ABOUT IRRITABLE BOWEL SYNDROME (IBS)​

Irritable bowel syndrome (IBS) is a disorder characterized by abdominal pain or discomfort and altered bowel habit (chronic or recurrent diarrhea, constipation, or both – either mixed or in alternation).* 

Up to 45 million people living in the United States suffer from IBS. For most people, IBS is best understood as a long-term or chronic condition (lasting more than 6 months) in which reoccurring issues with abdominal pain or discomfort associated in some way with their bowel movements. Although IBS is common, patients are often stigmatized and misunderstood, and the symptoms significantly impact their quality of life.

The causes of IBS are not completely understood. There is a tendency for the bowel to be overly reactive to various factors, like; stress, emotional arousal, GI infections, menstrual period, or gaseous distension. There are also possible factors like genetics and prior adverse life experiences (e.g., infection, trauma) that can predispose someone to get IBS. 

Your stomach’s link to the nervous system

When the digestive system is not working properly, symptoms like diarrhea, constipation, vomiting, and abdominal pain can occur. These responses all involve the actions of the enteric nervous system (ENS), which has many special features, including:   

1. Sensitivity: The ENS can sense invasive organisms like bacteria and viruses. This activates a protective response like vomiting or diarrhea. It can also sense nutrients and activate digestion.

2. Intestinal motility: The ENS processes information about nutrients and invading pathogens. This activates the appropriate gut behaviors, like mixing contents around for digestion or propelling them along the gut for elimination.

3. Secretion: This system also can activate or suppress the activities of muscles or glands in the gut.

IBS is not just a Women's issue.

Social media ads and other media outlets tend to portray IBS as a problem that only women develop. These gastrointestinal (GI) diseases and disorders affect people of all genders. The ways it manifests vary depending on biological sex and gender role. Researchers have been more likely to focus on how the condition affects women than on how it affects men. Consequently, men are often excluded from studies.4

Approximately 60% to 65% of individuals who report IBS are female. This chronic, often debilitating, functional gastrointestinal disorder shows that females with IBS experience a change in symptoms at various stages of the menstrual cycle, leading researchers to believe that there may be a hormonal link. Data also reveal an increased risk of unnecessary surgery for extra-abdominal and abdominal surgery in IBS patients. For example, hysterectomy or ovarian surgery has been reported in female patients with IBS as high as 47% to 55% and has been performed more often in the IBS patient than in comparison groups.1

Men are less likely to experience pain with IBS, and healthcare providers believe that testosterone and other androgens (male hormones) could be the cause.4 Androgens are natural steroids, and testosterone is an androgen. Research has indicated that higher levels of androgens lower a person's risk of developing a chronic pain disorder and that testosterone, in particular, may serve as a natural pain reliever. This might play into why pain is a predominant symptom of IBS in women, but not in men, and can partially explain why women report IBS symptoms more often than men. The stereotype could be an unfortunate misperception for men who may have digestive symptoms caused by IBS. Men may not get the help they might need simply because they assume that something else is going on.

*aboutIBS.org 

1 https://aboutibs.org/what-is-ibs/facts-about-ibs/statistics/

2 https://badgut.org/information-centre/a-z-digestive-topics/gender-gut/

3 Thakur ER, Gurtman MB, Keefer L, Brenner DM, Lackner JM. Representing the IBS Outcome Study Research Group. Gender differences in irritable bowel syndrome: the interpersonal connection. Neurogastroenterol Motil. 2015;27(10):1478–1486. doi:10.1111/nmo.12647

4 Kim YS, Kim N. Sex-Gender Differences in Irritable Bowel Syndrome. J Neurogastroenterol Motil. 2018;24(4):544–558. doi:10.5056/jnm18082

Living Magazine interview with Dr. Jennifer Bontreger

Top Doc, March 2022

Living Magazine interview with Dr. Jennifer Bontreger, co-owner of Southern Horizon Healthcare 

BY MEREDITH KNIGHT  

Jennifer Bontreger designed her boutique practice, Southern Horizon Healthcare, on the premise that no two patients are exactly the same. “Each is unique with their own personality, medical history, lifestyle, stresses, health concerns, opinions, preferences, and health goals,” she said. Dr. Bontreger carefully crafted an atmosphere where services are designed around each unique patient’s needs, staff is hand-selected for their patient-first philosophy, and patients never feel rushed or like their voice isn’t heard. 

“People are frustrated with no end to COVID insight,” she said. “They’re having job disruptions, relationship problems, and experiencing weight gain. They need a doctor who’ll slow down and really listen to them. When they have a question, there’s a staff member available to address it, and I try to promptly respond to emails. This practice exists for the patient, designed around their convenience, and to respond to what they’re experiencing.” 

Dr. Bontreger treats patients 13 and older with a range of orthopedic conditions and sports-related injuries. She also manages health issues including diabetes, high cholesterol, and high blood pressure, offers joint aspirations and corticosteroid injections, ankle-brachial index testing, and blood draw and testing. She also offers IV vitamin supplement to deliver specially formulated cocktails of nutrients, vitamins, electrolytes, and antioxidants to help replenish, restore, and detoxify the body, hormone-replacement therapy for men and women, and Nutrafol, an all-natural hair supplement. 

Because many patients requested it, Dr. Bontreger offers concierge care and a cash-pay plan. “Whether we’re filing insurance or not, I always try to be transparent about costs upfront,” she said. “No one should worry about finances when it comes to their health.” With dual certification in internal and sports medicine, Dr. Bontreger also serves as medical director at Integrated Medicine of North Texas and assistant professor of medicine at TCU. An avid athlete herself, she works to get patients back to the activities they love, as quickly and safely as possible. As her patients have requested, Dr. Bontreger has added aesthetic services, including chemical peels, Botox, laser hair removal, Xeomin anti-aging injections, and QWO to treat cellulite on the buttocks. She also sells ZO and PCA skincare products. 

When not on the job, she’s a wife and mother. “My husband, Robert, is an ER doctor and we’ve both worked throughout the pandemic,” she said. “Our daughter, Alyssa, is busy with swimming and dance and we’re enjoying these years we know will pass too fast.” Dr. Bontreger enjoys running, working out, painting, drawing, and traveling. She serves as team physician at Lewisville High, offers concussion management to other area schools, and sponsors local Little League teams. 

“I’ve been building up an extensive home gym and enjoying my daughter joining me in working out,” she said. “If I’m going to counsel my patients about their lifestyle, I want to practice what I preach by eating right, exercising, and managing my own stress.” She’s currently training for a half marathon.