This is an overview of irritable bowel syndrome (IBS). It is a group of symptoms that occur together that affects the stomach and intestines, called the GI/gastrointestinal tract. Symptoms include repeated abdominal pain, cramping, bloating, gas, mucus in the stool, having the feeling that you’re unable to empty your bowels after pooping, and changes in bowel movements, which may be diarrhea, constipation or both.
This is what several reliable medical institutions have written: IBS doesn’t cause tissue damage in your GI (gastrointestinal) tract or increase your risk of more serious conditions, like colon cancer. Instead, it’s a chronic (long-term) condition that needs long-term management. Experts estimate that about 10% to 15% of adults in the United States have IBS. Only about 5% to 7% see a provider and receive a diagnosis. It is the most common disease diagnosis that GI experts treat. Women are up to twice as likely to be diagnosed with IBS.
Researchers categorize IBS based on how the stools look on the days when having symptom flare-ups. Most people with IBS have normal bowel movements on some days and abnormal ones on other days. The abnormal days define the kind of IBS you have. (A) IBS with constipation (IBS-C). Most of the stool is hard and lumpy. (B) IBS with diarrhea (IBS-D). Most of the stool is loose and watery. (C) The stool with mixed bowel habits (IBS-M). There are both hard and lumpy bowel movements and loose and watery movements. The differences are important. Certain treatments only work for specific types of IBS. Symptoms of IBS can appear frequently especially during “flare-ups,” or the symptoms may go away and return other times.
Researchers don’t exactly know what causes IBS, but it is classified as a neurogastrointestinal (GI) disorder. These conditions, also called disorders of the gut-brain interaction, create a problems with how your gut and brain coordinate to help your digestive system work. Two types of “communication problems” can be: (A) Dysmotility: problems with how your GI muscles contract and move food through the colon/large intestine causing contractions, cramps and pain; (B) Visceral hypersensitivity – the person may have extra-sensitive nerves in the GI tract, with a tendency to have a lower pain tolerance than people without IBS and the digestive tract may be super sensitive to abdominal pain or discomfort. Other potential causes of IBS include: (A) Gut bacteria: Research has shown that people with IBS may have altered bacteria in their GI tract, contributing to symptoms. Studies have shown that the types and amounts of gut bacteria are different in people with IBS than in people without it. (B) Severe infections: Some people are diagnosed with IBS after a severe infection, suggesting germs may play a role, and; (C) Food intolerance: Sensitivities or allergies to certain foods may contribute to IBS.
There is no one test to “rule in” IBS. Your physician may order tests to “rule out” other GI conditions causing the bowel symptoms such as infection, food intolerance or a different digestive condition, like Inflammatory Bowel Disease. These tests may include blood tests, stool tests, hydrogen breath test – to see if you have an overgrowth of bacteria in your gut, or a food intolerance, and/or order some form of imaging – colonoscopy, flexible sigmoidoscopy, or upper endoscopy.
Your physician may have you modify your diet to help reduce flare-ups. These food changes may include: (A) Increased fiber/add a fiber supplement – especially if dealing with diarrhea. Introduce fiber slowly into your diet to give your gut time to adjust. (B) Limit dairy products – lactose intolerance is more common with people with IBS. (C) avoid gluten – people with IBS tend to be more sensitive to gluten. (D) Avoid foods that produce gas, including carbonated sodas. Even chewing gum can make you gassy. (E) Discuss with your doctor about trying the low FODMAPS diet – foods that reduce the amount of hard-to-digest carbohydrates. It recommends alternatives that allow you to get the nutrients you need while going easier on your GI tract. Some people are sensitive to certain carbohydrates such as fructose, fructans, lactose and others, known as Fodmaps – fermentable oligosaccharides, disaccharides, monosaccharides and polyols, found in certain grains, vegetables, fruits and dairy products. (F) Drink an adequate amount of fluids/water – it helps keep the GI tract lubricated and help treat/prevent constipation or dehydration if experiencing diarrhea. A suggestion: Keep a food diary noting the foods you eat to help determine which foods “trigger” IBS flare-ups.
There is no one specific therapy that works for everyone, but most people with IBS can find a treatment plan that works for them. Typical treatment options can include dietary changes, lifestyle changes, stress reduction modalities, trying to determine what are ‘triggers” for flare-ups, and as-needed medications. Many treatments options take time to work. They can help your symptoms and reduce flare-ups, but your symptoms may not go away completely.
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