During her freshman year in college, Ryann Wilcoxon struggled with painful stomach cramps and diarrhea. An IBS-D diagnosis gave her answers about what was going on in her gut, but what Wilcoxon was still unsure about was how to talk to friends and family about her condition.
“I’m a fairly open person, but having to tell a college boy you need to cut your date short because of cramps and diarrhea is not something even I want to do,” says Wilcoxon, of Mobile, AL.
Any time she turned down fried food or asked about the menu before a social event, her friends would ask questions.
“We all ate in the school dining hall together, so they saw what I ate at every meal,” Wilcoxon says. “Some friends thought I just wanted to be skinny or had an eating disorder. In reality, I was trying to avoid the awful pain of abdominal cramps. It was hard to try to explain to them what I was dealing with.”
As she got better at managing her IBS-D, she became more comfortable talking about it. Now, in her 30s, Wilcoxon says she doesn’t worry when her IBS-D comes up in conversation.
“I’m very straightforward,” Wilcoxon says. “I just tell people, ‘I have IBS.’”
It’s normal to feel nervous when you start talking to friends, co-workers, and family about your IBS-D. But anyone who is dealing with a medical condition deserves support.
“In this day and age, people talk openly about heart disease, breathing problems, prostate problems, and even sexual issues,” says Brian E. Lacy, MD, PhD. “Mentioning the need to use the bathroom more frequently, or the need to take medications while out in public, should not be a big issue.”
It may take some practice, but there are ways can get the point across and gain confidence along the way.
1. Keep it general.
If you’re shy about saying certain words, stick to vague terms when talking about your IBS-D.
“You don't really have to say ‘IBS’ if you’re not comfortable explaining it,” says Lin Chang, MD.
Try other terms like “digestion problems,” “cramps,” or “GI condition” as a quick way to describe your condition.
“The phrase ‘I have stomach troubles’ is very suitable and covers all the bases,” Wilcoxon says. “Usually, that’s all most people really want to hear anyway, and the conversation can move on without embarrassment.”
“Some patients even just make a bit of a joke about it [by saying] ‘My stomach is always a little jumpy in new situations,’” Lacy says. “No need to explain further.”
2. Have a script.
Practice what you’ll say before a moment comes up, so you don’t have to think on your feet.
“The script will differ for different people,” Lacy says. “But preparing in advance is key, and usually, the shorter the better.”
Keep things quick and upbeat, and start with the positive steps you’re taking.
“You can say, ‘I'm doing what I can to control my symptoms, but sometimes they act up or increase unexpectedly,’” Chang says. “Or ‘I have limitations, but sometimes it comes up even when I'm doing what I can.’”
3. Prepare for the unexpected.
It’s good to be ready to talk about your IBS-D when it comes up. With careful management of your symptoms, however, you might be able to prevent IBS-D from derailing your routine in the first place.
Lacy suggests these tips:
Think ahead: Take your medications before you go out. Also, find out where the bathrooms are as soon as you get to someplace new so you can get to them quickly.
Avoid your triggers: “People know their ‘safe’ foods,” Lacy says. Stay in your comfort zone when choosing what goes on your plate, and you can avoid long stays on the toilet that have to be explained later.
Soothe your stomach: Sipping water or a non-caffeinated drink like peppermint tea might do the trick, Lacy says.
4. Know you’re not alone.
It may help you to know that IBS is a common condition. “Remember that 10% of the U.S. population has IBS,” Lacy says. “You may not be alone out there.”
Guilt or shame often keep people from letting others in on their struggles with IBS-D.
“There can be a stigma attached to IBS,” Chang says. “Patients can feel very isolated, either because they can't go out, or because they can't share it, or because they feel ashamed of having their symptoms. They start doubting themselves.”
Chances are, someone you know is also dealing with IBS-D. Opening up about your challenges can be empowering for both you and others with the condition.
5. Be proactive.
It’s easier to talk about it when you can set the time and place for the conversation. It’s a matter of taking control of your health -- telling others what you’re dealing with helps you just as much as it helps them.
Be up front.
If there’s not quick access to a bathroom: Speak up to make sure your needs are met.
At work: Find out what the policies are at your job so you know what to expect when you need to miss work. It can also help to loop in co-workers who can support you.
At home: The stress of IBS-D can make your symptoms worse. Tell a partner or other people who care about you. It’s an important part of staying healthy.