Friday Q&A: Irritable Bowel; HRT & breast cancer; sudden cardiac arrest; & tinnitus

A holiday weekend hodgepodge of subscriber questions

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Disclaimer: The views expressed here are entirely my own. They do not reflect those of my employer, nor are they a substitute for advice from your personal physician.

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QUESTION #1

I have been told I have IBS, but isn’t that just a throw-away diagnosis that doctors give people when they don’t know what’s wrong?

- Katy

Dear Katy,

I hear this a lot. The truth is that irritable bowel syndrome (IBS) is a real thing. Just because it isn’t life threatening doesn’t mean it can’t significantly affect quality of life. IBS is thought to affect approximately 10-15% of the population, and it occurs more commonly in women.

The symptoms of IBS can include cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. The common causes are stress, certain foods, a bout of diarrhea (i.e., a gastrointestinal infection), and an imbalance in the gut microbiome.

A healthy microbiome is characterized by a diverse array living critters in our intestines that work together to maintain balance and protect against harmful pathogens. An imbalance between the “good” and “bad” bacteria is a phenomenon known as dysbiosis and can cause IBS symptoms.

Photo by Christina Rumpf on Unsplash

Here are my suggestions for managing IBS:

• Keep a detailed food diary in order to identify trigger foods, using the list of low-FODMAP foods as a guide. The common culprits? Alcohol, caffeine, and sugar.

• Check your list of medications and supplements. Diarrhea and constipation are common side effects of a host of prescription drugs and supplements. Remember, just because something is “natural” doesn’t mean it can’t irritate your digestion.

• Gradually increase your daily fiber intake to help bulk the stool and nourish your gut health.  

• Consider your stress level, because it tends to show up in our gut. Practice stress management techniques such as deep breathing, yoga, or meditation. Ask for help if you need it.

• Nurture your gut microbiome. For example, eating fresh vegetables and fruits will supply the “good” microbes, while eating too much sugar and processed food will tend to fuel the “bad” microbes.

  • Consume things like yogurt, kefir, kombucha and other fermented foods, all of which contain “good” microbes like Lactobacillaceae and Bifidobacterium.

  • Avoid taking unnecessary antibiotics that can kill healthy microbes.

  • Consider a tailored oral probiotic regimen.

At the end of the day, managing digestive distress is a process that requires awareness of our medical data and whole health ecosystem—from dietary inputs to stress management tools—all at once. Drop me a line below to tell me what works for you!

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QUESTION #2

My OBGYN says I shouldn’t take hormone replacement therapy because I have a family history of breast cancer (mom, age 70). I’m 54 and walk 2 miles most days. I don’t drink or smoke. Aside from hot flashes and insomnia, I’m healthy. Can I not take hormones?

- Aline