Whilst travelling in Europe during a heat wave several years ago, Emily became extremely hot and thirsty. Heading to the nearest water fountain she had filled up her water bottle and drained its contents before realising the water wasn’t suitable for drinking. “The next day I was standing in a queue for the Uffizi gallery in Florence when I realised I urgently needed to get to the toilet”, she says, “I literally ran to the nearest one and sat there for quite a while before I was confident to leave“.
This became a daily pattern for Emily who found it impossible to continue her travels while trying to cope with both the constant heat and bowel urgency. She became more and more depleted, deciding to head back to her temporary home base in London. Once there, she was able to see her GP who diagnosed gastroenteritis and advised her to drink plenty of fluids, rest and recover.
Whilst Emily recovered and had no further issues for some time, about six months later when she was back in Australia, she noticed a new pattern emerging. Whenever she was stressed, upset or anxious the same feeling of bowel urgency would return and she would need to rush to the toilet, often experiencing loose and frequent bowel motions and sometimes diarrhoea. “It started to become my regular physical response to stress and I would dread it,” she says. “I also had a couple of ‘accidents’ and I was so afraid people would smell it and see it."
So began a long journey of medical testing and investigations but nothing was found. When all the other potential causes had been ruled out, Emily was given a diagnosis of irritable bowel syndrome (IBS), but no real guidelines on how to manage it. She decided to keep a diet and symptom diary to see if she could establish any triggers and experimented with eliminating certain foods such as gluten and dairy to see if her symptoms improved. “Everything I did helped me initially, but if I was anxious or stressed it made no difference, and anything I ate would just go straight through me“, she commented. “I soon realised however that I needed to be careful with coffee and spicy foods, as these will set me off most of the time”.
Anyone who has experienced IBS will be familiar with the sense of not having control over their bowels. Emily became even more stressed if she thought this might happen if she was out in public or worse, at a social function. “Sometimes I would avoid eating or drinking anything beforehand and I would be super careful when I was out not to eat anything too rich or spicy," she says. “I also had to think carefully about what to wear and whether it would show if I had an accident. It was very tiring and made me even more anxious."
Emily decided she needed to work on her stress and how she could manage it better. She downloaded a mindfulness meditation app and committed to a five-minute guided meditation every morning before getting out of bed. “I felt better almost immediately," says Emily. “It was a really nice way to start the day and I found I was calmer and more relaxed." She also sought the help of a counsellor to learn other techniques and strategies for stress management and started to practice yoga and breathing exercises.
Over time, Emily found all these strategies helpful but says her bowel is always where she holds and feels her stress. “I still get flare ups and stress and anxiety are always the trigger," says Emily, “but I am kinder to myself and try to prepare myself better, especially if I know a stressful event or time is coming up. Of course, that’s not something you can always predict, but I try to be more mindful when I’m stressed and remember to breathe!"
Emily has learned to mostly self-manage her IBS, and like most people with her condition, she has her good and bad days. “Having IBS can be a real challenge, especially if you get caught out unexpectedly and I always need to plan my outings around where the toilets are," she reflects. “Sometimes I don’t have any symptoms at all and then other times it can be almost daily. It can be hard to predict, but I decided I needed to be open about it with my family and close friends. It saves a lot of additional explanation!" Emily is also a member of the Facebook group IBS Support Australia where she can chat to and get support from those going through a similar experience and finds it useful for tips and strategies to self-manage IBS. “Sometimes it’s just the little things that can make a real difference so I’m always willing to try new suggestions," she says.