Ask Dr. Etingin: Irritable Bowel Syndrome; Red Blood Cell Count
I have all the symptoms of irritable bowel syndrome (IBS), including abdominal pain, gas, bloating, diarrhea, and constipation, but have not yet gotten a definitive diagnosis. What steps can I take to ease these symptoms?
Recognizing IBS isn’t always easy, because its symptoms are also common to other gastrointestinal disorders, such as celiac disease, as well as food allergies and adverse reactions to foods, such as lactose intolerance and nickel allergic contact mucositis.
Until a definitive diagnosis is made and a treatment plan is prescribed by your physician, it may help to implement lifestyle changes that ease IBS symptoms for some people. For instance, IBS symptoms are often lessened by avoiding trigger foods such as dairy products, chocolate, caffeine, and foods that contain poorly digested sugars known as FODMAPs. FODMAPs, which stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, are found in many foods. Foods with the highest FODMAP content include, but are not limited to, garlic, onions, pears, apples, artificial sweeteners, and foods containing lactose (dairy products) and gluten (wheat, barley, and rye). FODMAPs can cause bloating because bacteria in the colon consume them, which produces gas. Most IBS patients don’t have to avoid all FODMAPs. Once foods are eliminated from your diet, the foods can be added back into your diet one at a time to identify which ones trigger symptoms. Also, overeating to the point of being excessively full can trigger IBS.
Other things to keep in mind: Stress can worsen symptoms of IBS. Try mindfulness meditation or guided imagery, or find a mental health professional who can teach you relaxation techniques. Exercise is also an effective stress reliever. © Oleksandr Hruts | Getty Images
My recent blood test shows I have a low red blood cell (RBC) count. What might be causing this?
Red blood cells contain a substance called hemoglobin, which transports oxygen around the body. The amount of oxygen that’s delivered to your body’s tissues depends on the number of red blood cells you have and how well they work. Women usually have a lower RBC count than men, and the level of RBCs tends to decrease with age. The common term for a low RBC count is anemia. Symptoms of anemia include dizziness, fatigue, and shortness of breath. Blood tests can point to the source of your anemia by measuring iron, folate, and vitamin B12, which are nutrients needed for red blood. A low RBC count may have several causes, including diseases and conditions that reduce the production of red blood cells, such as aplastic anemia, cancer, chronic kidney disease, cirrhosis, and Hodgkin’s lymphoma.
If your low count is due to a deficiency of vitamin B12, a condition that is common in older adults, include more B12-rich foods, such as fish and shellfish, lean meat and poultry, low-fat dairy products, and eggs, in your diet. Your doctor also may recommend a B12 supplement or monthly B12 shots. Folate is present in leafy, green vegetables such as spinach, broccoli, Brussels sprouts, and mustard greens, as well as fortified breakfast cereals.
If you have an iron deficiency, your anemia might be caused by internal blood loss. If your doctor suspects this, he or she may request an endoscopy (which looks for signs of bleeding in the stomach), colonoscopy (which can identify bleeding in the colon), or a stool occult test that can detect hidden blood. Health conditions that are associated with a low RBC count include ulcers in the digestive tract, chronic kidney disease, and underactive thyroid.
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