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Oh, My Aching Gut: Coping with Gastrointestinal Symptoms

We know that about 10% of women have PCOS (recently, some sources say 20% of women). About 20% of women also have irritable bowel syndrome (IBS), which is characterized by abdominal pain or cramping; a bloated feeling; gas (flatulence – aka, farting); diarrhea or constipation — sometimes even alternating bouts of constipation and diarrhea; and mucus in the stool. But a recent study indicates that about 42% of women with PCOS also have IBS – more than twice as many of the women who don’t have PCOS. As if that’s not enough, gastrointestinal irregularities can be caused by:

• Menstruation (those hormones surging will slam your gut, as well as your mood);
• Travel (unusual schedules, foods, or water supply);
• Stress and anxiety (ever have to go running for the toilet right before a big test, or a job interview?);
• Too much alcohol or caffeine;
• Side effect of medications, particularly metformin when it’s first introduced. Many women also report bowel disruption from birth control pills;
• Irregular eating habits – oddly spaced meals, excessive carbs, which can be constipating (remember the BRAT diet – bananas, rice, applesauce, and toast – for diarrhea);
• Wheat, dairy, soy, or other food sensitivity or allergies; and
• Undiagnosed celiac disease (inability to tolerate the gluten most commonly found in wheat).

In other words, if you’ve got PCOS, there’s an excellent chance you also struggle at least intermittently with some sort of gastrointestinal distress. The effects can range from mildly embarrassing and uncomfortable (a little gas, some cramps) to wildly humiliating and awkward, up to and including bowel accidents while out in public, urgency that brings your condition to the attention of friends or family members, acute pain from chronic cramping, and fear of having an undiagnosed serious illness. These problems can cause or contribute to social anxiety and depression.

From a health psychology perspective, there are many things that can be helpful in managing gastrointestinal distress. Chief among them:

• Improved diet (consult with your doctor or dietician about your specific condition), or shifting the content/balance of your diet – this may also help with mood;
• Medications, extra fiber, or supplements to help regulate the bowels (again, consult with your doctor or dietician about what’s best for you specifically);
• Daily meditation, or other stress reduction techniques, such as yoga or Tai Chi;
• Talk therapy to reduce the stress and anxiety that triggers an attack of IBS; and
• Hypnotherapy is also recognized as an important treatment for IBS.

While these symptoms may be embarrassing, and even seem shameful, it’s important to know that you don’t have to suffer from them. They are not normal and, while they may not be entirely curable, there are many effective ways of managing or reducing them to a point where you’re no longer self-conscious about going out of the house. Treatments usually result in fairly quick improvements, so there’s no reason not to try implementing some changes. Here’s to your healthy gut!

Reference:

Dig Dis Sci 2010 Apr;55(4):1085-9. Epub 2009 Aug 21. Polycystic ovary syndrome is associated with an increased prevalence of irritable bowel syndrome. Mathur R, Ko A, Hwang LJ, Low K, Azziz R, Pimentel M. Source: Department of Obstetrics/Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at Gretchen@drhousemd.com. You can also follow her on Twitter @askdrhousemd.