Vim & Vigor - Spring 2020 - Northside Hospital - 27

You mentioned
cognitive behavior therapy.
What about prescribing
antidepressants for IBS?

Grover: Antidepressants and behavioral

therapies have been shown to be helpful in IBS,
especially in the moderate to severe spectrum
when pain is frequent or there is difficulty with
quality of life, or both. Tricyclic antidepressants
and selective serotonin reuptake inhibitors
(SSRIs) have been tested in IBS. Typically,
tricyclic antidepressants such as amitriptyline
and nortriptyline are helpful in patients with IBS
with diarrhea. SSRI drugs are more frequently
used for IBS with constipation. These are usually
prescribed in low doses, and we watch carefully
for side effects. Psychotherapies like cognitive
behavior therapy and hypnosis are also effective, especially if provided by therapists with an
expertise in IBS and gastrointestinal disorders.

What foods make IBS worse?

Grover: It depends. It's not always easy to

Expert
Care That's
Easy to Digest

PHOTO BY STOCKSY

Although digestive health
may be complex, the care you
receive should be simple. With
knowledgeable providers, a wide
array of services and helpful
resources, Northside's Gwinnett
Medical Group is making health
care easier than ever. Schedule
your appointment by visiting
gwinnettmedicalgroup.com/
pcpscheduling.

understand whether a food causes IBS or
whether the body has developed a hypersensitivity to the food over time. So we have to be
careful when looking at the diet.
I would say, typically, fatty, greasy foods and
carbonated beverages can have an impact. We
realize that things containing either high fructose corn syrup or artificial sweeteners can
make symptoms worse, so regular soda and
diet soda are equally bad when it comes to
IBS. And, of course, if somebody has bloating
or a lot of gas, carbonated beverages like beer
and soda will make things worse. Another
factor is the caffeine in cola and other drinks,
which people may not realize is a problem.

What's the difference
between IBS and IBD?

Grover: Inflammatory bowel disease (IBD)

comprises two main subsets-ulcerative colitis
and Crohn's disease. The mechanisms are quite
different, and in active IBD, there is inflammation that can be seen during endoscopy and
through biopsies, whereas in IBS, inflammation is not present. Symptoms like bloody
stool, weight loss and fever should raise alarm
for IBD and prompt additional work-up by a
doctor. That being said, IBD patients can have
overlapping IBS symptoms as well. *

How Is
Irritable
Bowel
Syndrome
(IBS)
Diagnosed?

Figuring out that someone
has IBS isn't always
straightforward. "We don't
have one go-to test that
can definitively diagnose
IBS, so we use symptombased criteria," says Tik
Pau, MD, a primary care
provider with Northside's
Bostock Family Medicine.
To gain better insight
into what symptoms
you cope with, your
provider may:
Ask about symptoms
and your family
members' history of
gastrointestinal issues.
Perform a physical
exam, including feeling
the abdominal area for
inflammation or discomfort.
Ask about certain
foods or behaviors that
seem to alleviate or
exacerbate symptoms.
"Once we have a
more comprehensive
understanding of digestive
health, the next step is to
eliminate other potential
causes, such as a food
allergy or inflammatory
bowel disease," Dr. Pau
says. "When it comes to
diagnosing something like
IBS, time is of the essence
because chronic conditions
like this can significantly
impact quality of life."

VIM & VIGOR SPRING 2020

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Vim & Vigor - Spring 2020 - Northside Hospital

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