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There’s No Cure for IBS, But Plenty Of Treatment

Dear Dr. Roach: I have been diagnosed with irritable bowel syndrome. However, the only time I am affected with multiple bowel movements, cramps and loose, watery stools is after breakfast and lunch. Do you have any ideas of why this could happen at these two meals only? I did not have any problems until after the removal of my gallbladder.

I am afraid to travel now because of my condition. What is your opinion regarding being affected with IBS only after breakfast and lunch, and can you provide more information about possible treatment or cures? — R.G.

Answer: Irritable bowel syndrome is a common condition that encompasses one or more of the following characteristics: abdominal discomfort, usually cramping or fullness, often relieved by bowel movements; stool changes, constipation, loose bowel movements or alternating between. It affects more women than men.

IBS can be debilitating, and many people with this condition limit their social activities because of symptoms or fear of symptoms. There is no cure for IBS, but most people can find relief with treatment. Treatment includes dietary changes, medications and stress management. IBS does not cause permanent damage to the intestines and does not increase cancer risk.

Dietary changes are tricky, because what works for one person may make someone else worse. For example, fiber helps many people with constipation symptoms, but may worsen people who have fullness and bloating. Broccoli and onions are frequent triggers, as is caffeine. Keeping a food diary and a symptom diary can be helpful in tracking down whether foods are a big trigger.

In your case, I would concern yourself with the foods you’ve eaten during breakfast and lunch, especially caffeine. However, since stress can make a big impact on symptoms, I wonder if work stress may be part of your issue. Also, I have had a few patients who developed IBS symptoms after gallbladder removal, and the use of the prescription medication cholestyramine, which binds bile acids (formerly kept in the now-removed gallbladder), occasionally has been life-changing. Having a talk with an expert in this, usually a gastroenterologist, can be very helpful.

Dear Dr. Roach: I have been with my husband for 33 years, and for the past six I have been suspicious of him being unfaithful. I went to the doctor and tested negative for HIV, but I was positive for herpes 1 and herpes 2. My husband claims I could have had this since before we met and says that he is completely innocent. Do you think I could have had this for 30 years and not known it? It seems rather unrealistic to me. — D.F.

Answer: Herpes viruses are a group of common viruses that share several traits, one of which is that they all stay dormant in the body and may cause recurrences in times of stress. Herpes simplex 1 causes an outbreak of cold sores: These often come out when people are ill or stressed. Herpes simplex 2 usually causes genital lesions. About 20 percent of adults in the U.S. are positive for HSV-2; many or even most of them don’t know they have it. Once you acquire HSV-2, it stays in your body forever, and may (or may not) cause recurrent disease, which most commonly looks like a clear, fluid-filled blister. These are very infectious, but it is possible to transmit the virus even when there are no symptoms. It is possible that you acquired the condition 30 or more years ago. The test isn’t able to tell how long you’ve had it.

Dear Dr. Roach: In the past couple of years, I have experienced a small degree of hair loss during the winter. I find, however, that growth restores again during the rest of the year. I have read that this may be due to the flu vaccine. Can you explain? — A.R.

Answer: There have been a few cases of documented hair loss after vaccination, usually the hepatitis B vaccine. However, there have been even more cases associating with influenza (the flu) and hair loss.

In my opinion, the likelihood that this is due to vaccines is very small, and the overall benefit of influenza vaccine is greater than the risks. There are other reasons people have published for winter hair loss, including dryness, hat wearing and hormonal changes. It’s not clear what causes it, but don’t skip the flu vaccine due to fears of hair loss.

Email: ToYourGoodHealth@med .cornell.edu.