can be associated with the onset of IBS." Additional theories regarding the root of IBS include reproductive hormones (women may notice more symptoms premenstrually), genetics and intestinal bacteria.

The Right Remedies

To get relief from IBS symptoms, your diet may be the best place to start. Before you make adjustments, however, start to keep a food journal. Note when you're feeling discomfort or distress. Discussing your findings with your doctor will help him or her determine whether you may be suffering from IBS or an intolerance to a specific food.

Increasing your fiber intake may be helpful. Soluble fiber, which helps ease diarrhea and constipation, can be found in oat-bran muffins, cereal and bread, Fiberall, Metamucil and Perdiem. Insoluble fiber--be careful, this kind can worsen diarrhea--is found in fruits, vegetables, whole-grain breads and cereals.

Using medication to treat IBS is controversial. The FDA pulled the drug Lotronex off the market after its side effects were said to cause seven deaths and more than 160 hospitalizations. (On June 7, 2002, the FDA announced the approval of a supplemental New Drug Application that allows restricted marketing of Lotronex, to treat only women with severe diarrheapredominant IBS.) Kellman suggests trying natural remedies like chamomile, English lavender or peppermint leaf.

If you suspect stress is more of a problem than your diet, exercise and therapy could help. Physical exercise is crucial in beating IBS: "In terms of constipation, the more sedentary you are, the slower your bowels are," explains Chang. And when researchers at the University of Alberta in Canada studied IBS patients who had suffered emotional trauma, they found that such patients could benefit from self-help groups.