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What Is IBS-D?

Irritable Bowel Syndrome with Diarrhea, a chronic gastrointestinal disorder known as IBS-D, cannot be wholly generalized as each person experiences the symptoms differently. Affecting 10-15% of the people around the world, triggers for all forms of IBS-D often include eating certain foods which that may aggravate your system; these foods include wheat, dairy products, red wine, and caffeine.

There are some commonalities with the symptoms and diagnosis, as well as strategies with living with IBS-D and the treatment options. A clearer understanding of IBS-D will help individuals who are affected directly by the group of symptoms.

Symptoms of IBS-D

IBS-D symptoms include an urgent and sudden need to have bowel movements usually accompanied by loose and frequent stools, and abdominal pain. It is not uncommon for individuals to lose control of their bowels and soil their clothing, which makes living with IBS-D extraordinarily challenging and difficult. Most people change their lifestyles so that they always are near bathrooms and often will refrain from doing anything that will require the risk of having an accident.

Diagnosis of IBS-D

Although it is easy and one might be self-inclined to self-diagnose IBS-D, it is best for your gastroenterologist to make the official diagnosis after doing a health history, examining you, ordering a blood workup, and requesting a stool sample. It will be important for you to know if others in your family have had Crohn’s disease, Celiac disease, and colon cancer. An official diagnosis for IBS-D is only given if you experience diarrhea about a quarter of the time and also have constipation than a quarter of the time.

Living with IBS-D

Eliminating Trigger Foods and Drinks. You will begin to recognize which foods are your trigger foods which give you an adverse reaction. Understand the relation between your diet and the severity of your symptoms is key, and you should plan to keep food journals until you can identify definitively what you’ll want to avoid if possible, whether that be dairy products, artificial sweeteners, highly fatty foods, vegetables that cause gassiness, caffeine, and alcohol.
Finding the Right Treatment Plan. You will want to work with GI to find the best treatment plan for your symptoms, which may include taking antidiarrheal medications or prescription medications that may be recommended.
Exercise Regularly. You will want to stay physically fit and get regular exercise which will help reduce stress and can significantly alleviate symptoms.
Reduce Stress and Address Depression. In whatever way is possible, be sure to work to ease any stressors as anxious feelings and depression may negatively impact your gut. Many individuals practice relaxation techniques including yoga, and or try biofeedback as well as treat depression. You will want to be sure to address whatever it is that troubles you head on.

There is no known cure for IBS, and it is likely that you will have episodic periods which will be challenging. Be sure you have an excellent GI following your case and who advises you accordingly.

What Is IBS-C?

With over 13 million adults across the United States suffering from Irritable Bowel Syndrome (IBS), it is the most common gastrointestinal disorder. There are different types of IBS, and we are addressing here more about Irritable Bowel Syndrome Constipation (IBS-C), which is also referred to as constipation-predominant IBS.

Symptoms

The most prevalent symptoms of IBS-C is discomfort and pain in the abdomen, constipation, straining, and bowel movements that are both small and hard that look like pellets. Many women share that their symptoms are more prominent while menstruating. In general, IBS-C affects more women than men and is more common in adults who are under 50 years of age.

Diagnosis

A diagnosis of IBS-C is individualized, but many individuals suffer from constipation having less than 3 bowel movements a week coupled with abdominal discomfort over the course of a few months. The diagnosis of IBS-C will be made by a general physician or gastroenterologist (GI), to be sure that there is not something more serious going on. A rule of thumb is that IBS is diagnosed by ruling out other potential issues.

Bring a complete medical history including a record of your bowel movements to your appointment with your doctor. It is also useful to provide a food history and a list of any medications you have taken. Providing as much information to your doctor, preferably in journal form, about your symptoms and what you were eating and drinking before and around that period will allow for the best opportunity to understand what is happening and which foods may be triggering your symptoms.

Treatment

A first step for treating IBS-C usually includes taking a serious look at your diet to be sure it is balanced and strategic in terms of everything you eat. Significantly increasing your fiber intake with the goal of getting anywhere between 25-35 grams of fiber. Typically a GI will provide lists of the most fibrous fruits, vegetables, whole grains, and beans to help you build a diet designed to keep you symptom-free. There is no question that cutting out highly refined foods and avoiding white bread and carbohydrates is key; carefully planning what you eat with your doctor will help you be sure that you get relief from constipation without causing cramping and gas. Since not drinking enough water will often be a factor in constipation, you will want to prioritize monitoring your water intake to help move the food through your intestines.

Most individuals with IBS-C are encouraged to exercise and look into stress management programs to address any external factors that may be adversely affecting your gastrointestinal tract.

Medications

Taking medications is commonly prescribed for individuals with IBS-C because they usually provide fairly quick relief from the discomfort you may be feeling. Common medications include laxatives, Linaclotide, and Lubiprostone and you will need to plan for the best medication to find the best treatment options for you to follow. Many individuals also will take fiber supplements to help supplement their daily intake of fiber.

Summary

IBS-C is individualized and is the experience of constipation may manifest itself differently for each person. There is no cure for IBS, but the symptoms can be mitigated with a well-planned treatment strategy that continues to be tweaked and adjusted until optimum results are achieved.

IBS – Tips for Your Travels

Even with the excitement of an upcoming trip, those suffering from Irritable Bowel Syndrome (IBS) know that traveling is not easy and can cause lots of challenges that are far from straightforward. Planning and strategizing to help you be sure that your IBS is not aggravated over the course of the vacation is key because being in a new place, on a different schedule, and far away from your kitchen, can present difficulties and anxiety too. But don’t let that delay planning your trip; instead, consider the following tips.

Carefully Plan Food and Meals

While traveling, if you are not staying in a place with kitchen facilities, planning your own food is key for individuals with IBS. This will include making the best food choices off a menu in a restaurant and/or piecing together parts of the menu with side dishes you can always order separately. Especially if you are aware that certain foods that you eat such as greasy foods or not eating enough fiber will cause you difficulties, you will want to order carefully.

One tip is to carry around smart and healthy snacks that will carry you over until you get to a restaurant where you can choose your meals wisely. Also be sure to carry around a reusable water bottle so you are sure to get enough fluid intake through the trip from the very moment you leave your home.

Maintain a Schedule

Being sure to keep a good routine even while you are enjoying your travels is key. If you are in a different time zone, this always presents challenges to get your sleep and meal schedule in sync with your new location so that your gastrointestinal system does not get out of whack. Continue to eat your regular meals just as you would if you were not traveling. Be sure to get enough sleep and plan extra time for jetlag at the beginning of your trip.

Planning Bathroom Stops

It is a careful balance between sightseeing and running non-stop while also ensuring to able to plan time adequately for bathroom breaks. Check with tours to be sure how much flexibility there is with taking breaks and be sure to carry around small pocket-change in case you visit a country which charges for bathroom use. And most importantly, be aware of your body and do not ignore any symptoms that may arise. Be sure to address them immediately.

Leave as Much Worrying as Possible at Home

There is a lot of stuff around vacationing that is simply out of your control and with IBS, those pieces may become anxiety producing. Because there is a link between stress triggering episodes of IBS, it will be to your advantage to plan accordingly for your trip, but also recognize that it’s almost impossible to plan for everything. Be sure to talk honestly about IBS with the people you are traveling with so that they will understand what may be happening at any given time. Most importantly, enjoy the trip and the upcoming adventure and making new memories.

Digestive Enzymes & IBS

IBS stands for Irritable Bowel Syndrome, and it is difficult to diagnose. Although there is no known cure, there are many ways to appease your sensitive bowels. Symptoms of IBS alternate between both diarrhea and constipation, accompanied by pain from bloating, gas, and stomach cramps. This is not just caused by the stomach flu; symptoms occur for 6 months or more. If you have prolonged symptoms of anything on this list, make an appointment to see your doctor.

Because IBS is located in the large intestine, a healthy diet and frequent exercise are not the only treatments needed for this disorder. An enzyme supplement should be added to your diet. Digestive enzymes have proved to appease nasty IBS symptoms by helping your digestive tract back to its normalized state. More about how these enzymes work is written below.

Medication vs. Enzymes: What You Need To Know

Your doctor has probably outlined the kinds of medications you can take to help treat your IBS. However, many clinical studies have not concluded that medications help IBS at all.

That’s where enzymes come in. Enzymes designed to be easily digested are actually complex proteins. They work by breaking down foods so your body can use the nutrition for energy. Your pancreas has the job of creating these types of enzymes, but sometimes it needs an extra amount if your bowel is having severe problems.

Just like you should be well-versed on the medications you take, so, too should you be on the quality of the digestive enzymes you may take. Anti-inflammatory ingredients like peppermint oil and turmeric help soothe irritated abdominal organs, while the enzymes work to relieve unpleasant symptoms like uncomfortable bowel movements, gas and bloating.

3 Ways Digestive Enzymes Help Your Digestion

IBS is triggered by your diet. If you eat something that causes a flare-up or have a poor diet that is causing intestinal distress, taking a digestive enzyme can treat both your pain and stabilize the enzymes in your gut to prevent further troubles in the future.

Three things digestive enzymes help you are:

maintain a healthy digestive tract
break down fats, protein, and carbs for nutrient absorption
reduce bloating, gas and cramping after eating

All three of these functions do not function normally if you suffer from IBS or any of its symptoms. And all three of these can be assisted by an influx of enzymes. If you eat some food and get food poisoning, your digestive tract may be out of commission for a few days, but then go back to normal. However, this doesn’t happen with IBS: flare-ups and painful cramps happen all the time and do not go away.

The same thing is to be said of nutrient absorption. If your stomach doesn’t have the correct amount and type of enzymes, nutrients will not be efficiently absorbed and used by your body. That’s where digestive enzymes come in: they can maintain a healthy balance of enzymes while reducing IBS symptoms like bloating.

Can Yoga Help Soothe IBS?

IBS is a bowel syndrome located in your large intestine. Symptoms include stomach cramps, gas, diarrhea and constipation. It actually affects 25 to 45 million Americans, a much higher number than you’d think. It is most commonly found in women, especially those between their 20’s to 40’s. Although it is not life-threatening, it is a painful condition and has no known cure. IBS also increases the likelihood of getting colon disorders such as ulcerative colitis, Crohn’s disease or even colon cancer. This disorder can be managed by a healthy diet, exercise and medication.

Fast cardio and weight lifting are great forms of exercise, but not if you have an upset stomach to think about. Instead, light cardio is preferred, including aerobics and of course yoga.

The Benefits of Yoga

Yoga is a kind of exercise that originated in ancient India. It involves many different poses and holds to stretch your body, speed up your heart rate, and increase your blood flow to your internal organs. Therefore, many poses help ease digestion, diminish cramps and bloating, and even help relieve constipation.

Yoga is especially useful in decreasing IBS symptoms: it is a light aerobic exercise that doesn’t include jarring poses and sweat-soaked workouts. It doesn’t push you past your limit and allows you to center yourself with special breathing techniques, which help both relieve stress that IBS brings with it while easing IBS symptoms. Please note that some poses are not beneficial to you if you have loose bowels, so if you have diarrhea, you can skip those poses.

Pose 1: Half Seated Twist

This pose is also known as the Half Lord of the Fishes. Twists bend the spine and help blood reach the intestines, helping digestions. It also assists liver and kidney function. If you are experiencing loose bowels, do not go into the twist as deeply.

Pose 2: Wind-Relieving Pose

Yes, this is an actual pose, and you may consider doing this pose in your own privacy. By clutching your knees to your stomach, gasses stored in your intestines are helped to be released. This pose is especially helpful with stomach cramps and pain associated with IBS. It also can reduce bloating after holding this pose for several minutes. Lying on your back helps deliver blood to the kidneys, increasing their functionality. This can lead to relief in reduction of stomach acid and indigestion.

Pose 3: Cobra

This pose does two things: it tones the muscles of your stomach while relieving any stress that you keep in your back and shoulder blades. Lying on your stomach is said to stimulate the blood flow in your abdominal organs.

Pose 4: Gate Pose

Get on your feet and try your hand at the Gate Pose. This pose stretches your abdominal muscles as well as concentrating your weight on your hips, which doesn’t strain your stomach too badly.

Using Turmeric To Treat IBS

IBS, or Irritable Bowel Syndrome, is a common disorder in the large intestine. Symptoms of IBS are diarrhea, constipation, bloating and stomach cramps. IBS can be treated but so far there is no cure for it. IBS can be maintained by a healthy diet and certain medications. A supplement of turmeric is a great way to diminish pain symptoms and other digestive issues that crop up with IBS. Keep in mind that a supplement is just that – a supplement – and in no way can replace a full treatment for IBS. However, there are so many benefits that turmeric provides to the body that it is hard to find any negatives to say about it.

What’s So Great About Turmeric?

Turmeric has been used a supplement for a long time, especially in Indian and Chinese cultures, used both as a spice and as a medicine. Its rich yellow color and pungent smell are easy to recognize. A supplement can be added to your daily nutrition intake to help ease pain and quicken digestion. Studies have shown turmeric can appease unpleasant IBS symptoms such as diarrhea, because it assists the bowel is working well and not be inflamed due to illness.

Turmeric was tested to see if it helps mitigate mood disorders or mental illnesses, like depression, stress, and anxiety. Although this has only been tested on animals, rats who took turmeric showed improvement in their mood and acted much less stressed than the control group. There are strong links from the conclusion of these studies to show that turmeric increases the function of neurotransmitters.

How Do I Know If I Have IBS?

Diagnosing IBS is difficult because there are various symptoms that are sometimes complete opposites. For instance, IBS symptoms include diarrhea and constipation, or a combination of both. The difference between having just one of these symptoms during the bout of the flu and having IBS is the continuation of symptoms over a long period of time, from 6 months to a year. IBS luckily does not do any lasting damage to the organs, but it can cause so much pain and discomfort that can seriously impact your quality of life.

How Much Tumeric Is Too Much?

Turmeric capsules that are high quality should have at least 1,000 mg and should also contain BioPerine, or piperine, which helps your digestive system process turmeric faster. Piperine is an extract made from black pepper, and a turmeric supplement must contain at least 20 mg of BioPerine in order to work properly.

You should not take more than 2,000 mg of turmeric a day. There are many side effects to turmeric, like nausea, dizziness, and hematoma. Ask your doctor to see how turmeric can help in your digestive system.

Turmeric Summed Up

IBS is a difficult disorder to live with, making your life unpleasant and sometimes unmanageable when trying to plan trips. However, there are many ways to help treat this condition to make your digestive system work normally again. IBS can be treated with certain medications, a healthy, balanced diet, and some studies have shown turmeric is a great supplement to decrease unpleasant symptoms.

Typical Foods To Avoid With IBS

Irritable Bowel Syndrome or IBS is a disorder that affects the large intestine. Symptoms include cramping, abdominal pain, bloating, gas, diarrhea and/or constipation. It is estimated that 10-15 percent of the American population is suffering from some degree of IBS but only a fraction will be diagnosed with the disease. Many will resort to medications to manage their symptoms but it is possible to get IBS under control through diet. Continue reading to learn tips on what foods to avoid if you have been experiencing symptoms of IBS.

Foods to Avoid

– comes from milk and any other dairy products like cheese, ice cream, pudding, and coffee. Humans are the only species that are able to digest milk after infancy although most humans are not able. The issue with lactose intolerance is not that a person is allergic to dairy, rather their immune system does not respond to the milk. The person is unable to digest lactose. It is a genetic mutation that any person is able to digest dairy after infancy. The body stops producing the enzyme that digests lactose, lactase, usually between the ages of two and five. Undigested sugars wind up in the color where they begin to ferment and subsequently produce gas that causes gas, bloating, diarrhea and nausea. If you are suffering from IBS, eating dairy can amplify and worsen your symptoms. Lactose is one of the first foods that doctors will recommend cutting out from a diet for a person suffering from IBS.

Eat Instead: With veganism rates steadily increasing across America, there are a variety of soy based cheeses, milks and ice cream that can make it easier to transition to a dairy-free diet.

– fructose malabsorption is a digestive disorder in which a person does not have the required fructose carriers in the small intestines to properly absorb fructose. Symptoms are similar to general IBS symptoms like gas, bloating, diarrhea and/or constipation. Fructose levels are high in fruits like apples, pear, watermelon, dried fruits and fruit juices.

Eat Instead: Replace high fructose fruits with lower ones like bananas, cantaloupe, grapes, lemons, strawberry, and blueberry.

Legumes and Beans – are harder to digest because they contain carbohydrates called oligosaccharides which are a type of sugar that is not absorbed well by the body. They require an enzyme called alpha-galactosidase that will help break them down so that they can get absorbed. Many people do not produce enough of this enzyme which means that the sugar are left in undigested and available in the intestine to become infested with bacteria. This can cause symptoms like bloating, gas and abdominal pain. People with IBS do not produce enough alpha-galactosidase enzyme which can make it especially hard to digest beans and will cause their digestive tract to be launched into distress.

Eat Instead: There are not many legume replacements that are recommended for people suffering from IBS. It is often best to avoid eating them altogether.

If you have not yet been diagnosed by your doctor with IBS but you relate with many symptoms, make sure to set up an appointment with your doctor to rule out other possible digestive abnormalities and to get an official diagnosis. Consider talking to your doctor about making changes in your diet in order to naturally get your symptoms under control.

Top 3 IBS Diets

IBS, or Irritable Bowel Syndrome, is an unpleasant syndrome that affects the bowels. Symptoms of IBS involve uncomfortable fluctuations in the gut, resulting in diarrhea or constipation, depending on the type of IBS. It is common to have cramps and abdominal pain, which could make your daily life unbearable.

Although there are medications on the market to help manage your IBS, finding a diet that soothes your digestive tract is equally worthy of improving your quality of life. Many foods irritate the gut and you’ll be surprised to see the results when you eliminate high-fat or fried foods from your diet.

1. The Low-Fiber Diet

This diet helps treats symptoms like gas and diarrhea. You may have heard of a high-fiber diet for people with IBS, but the low-fiber diet is also worth mentioning. Before erasing all sources of fiber from your diet, eating soluble fiber, or fiber that absorbs water, can help with digestion. You should eat soluble fiber in favor of insoluble fiber. Soluble fiber is in foods like apples, blueberries, oatmeal, beans, and nuts.

Low-fiber diets stress the importance of avoiding fruits, vegetables, and even dairy. If you also are lactose-intolerant, substituting milk in favor of rice or soy will help diminish gas and diarrhea. You also should check food labels on certain products, such as yogurt, cereal and some drinks have added fiber. Foods with 1 gram or less of fiber are appropriate.

2. The Gluten-Free Diet

Gluten is a protein that allows flour to have a stretchy texture and helps it stick together. It can be found in many grains such as wheat, barley, spelt and rye. Gluten actually damages intestines for people with celiac disease or people who are incapable of digesting gluten. People who are sensitive or intolerant to gluten also have IBS symptoms. To reduce symptoms, sticking to a gluten-free diet is advisable.

Instead of eating bread, you can feel full after eating lentils or quinoa as a staple. Rice is a very common grain that does not contain any gluten. Some pastas and breads with little or no gluten are on the market and replace gluten with oat, rice or almond flour.

3. The Low-Fat Diet

Foods that are high in fat are usually low in fiber, which causes problems with people suffering from constipation. Fatty foods particularly worsen the IBS symptoms of both constipation and diarrhea. High-fat foods include fried food, sugary treats, and cream. Instead of indulging in a big plate of nachos or gulping down a milkshake, increasing your consumption of lean meat, fruits, vegetables and whole grains can help keep your digestion functioning normally.

Wrapping Up

There are three reliable, specific diets outline above. The combined nutrients with the foods specifically targeting vital intestinal functioning will help you live your best life pain-free. Nothing is worse than your bowels obstructing your day and impeding you from normal functions because of pain and uncomfortable bowel movements. While medication is a surefire way to manage IBS, sticking to a diet that best suits you can ease your worries of IBS symptoms.

Can Eating Yogurt Help IBS?

IBS or Irritable Bowel Syndrome is estimated to affect anywhere from 10 to 15 percent of the American population but only a fraction will seek a diagnosis or treatment. The exact cause of IBS is unknown but it is a disorder that affects the large intestine, also known as the colon. Researchers suspect that it may be caused by faulty communication between the brain and intestinal tract. IBS occurs when muscles lining the small intestine do not contract and relax in a coordinated manner. Symptoms include stomach pain and cramping, constipation, diarrhea, gas, bloating, food intolerance, changes in bowel movements and depression. Some will find that changing their diet will help manage their diet but many will take medication to get their symptoms under control. Recently, studies have shown that eating yogurt that has probiotics can possibly help get symptoms of IBS under control. Continue reading to learn more.

What are Probiotics?

Although bacteria have often been associated with being detrimental to your health, probiotics are a type live “good” bacteria and yeast that are good for you health, especially your digestive system. Probiotics are thought to keep you healthy by replacing the “good” bacteria in your body. This is especially important after taking antibiotics, as probiotics can help replace them. They can also help restore a balance to your digestive tract by balancing your “good” and “bad” bacteria. There are two main types of probiotics, Lactobacillus and Bifidobacterium. Lactobacillus is the more common type of probiotic that can help people with diarrhea and people who are lactose intolerant. You can find the min yogurts. Bifidobacterium is found in dairy products and are believed to help ease symptoms of IBS. Research also indicates that taking probiotics may also be helpful for skin conditions, urinary and vaginal health, oral health, allergies, and colds.

How Can Eating Yogurt Help?

A study done in which patients consumed a probiotic yogurt every day for four showed that stomach distention was reduced by up to 78 percent in 34 women. The study also showed that patients who ate yogurt with probiotics had improved gastrointestinal transit time. Patients also reported experiencing relief from abdominal pain and cramping. The yogurt contains Bifidobacterium Lactis which is a bacteria that supports stomach health. It can be found in various yogurt brands across the market. You can identify yogurts containing probiotics by their seal. In order to obtain this seal, a manufacturer must provide evidence that their product contains at least 100 million CGU per gram.

The bottom line regarding whether or not yogurt can be beneficial for someone with IBS is that it depends on each individual. Research has indicated that having probiotic yogurt can decrease symptoms of IBS and can improve overall digestion but because every person can have individual triggers and reactions to different foods, the results can vary according to each person. If you are suffering from IBS but are not triggered by eating dairy, trying a probiotic yogurt is definitely worth it exploring. Talk to your doctor about making a plan to get your IBS symptoms under control.

What Is IBS?

Irritable Bowel Syndrome also known as spastic colon, irritable colon, mucous colitis and spastic colon is a group of intestinal symptoms that generally occur together. Symptoms can vary from person to person but in order to be classified as IBS they must last for at least three months with at least three days per month. Although IBS can cause intestinal damage, it is rare and it cannot increase your risk of gastrointestinal cancers. This syndrome is estimated to affect three to twenty percent of Americans, most of them being women, although the reason for this is not known. This article is going to take a closer look at IBS to learn everything you need to know about this syndrome and how to manage it.

Symptoms of IBS in Men and Women

General symptoms of IBS in men and women generally include cramping, abdominal pain, gas and bloating, constipation and/or diarrhea. The degrees of each symptom can vary in severity and how long they last. Symptoms are not always persistent. They can go away for a while then suddenly reappear in full force. For women, symptoms will generally occur around the time of menstruation. Pregnant women also report increased symptoms throughout pregnancy. Men have similar symptoms as women although fewer men will report their symptoms or get treatment.

At Home Treatment for IBS

Although there is no known cure for IBS, there are various things you can try to improve your symptoms. Patients experiencing IBS have reported that maintaining a regular exercise routine has helped regulate their digestive system and has reduce their symptoms. Other practices that patients with IBS have reported to help alleviate symptoms include:

Cutting out caffeinated beverages that irritate the intestines.
Eating smaller, frequent meals.
Cutting out spicy and fried foods.
Reducing stress.
Taking probiotics.

Talk to your doctor about the best route of treatment for you.

Foods to Avoid With IBS

Dairy – humans are the only species that consume milk past infancy. It is a genetic mutation that humans are able to digest dairy passed the age of five, although many are not able. Eating dairy can amplify symptoms of IBS in patients who have been diagnosed with it. Lactose is often the first food group that doctors recommend cutting out if you are experiencing IBS. With veganism on the rise, there are many dairy alternatives available on the market.
Beans and Legumes – contain carbohydrates that are harder to digest because the type of sugar is not absorbed easily by the body. Many people do not produce enough of the enzyme needed to digest beans which means they will oftentimes be left in the intestines to rot and be overcome with bacteria which can launch the digestive tract into distress.
Fructose – fructose malabsorption is a digestive disorder in which a person does not have the necessary fructose carries to properly absorb fructose. Fruits with high levels of fructose include apples, pears, watermelon, fruit juice and dried fruits. Good, lower fructose fruits include fruits like bananas blueberries, strawberries, grapes and cantaloupe.

If you can relate to the symptoms of IBS, make sure to schedule an appointment with your doctor to verify the diagnosis and to come up with a good plan to get your symptoms under control.