We all know what it feels like to have stomach cramps. They are not pleasant and can leave you completely debilitated.
hankfully, for most people, the pains will ease after a couple of days or with appropriate treatment. However, there are a growing number of people who suffer with ongoing pain in their stomach, constipation, and diarrhoea for what might appear to be no reason whatsoever.
Anne Tuohy (61) knows what this is like. Last summer she began to feel very unwell and with a background in healthcare, she initially diagnosed herself with digestive issues from relying too much on convenience food. She took steps to remedy this, but despite being vigilant about what she was eating, the symptoms continued so she decided it was time to seek medical advice.
“Last June, I began to experience abdominal cramping, diarrhoea and bloating,” she says.
“I had trained as nurse in my previous life so I decided to see if I could treat myself. We had been spending a lot of time where I grew up in Carrick, in south-west Donegal, and I don’t usually do much cooking while I am there. I thought the problems were being caused by having too much fried and takeaway food, along with more wine than usual.
“I was feeling very miserable, so I decided to go home early and cut both completely out of my diet for a month. But even though I was very careful, the diarrhoea became much worse, to the point that while we were at a family wedding in July, I ended up spending most of the day in the bathroom. It was awful.
“I called my GP on the Monday morning after the wedding. She checked all my bloods and did a calprotectin test to determine the level of intestinal inflammation present. Normal calprotectin is 50, mine was 1,050, which indicated that I most likely had Crohn’s disease or ulcerative colitis. This was worrying, as both currently have no cure and can only be managed.”
The Donegal woman, who is an interior designer and online course creator, was given a course of medicine while she waited to get an appointment for further investigation. But as her situation worsened, she was seen sooner rather than later.
“My GP put me on an antibiotic and requested an urgent colonoscopy,” Anne says. “At this point, the diarrhoea was constant and the bloating became worse. In fact, I actually didn’t leave the house for weeks. I also started getting a specific pain in my gall bladder area, so I was called for an urgent ultrasound, which thankfully was normal.
“Then in the middle of August I went back in for a colonoscopy. At that point I was sure I had Crohn’s disease because I was so unwell. So after the scan, it was wonderful to hear my physician say that I didn’t have irritable bowel disease, instead, the scan picked up six polyps, which were removed along with two diverticuli (a diverticula is a small, bulging pouch which can form in the lining of your digestive system). “After this, I began to feel a bit better and then we went to another family wedding. However, the very next day, the diarrhoea returned worse than ever, so I rang my consultant who told me to come in to see him the following day. He told me that the histology on the polyps was benign, and he gave me a diagnosis of irritable bowel syndrome (IBS).
“He suggested that I begin a gluten and dairy-free diet in conjunction with the low FODMAP (fermentable oligo-, di-, mono-saccharides and polyols) diet. FODMAPs are a group of fermentable carbs which aggravate gut symptoms in sensitive people, of which I’m obviously one. They are found in a wide range of common foods. I had never even heard of them before, but now I’m something of an expert on it.”
Anne, who is married to Niall and has three grown-up sons, made a concerted effort to stick to the new diet which had been drawn up for her, but because she has to avoid so many foods, it hasn’t been much fun.
She adds: “I decided to adhere 100pc to the regime set out for me because I couldn’t bear to feel so unwell anymore. Normally, I am a high-energy person, but I was mentally and physically exhausted and would have done anything to get better and get my life back.
“So right from the start, I gave up all dairy and gluten, and downloaded the Monash University app for my phone.
“This is an amazing resource where I can check foods for suitability when I’m grocery shopping and if I am eating out it’s really useful as there are hundreds of foods that I used to enjoy, everyday stuff like onion, garlic, mushrooms, and lots of fruit which I loved but can’t eat any more. My diet is now quite simple and bland, but I love to cook and I’m trying to be innovative in adapting recipes.
“Having said that, dining out is a particular challenge. Recently, I was on a trip to Edinburgh and visited a gorgeous five-star Indian restaurant with an extensive menu, but all I could eat was plain rice and some potato. So now, if I’m going to be eating out, I will ring the restaurant before I go to discuss my food options.”
Being organised and disciplined has been difficult, but Anne says that despite the challenges, all of her aches and discomfort have gone and, as long as she sticks to her new diet, she feels fantastic and has lost weight to boot.
“When I started eliminating all the foods that I would have eaten every day, something miraculous happened,” she says.
“The cramping and diarrhoea just stopped, and the bloating disappeared completely. I lost 10lbs, my waist measurement reduced by six inches, my energy returned, and I could fit into all my clothes again. It was fantastic.
“So I’m actually coping really well, but I still have to be very careful as I seem to be particularly sensitive, and a few times have inadvertently eaten something that I shouldn’t have.
“When that happens, I will have instant diarrhoea, For example, a few days ago, I ate some sweetcorn, which is actually allowed on FODMAP but I became terribly unwell. So I’m learning as I go.
“On the whole, I feel amazing again. My energy is back and my body is back which has also helped me to feel more positive and prompted me to launch a new online course called Finding your Fabulous. This helps women boost their mindset and confidence and I have a book of the same name in the pipeline.
“I know that the mindset practices which I carry out every day helped me to deal with my illness and treatment in a very positive way — and no matter how bad I was feeling, I made sure to practice gratitude and journalling daily which enabled me to stay confident and strong.
“Looking back, I lost two months of good health by hoping everything would just settle down, so I would urge everyone to heed their body, acknowledge unusual symptoms and talk to their GP if they have any concerns. I am delighted that I did.”
Professor Reza Kalbassi, a consultant in colorectal, general and minimally invasive surgery, says although there are no official figures regarding the number of people with IBS in Ireland, it is a common condition which can be triggered by either diet or stress.
“IBS is a functional bowel disorder without anatomical abnormalities of the bowel or the colon,” he says.
“Essentially it involves a series of symptoms such as alternating bowel habits (diarrhoea and constipation), cramping, bloating, heartburn and reflux.
“It mainly affects younger people in their teenage years, 20s and 30s and trigger factors can include stress and anxiety but also certain foodstuffs which are determined to be high FODMAP and can irritate the bowel. These can include garlic, onions, beans and cheese but the list of high FODMAP foods is long, and irritants will vary between patients.”
Professor Kalbassi, who is the clinical lead and head of the endoscopy department at the Beacon Hospital, says along with dietary changes, there are other recommendations for easing the pain of IBS. But he says it is vital for people who think they have the condition to be investigated fully, to rule out the possibility of another, more serious ailment.
He adds: “It is very easy to brand someone as having IBS, but if they have symptoms, it is crucial that they are investigated to rule out a more serious condition such as inflammatory bowel disease or even cancer.
“Once IBS has been established, we would often suggest a restricted low FODMAP diet for four to six weeks to see if their symptoms improve. As each individual is different, we would then ask them to slowly reintroduce some of the high FODMAP foods to see which ones agree with them and which ones don’t and after time, a balanced diet can be achieved.
“Other treatments include a reduction of stress and anxiety along with plenty of exercise, more water — as most people don’t drink enough — and probiotics, which have been noted to be useful.
“IBS is very common in younger people and most tend to grow out of it as they get older, but those who are affected more by diet than stress can see it stretch into later life.
“If anyone has any concerns, they should seek medical advice and ensure investigations are carried out.”