By Taylor Pasell, Allergychoices
Irritable bowel syndrome (IBS) is a very common disease that affects 5-10% of the general population. Most times, individuals are diagnosed with irritable bowel syndrome after a number of tests have been completed with no determining factor as to what is causing symptoms. When testing for ulcers, reflux and structural issues all come back negative, sometimes an allergist is added into the equation and it’s then that the relationship between IBS and allergy is recognized and can then be treated.
- An irritant
- An enzyme deficiency
- An infection
- An allergen
The idea that an allergen can cause or further aggravate IBS symptoms is not widely recognized. Studies that have looked at it, though, have determined that 20-65% of IBS patients attribute their symptoms to an adverse food reaction, and those who experience atopic allergy symptoms are 3.2x more likely to have IBS. Dr. Kroker believes in the connection between allergy and IBS and continues to help those that suffer find relief through allergy treatment.
There are patients who have allergy and have IBS.
While not all patients experience IBS due to allergy, a segment of patients do have allergy. Generally, symptoms are the same, such as pain and cramping, diarrhea, constipation, and fatigue. There might be slight differences for those with allergy related IBS, depending on which type of allergy is impacting them.
If there is an environmental allergy affecting the bowel issue, IBS symptoms become worse at certain times of the year, perhaps when their respiratory seasonal allergies are in full swing. Dr. Kroker says that it does make sense, as when pollen circulates in the air, we not only breathe it in, but it has the potential to be swallowed and put into the digestive tract. This could most definitely cause irritation in the bowel.
Food sensitivity can also cause IBS; you can tell this is the case when there are additional intestinal symptoms on top of those typically felt because of IBS. Dr. Kroker explains that after ingesting a food you are sensitive to, “I might feel tired, I might have a headache, I might feel moody, I might have phlegm and mucus, and all of these things are happening in addition to the typical IBS symptoms,” and these additional symptoms are often directly related to the food being ingested.
People have considerable morbidity from IBS that the general population doesn’t recognize.
Dr. Kroker explains that IBS can affect the quality of life for sufferers enormously.
“What if you are an airline pilot and you are making flights between Minneapolis and Amsterdam and you have to have good bowel function?” he asks. Studies have shown that those who suffer from IBS miss, on average, 13.4 days of work each year, in comparison to those without a GI disorder who miss 4.9 days.
It not only affects work life, but personal life,too. Even a quick trip to the store can cause worry for those with IBS. Dr. Kroker explains, “I have patients who say every time they go into a new retail store, the first thing they do is find where the toilet is because they never know when they’re going to get the urgency or the cramping. IBS has a considerable amount of morbidity.” People with IBS can be hesitant to do even the simplest of tasks in fear that their symptoms may surface.
Doctors don’t often ask about IBS, and they should.
There does appear to be a correlation between allergy and IBS for a certain group of patients, and it’s something Dr. Kroker hopes more doctors will start to recognize. He says, “I think we’ve let our patient population down as allergists in general because we say ‘if you have a bowel issue, talk to the gastroenterologist.’ And the gastroenterologists say, ‘we can’t find anything. If you think you have a food issue, why don’t you talk to an allergist?’ So you have these two groups who are not meeting and communicating.” This gap in communication causes a lack of treatment for patients, who are then left to “just deal with” their symptoms.
At his practice at Allergy Associates of La Crosse, Dr. Kroker goes into depth about symptoms with patients. Some patients who come to the clinic to treat frequent sinus infections or constant sneezing raise their eyebrows when asked about their gastrointestinal health. Dr. Kroker believes it’s fitting to ask these questions in order to best treat the root cause of all of their symptoms, whether they know they could be related or not.
Medicines for IBS are not great.
After being a doctor for 43 years, Dr. Kroker has seen a great progression in medicine. Sadly, though, he feels that treatment for IBS hasn’t progressed like it should. “There are plenty of inhalers that weren’t around when I became a doctor 40 years ago. There are great nasal sprays that were not around 40 years ago. There are disappointing medicines for IBS,” Dr. Kroker explains. “It’s a very hard disease. There are medicines that are out there, but they’re not by any means, in my opinion, as effective as the medicines we have available for the respiratory allergies.”
Fortunately, there is treatment for those who experience IBS in correlation to their allergies. While it’s more difficult to diagnose the connection, there are steps that can be taken in order to do so. Allergists look closely at the history of the patient, asking what they patient eats, what they don’t eat, and so on. Dr. Kroker says, “What is critical for them is to tell me what they’re doing when they experience symptoms.” Kroker and his colleagues will also use blood testing and occasionally, a challenge test. After determining the direct connection, allergy drops can be taken in order for the body to build tolerance to the allergen and in turn, can help to reduce not only typical allergy symptoms, but allergy-related IBS symptoms, too.
More information can be found on our website about how Allergychoices addresses the total allergenic load in relation to these and other conditions.