Are you having back pain with any of the following?
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Irritable bowel syndrome (IBS) is one of the most common long-term disorders of the digestive system. About 10 to 20 percent of people in the United States have IBS. It usually starts in young adulthood.
If you have IBS, it means the nerves and muscles in your bowel are overly sensitive and are not working in sync with each other. Because of this, you might experience frequent stomach pain, cramping, bloating, diarrhea, or constipation.
The causes of IBS are not well understood. There are no specific tests that can diagnose the condition. We think that IBS symptoms increase with stress, certain medications, lack of physical activity, and some foods. Home treatment methods are effective at reducing the pain and discomfort associated with IBS.
The main symptoms of irritable bowel syndrome include stomach pain or discomfort and bloating.
Some people may also experience one or more of the following symptoms:
Other gastrointestinal (GI) conditions, such as inflammatory bowel disease or diverticular disease, have similar symptoms.
Following are symptoms that are not typical of IBS:
Unfortunately, there is no single test to help us diagnose irritable bowel disease. In addition to doing a physical exam, we will ask you a series of questions to better understand the nature of your symptoms and how long you have had them.
There are a standard set of criteria, called the Rome Classification, which can be helpful to support a diagnosis. The criteria include:
We may also request a series of tests (blood and X-ray) to help rule out other disorders. The type of test will depend on your age, symptoms (how often and severe), and response to initial treatment.
If you have a family history of colon cancer or are 40 years old or older, we may order a screening test like a flexible sigmoidoscopy to check your colon health.
Despite much research, the causes of irritable bowel syndrome remain unclear, but experts have theories about how it develops:
Unfortunately, there is no cure for irritable bowel syndrome. Don't let this discourage you, as many strategies are effective at reducing symptoms, including pain. We will work together to develop a treatment plan to minimize your discomfort.
Your treatment will depend on your symptoms and how severe they are. Depending on your symptoms, we may prescribe a combination of different medications and treatments.
Sometimes, patients need to try more than one combination of treatments to ease symptoms. Long-term treatment is often necessary to manage symptoms, but this depends on the individual.
IBS symptoms can be affected by stress, medications, physical activity levels, certain foods, and other factors. Maintaining a regular exercise routine and managing stress can help prevent and manage your symptoms.
Tracking your symptoms may help you identify patterns or triggers. For each IBS episode, take a moment to write down:
After you record each episode, review your notes and look for patterns that might identify triggers. For example, you may notice that spicy foods cause diarrhea. Or you might get constipated when your diet lacks fruits and vegetables. Once you identify triggers, try to avoid them.
Several different types of medicines are used to treat IBS symptoms, including:
It may take a trial period of a few months to determine which medicines work best to address your symptoms.
Many different home treatments can help decrease irritable bowel syndrome symptoms. We may recommend that you:
Slowly increase your fiber intake. High-fiber foods include fruits, vegetables, whole-grain breads, and cereals. Fiber helps reduce constipation. If you make changes to your diet, try to do it gradually to allow your body some time to adjust.
Take nonprescription fiber supplements. Fiber supplements work by absorbing liquids in the digestive tract. They can help reduce cramping and prevent both diarrhea and constipation. They are available as powders (mix with water and drink) or as pills (chewable or meant to be swallowed whole with water). They are different from laxatives because they are gentle on the lining of the intestine and safe for long-term use.
Drink more water. Water is important because it prevents bloating and constipation. If you use fiber supplements, drink plenty of water because the supplements work by absorbing water to create more bulk in the stools.
Get regular physical activity. Physical activity helps to reduce tension and make your bowels more regular. Exercise, such as walking and yoga, is a great stress reliever that can also help to manage symptoms such as bloating, gas, and constipation.
Get 7 to 9 hours of sleep each night. Lack of sleep leads to fatigue and lowered stress-tolerance levels, which are common triggers for IBS symptoms.
Practice stress management techniques. Stress can stimulate colon spasms, which cause IBS symptoms to flare up. To help reduce stress and anxiety, we may recommend that you try:
Avoid dairy products. For some people, milk and other products with lactose may cause symptoms to flare up. If you eliminate milk and milk products from your diet, we can recommend ways to ensure that you get the recommended amounts of calcium and vitamin D.
Avoid or limit foods that cause gas or tend to aggravate IBS symptoms:
Avoid chewing gum and eating too quickly. These can cause you to swallow air, which leads to gas.
Avoid carbonated drinks. Soda and fizzy drinks can cause gas and discomfort.
Complementary and alternative medicine (CAM) is defined as any treatment that arose outside of conventional Western scientific medicine or is not generally practiced within Western medicine. This may include many different healing approaches and techniques, which come from specific cultures around the world. The Permanente Medical Group's approach to CAM is to evaluate whether it is safe and effective, and to counsel our patients about the relative risks and benefits based on available evidence.
We also recommend that CAM approaches be combined with a healthy diet and a regular exercise routine.
Mind-body approaches to long-term conditions like IBS can help reduce symptoms.
Some herbal approaches to chronic conditions like IBS can be effective, while others have not been proven to be effective and may do more harm than good. In addition, we know that some herbs interact or interfere with medications you may be taking. We recommend that you consult with us before taking herbs.
Before using herbs and supplements, consider:
Irritable bowel syndrome symptoms can persist for many years, but the condition does not harm the intestines or lead to more serious diseases, like cancer, Crohn's disease, or ulcerative colitis.
If your IBS symptoms flare up, we encourage you to:
We can help you develop a strategy to help manage your symptoms and ensure that you live a healthy, active life.
If you already have a diagnosis of IBS your symptoms in most cases can be treated at home.
If you are having symptoms that concern you, your first contact will typically be with your personal physician, who will evaluate your health and symptoms.
If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day or soon thereafter.
Your first office visit for your IBS may be a group appointment or class, which will help you to better understand IBS and how to manage it. If needed you may be scheduled for a follow up appointment by phone or in our office, after attending the class.
During your office visit, we will discuss your symptoms, medical and family history and I may perform a physical exam. I will explain the findings of your exam and answer any questions or concerns you may have. There is no specific test for diagnosing IBS. Tests are sometimes done to rule out other disorders. We will discuss treatment options and develop a treatment plan that is right for you.
If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.
If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.
If you are experiencing a serious problem or an emergency, call 911 or go to the nearest Emergency Room when the clinic is not open.
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.
If refills are needed in the future, you can:
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the Radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.
I will recommend that you review educational information and tools to help you prepare for your procedure or surgery. The information will often help you decide whether surgery is right for you. If you decide to have a surgery or procedure, the information will provide details about how to prepare and what to expect.
If we proceed with surgery, I will have my Surgery Scheduler contact you to determine a surgery date and provide you with additional instructions regarding your procedure. Once your surgery is scheduled, a medical colleague of mine will contact you to conduct a preoperative medical evaluation that will assure that you are properly prepared for your surgery.
As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available at any time that is most convenient for you. From my home page you can:
• View and compose secure e-mail messages.
• Manage your prescriptions.
• View your past visits and test results.
• View your Preventive Services to see whether you are due for a routine screening or updated immunization.
• Read about causes, symptoms, treatments, and procedures.
• Find interactive health tools, videos, and podcasts to help you manage your condition.
• View programs to help you decide on or prepare for a surgery or procedure.
• Locate health education classes and support groups offered at every medical center.
• Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
• View your Preventive Services to see whether you are due for a routine screening or updated immunization.
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.