FRIDAY, Oct. 22, 2004 (HealthDayNews) -- Pushing through the pain while starring in movies and hit TV series such as Moonlighting, actress and singer Cybill Shepherd said that for more than 20 years she suffered from chronic constipation, bloating and abdominal discomfort.
"I kept it a secret because I didn't want it to interfere with my work -- and I made sure it didn't interfere with my work," she said.
Equally frustrating was the fact that "all the doctors told me that it was in my mind -- a psychological or emotional thing," said Shepherd, 54.
She tried fiber supplements and over-the-counter laxatives, without relief. The worst part of her long struggle, she said, was how it impacted on time spent with her family.
"I felt that when I wasn't working that I should rest," Shepherd explained. "So it mostly affected the time spent with my children -- I could have had a much more active, fun time."
Six months ago Shepherd switched to a new doctor, who diagnosed irritable bowel symptom (IBS) with constipation. She said she's now taking the only FDA-approved drug for use in patients with IBS with constipation, Zelnorm.
"It's really helped me," she said.
Emboldened by her experience, Shepherd has now joined with the nonprofit National Women's Health Resource Center and Novartis Pharmaceuticals (the maker of Zelnorm) as a spokeswoman for their Amazing Women Campaign. The campaign is aimed at raising awareness about IBS with constipation.
According to expert Dr. Susan Lucak, a consultant with the campaign, IBS is "the most common gastrointestinal disorder in the U.S., affecting one in every five Americans."
IBS with constipation is a major subset of the disease, affecting an estimated 6 million American women, most of whom may still be undiagnosed, according to experts. Women make up 70 percent of all IBS with constipation patients, Lucak said.
"The precise cause of the disorder is not known," she said. "However, the consensus among experts is that the gastrointestinal tract does not work as quickly -- it's too slow, and too sensitive," resulting in recurrent constipation, bloating and abdominal pain that can last for years.
For years, "most people thought it was caused by diet or stress, and that's really the big issue behind why people don't come forward," Lucak said. "They think it's something they are eating, or that they're stressed, so they don't go see a doctor."
But Lucak, a faculty member at New York's Columbia Presbyterian Medical Center, said stress may exacerbate IBS, but probably doesn't cause it.
"There are a lot of people who are stressed, but they don't have these GI symptoms," she pointed out.
That's why she and Shepherd are urging individuals with classic symptoms of IBS with constipation to go to their doctors for a proper diagnosis. Those symptoms are "a combination of those three things -- constipation, abdominal discomfort and bloating," Shepherd said. "That's how you know you might have it. But you really have to go to your doctor."
In the past, there was no FDA-approved medication to ease this type of IBS, Lucak said, but Zelnorm does appear effective for many patients. The drug works by re-setting the balance of serotonin within the enteric nervous system -- a kind of abdominal "mini-brain" that seems to govern gastrointestinal activity.
"We're gaining a greater understanding that IBS with constipation has to do with the functioning of this nervous system of the gut," Lucak said.
Diagnosis of IBS usually involves blood and stool tests to rule out conditions such as Crohn's disease or celiac disease, as well as a sigmoidoscopy or colonoscopy to rule out colon cancer, she said.
Shepherd said shame may be another factor keeping many American women from a proper diagnosis. She sees her work with Amazing Women as typical of her attitude to matters concerning women's health.
Bowel symptoms remain "one of those unmentionables," Shepherd said. "Even to say 'constipation,' it's embarrassing. But I've long worked at being an advocate for women's health, talking about our reproductive freedom and marching in Washington, helping to bring menopause out of the closet -- even writing a song about it."
She's been hard at work on stage, too. The four-time Golden Globe winner just finished the London run of her one-woman show, Cybill Disobedience , and Shepherd says she plans to re-create the show on the New York stage "in six or seven months."
Right now, though, she said she's busy passing on the lessons of her own long, tough experience with IBS to other American women.
"I just have a feeling that I have a responsibility to give back, to speak up," Shepherd said. "I figure that if I can speak up about this, then I can encourage other women to speak up, too, so they don't have to suffer in silence."
More information
To learn more about IBS, check out the National Digestive Diseases Information Clearinghouse.
