Working with IBS? How do you do it?

[ccprincess]

Hi everyone. I have finished university and have luckily secured myself a full time job, but the closer it gets to me starting, the more anxious I am becoming. I have an IBS flare up at least once a day minimum at the moment (it is currently at its worst) and I am so worried about how understanding my workplace may be with this. Have you been honest with your employers and how have they reacted and dealt with your condition? IBS has already ruined my social life, I’m really hoping it won’t ruin this too.

[Viklou]

I have been honest with my employer and have a policy relating to my specific needs while working. They have been extremely understanding. Sadly not all employers are but honesty is the best policy and this will help you manage the condition while at work. You must also do what's right for you even when things seem out of control. Thankfully again my role is very flexible and I can arrange my work load around my condition.

In regards to appointments I'm allowed to take time for these and then make the time up.

[Linley]

Firstly, congrats on your new job. For most of us IBS sufferers anxiety is the key word and makes our condition worse. I worked for a large international company whose HR dept had a person employed for staff welfare among other things, that said I told my line manager only about my IBS so she used to understand if I disappeared a few times a day and that alone reduced my anxiety. There is always the IBS network to fallback on if you get any agro from your company. Good luck🍀

[Maureen1958]

Hi ccprincess, well done for getting through university with IBS and securing a job in the present climate. I agree with Viklou, it's best to be honest with them. Do you need to actually be in the workplace all the time or could you work from home, some of the time at least. My son got his first job about a week before lockdown and has been working at home since. They are talking about going back to the office situation soon but it proves it can be done, if you are in the right environment.

[BabsyWabsy]

I agree with your other responders. I worked in a small office where it was not possible to disguise your gurgling guts, so I was honest about my condition, and found that I had company. One colleague with colitis, and one who was coeliac. So you may not be the only one, which makes it easier. I also worked from home two days a week. It was manageable. Congratulations on the new job.

[Library_lady_]

Hi ccprincess, speak with your manager and explain to them your condition. I found that with the loperamid I'm almost fully capable of functioning normal. There are moments that I need to up my dose, but mostly I am okay at work.

I believe that the key is to try to have a regular meals, enough sleep and not stressing to much over IBS.

I found out that most of my colleagues are very understanding and if they don't know what IBS is they would ask questions and try to help in any way possible.

Congratulations on your new job!

[xjrs]

Your employer will have a duty of care towards you, so they need to take reasonable steps to accommodate any health issues you may have, which means they need to be aware of your condition first. For example, you could ask to have your desk near a toilet. Many managers are professional and won't pass this information on if you are embarrassed. Just in case it might be best to make it clear that you want this information to be confidential - if this is the case. As others have said it is amazing to find out how many people have digestive issues once you start talking about it.

However I am wondering what help you've been getting with your IBS, so that your symptoms are under control, so there's no need to worry in future. Here is some information about IBS that I have shared with others in this group:

IBS can be due to a number or combination of factors - these can be stress (including stress from early life experiences) which impacts the communication between the brain and the digestive system. There are lots of free webinars online at the moment regarding mindfulness meditation which might help. Plus you can ask to be referred for CBT or something similar to reduce your anxiety - I would have thought online appointments are available. Exercise can play a major role in IBS in terms of reducing stress, helping your gut microbiome and regulating bowel movements.

There is also not absorbing certain types of carbohydrates called FODMAPs very well, the residue ending up in the colon and bacteria feeding off them causing symptoms. Ordinarily feeding gut bacteria is a really good thing - when you feed good gut bacteria these produce by-products that have great health effects in the gut and throughout the body. However, in some people with IBS bad bugs might have the upper hand over good - these bad bugs may cause symptoms such as pain or disordered bowel movements. There is an interesting infographic on this here: gutmicrobiotaforhealth.com/.... This is why it’s worth trying probiotics such as Alflorex (which has been scientifically studied for IBS) or Symprove to crowd out the bad bugs and make their numbers die down. If that doesn't work you can try the FODMAP elimination and reintroduction diet. This is normally under the guidance of a nutritionist via GP referral - this may not be possible at the moment so you can read about it online. If you download the Monash University FODMAP app it will tell you which foods contain FODMAPs and in what quantities. You can eliminate all FODMAPs for 2 weeks and then introduce each type of FODMAP one at a time starting in small quantities, increasing over a 3 day period and wait up to 4 days for symptoms. I go much slower than this - only introducing a small amount (1/4 to 1/3 of a normal portion size) of the same food for 3 days and then increase if tolerable or no symptoms and cut back to the previous amount if symptoms for longer and then try to increment again . I've read your microbiome can adapt to handling a new food if introduced very slowly and your bad bugs are under control with a good probiotic. Ideally you want to eat as many FODMAPs as you can since they are good for your health. Many people with IBS don't have diverse gut bacteria - it has been found that people who lack a diverse microbiome are more prone to diseases in general. In the long run, if you can get your symptoms under control, the ideal situation is to have a very varied diet - lots of different coloured fruits and vegetables, a variety of protein and carbohydrate sources including cereal fibres. This may seem a long way off, but with the right treatment all of this is possible. Last year all I could consume to control my IBS was white rice, protein and limited low fodmap veg. Using the approach above (particularly introducing Alflorex) I am now able to consume far more foods - more than I've ever dreamed of including wholewheat bread which is unheard of for me.

If you are also suffering from pain, you may be suffering from visceral hypersensitivity (functional abdominal pain) - there is info about it here:

iffgd.org/lower-gi-disorder...

It is where the brain interprets the normal activity of the bowel as pain - this is due to a wearing down of neurons in pain control centres of the brain which can be caused by PTSD, neglect or abuse in childhood, extreme stressful events etc. The first line treatment is nerve pain agents such as low dose amitriptyline. There is a theory that being on something like amitriptyline for 6-12 months can help the pain control centre neurons to regenerate. Note that amitriptyline can cause constipation, but this can be helpful in people who are diarrhea dominant. Unfortunately I couldn't tolerate these. Linaclotide (for IBS-C only) & Alflorex have helped me with this intestinal pain.

You may also find assistance with anti-spasmodic medication such as mebeverine (Colofac) or enteric coated peppermint.

You can find some info on self management here:

theibsnetwork.org/the-self-...