This month is Irritable Bowel Syndrome Awareness Month. And telling it like it is… The IBS diagnosis is a load of BS. As a practitioner specializing in helping people overcome fatigue and regain a vibrant life full of energy, I work with a lot of clients that have been labeled (and accept their label) as having IBS and come to me because of their accompanying fatigue. Unfortunately, IBS is an easy label doctors like to give to patients with digestive complaints—a label that takes away agency and precludes getting to the root cause of the symptoms (not unlike the label of chronic fatigue syndrome or fibromyalgia, in fact).
There is a reason that we gravitate toward labels. The diagnostic label can make symptoms feel less mysterious or scary (i.e. “Oh, my intestines are not falling out… All this diarrhea and pain is normal for IBS.”). It can also give us the sense that a health situation is manageable, understandable, that there is research on it and it is based on treatments (i.e. “Now that I know I have IBS, I can wait for the pharmaceutical drug companies to come up with a cure, but in the meantime I’ll just continue to pay enough money to put my child through college for drugs that mask my symptoms…”). Perhaps most importantly, it creates community, something we often lack in industrialized countries. It means the person with the diagnosis is not alone, is not unique, but has a knowable situation others have navigated (i.e. IBS support groups where everyone gets together and talks about a lifetime of coping with diarrhea, constipation and stomach cramps).
So what is the requirement of a “label”? It must have set diagnostic criteria or expectations surrounding it. In this way, we cannot be “labeled” as happy because happy is general and vague—we have not attached specific expectations around it (though perhaps we should); whereas depression has been defined by specific criteria, as has IBS (though specific seems like a stretch). As an aside, isn’t it interesting that we have only set specific diagnostic criteria around culturally defined negative things?
The IBS label is usually based on:
The Rome II Diagnostic Criteria for IBS:
At least 12 weeks (which need not be consecutive) in the preceding 12 months of abdominal discomfort or pain with two of the following features:
Symptoms that cumulatively support the diagnosis of IBS:
Hmm… Could it get any vaguer or more encompassing of all digestive complaints than the Rome Criteria? After reading this criteria, it should be obvious to you why 20% of the US population is diagnosed/labeled with IBS. The experience of having to contend with frequent or infrequent trips to the bathroom producing too solid or not solid enough results accompanied by or lacking pain, bloating and/or gas is not exactly rare. So at least with this diagnosis, a person gets to feel “normal” and in fact, IBS is becoming the norm. Oh and not surprisingly, there are all sorts of pharmaceutical drugs that are offered to IBS sufferers that help them deal with the symptoms of IBS (though only mask or ignore the underlying causes). IBS drugs equate to big money for pharmaceutical companies (but only if the causes are never addressed).
A diagnostic label can feel very disempowering. A label implies that a disorder itself is responsible for behavior, experiences and feelings and therefore, it is unnecessary to look at the environment or context that a diagnosis occurs in since there is a medical reason for it all. Unfortunately, this limits the opportunity to do things that could help the situation and ignores causative factors. Likewise, a medical label is considered serious and often evokes a feeling of hopelessness, causing the labeled person to give up or be given up on. They evoke a gloomy outlook and preclude looking at uniqueness—avenues that allow for improvements and success.
I’ve watched the label of IBS remove agency from clients and disempower them in achieving health. For instance, I’ve consulted about digestive complaints and mapped out a strategy to get to the root cause of symptoms based on specific metabolic results to overcome digestive disturbances that are at the root of the fatigue. In between that consultation and scheduling blood work to help determine the root causes, I’ve had clients go to a doctor’s appointment and based on the Rome Criteria and little to no blood work, be diagnosed (and labeled) with IBS. And then comes the dreaded call from the client that goes something like this: “Don’t worry. I found out what it is. I have IBS, so we don’t need to test for parasites, bacterial overgrowth, candida and/or food intolerances anymore.” And so it goes, and the client succumbs to the “rational, persuasive expertise” of the MD with the medical label/diagnosis and loses agency to improve her health and life. I watch clients become their diagnoses and introduce themselves in life as their labels—externally imposed but self-enforced.
The rest of this month, I will be celebrating IBS Awareness month by eschewing the diagnostic label of IBS and writing about some of the root causes of digestive disturbances and how they relate to fatigue and in doing so return agency to the hands of those labeled with IBS. And hopefully, in turn, those readers with the IBS label will begin saying they have been diagnosed with IBS, not that they have IBS and will start taking actions to get to the root cause of their complaints so they can turn their health around. The four most common causes of digestive complaints I see in my own practice are: 1) Parasites 2) Candida/yeast 3) Intestinal bacteria and 4) Food intolerances/allergies.
We should never let ourselves be defined by a label—we are so much more than a label—an accumulation of experiences, behaviors, thoughts and environmental circumstances that makes each of us different and unique. It’s amazing how incredible it feels to release a label and come into our own. There is freedom in living outside of labels and eschewing diagnostic criteria. Freedom to be who you are and why you are, not who you are supposed to be and are expected to be.
So this is what I want you to say to your health practitioner if s/he tries to stick you with the IBS label: “The IBS diagnosis is a bunch of BS and I want to get to the root reason of why I am experiencing digestive disturbances, because I know that there is a reason—I just have to uncover it. Will you help me?” And after you say this to your doctor—feel free to smirk a little and then feel yourself get a little bigger as all that empowerment goes to your head and you take back some of the agency for your own health from the medical establishment. And then I want you to comment below and share about your bad ass self and how good that felt.
If you know someone with an IBS diagnosis or is questioning whether s/he has IBS please share this article. And below, in the comments, I’d love to hear about what labels you eschew—health or otherwise. What labels do you think are a load of BS?