context: Irritable bowel syndrome ( IBS) is especially hard on people at work, but there are ways to cope. Even getting ready to go to work can be hard for people who have some types of IBS. It's not unusual for people with IBS to have four to five bowel movements before they leave the house, says Jeffrey Roberts, founder of the IBS Patient Support Group. The group has thousands of active members online. " We have seen people who've stopped working, because they can't cope with getting ready in the morning, leaving, and having that uneasy feeling of having to deal with (symptoms)," says Roberts. Leaving the working world is just one of the things people with IBS do because of their disorder. They often miss or are late for work, school, and other activities. The direct and indirect cost of irritable bowel syndrome in the U. S. has been estimated at between at about $1.5 billion each year. The numbers alone are staggering. And numbers cannot even begin to quantify the cost of human suffering and damage to relationships. To reduce your own potential economic loss, Roberts suggests giving yourself time to prepare for work. He has IBS, and gives himself at least two hours to get ready in the morning. Once at work, he does the best he can to deal with IBS symptoms. " I roll with the punches," says Roberts. " My IBS is quite severe. I deal with it with some medications, but I also deal with it by realizing that I'm going to have some bad times, and I'm going to have some good times." It may help to talk with a trusted and sympathetic co-worker or boss about your IBS. " Most people are very supportive," says Lynn Jacks, founder of an IBS support group in Summit, N. J. She suggests being honest with your supervisor. Let your supervisor know you have IBS without giving too many personal details. This may mean explaining IBS and its symptoms. It's also important to let your manager know that while you don't always have control over IBS symptoms, you are a dedicated worker and will deal with the situation accordingly, says Roberts. Let them know that symptoms may force you to leave a meeting or go to the bathroom often, but that you'll be able to do your job after the pain and discomfort subsides. If your supervisor isn't sympathetic, you may want to ask your doctor to write a note explaining that IBS is a real illness, and that certain symptoms may occur. Once IBS symptoms do flare up at work, little can be done except to bear through the discomfort and pain. Deep breathing and walking around may help during episodes of pain. But experts say the best way to deal with IBS at work is to try to prevent symptoms. Your doctor may prescribe medicine to prevent IBS symptoms. Some drugs may take a few weeks to take full effect. Jacks suggests regular exercise. " Working out on a regular basis releases tension," she says. Also, she notes that physical activity can help tone intestine muscles. Roberts recommends behavioral therapy for IBS, which could include hypnotherapy, psychotherapy, and relaxation techniques. Other strategies that may help prevent flare-ups of IBS symptoms at work include: Changes in your diet Stress management Acupuncture and other alternative therapies Talk with a doctor about which IBS prevention and treatment strategies may work best for you.