Understanding IBS: Unraveling the Enigma
Irritable bowel syndrome (IBS) is a chronic and debilitating functional gastrointestinal disorder that affects 9%-23% of the population across the world (World Gastroenterology Organization, 2009).
Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction (previously referred to as a functional gastrointestinal disorder), characterised by abdominal pain associated with a change in frequency or form of bowel habit (Farmer et al., 2020). It remains a common gastrointestinal disorder encountered by clinicians in both primary and secondary care settings. As we delve into this perplexing condition, we uncover a fascinating aspect known as the gut-brain axis, revealing how emotions, anxiety levels, and environmental influences can profoundly impact IBS symptoms (Farmer et al., 2020). Not just dietary choices.
'Unravelling the Symptoms'.
IBS presents diverse symptoms that significantly impact daily life. One of its hallmark symptoms is abdominal pain or discomfort, often described as crampy or sharp, predominantly felt in the lower abdomen.
Patients report the most distressing symptoms to be abdominal pain, straining, myalgias (muscle pain), urgency, bloating and feelings of serious illness (Saha, 2014).
The intensity of the pain may vary, ranging from mild to severe, and it may be relieved or temporarily alleviated after a bowel movement.
Altered Bowel Habits:
IBS can significantly affect bowel habits, leading to changes in the frequency and consistency of stools. The following subtypes of IBS are recognised based on these changes:
01
IBS with Constipation (IBS-C):
Individuals with IBS-C experience infrequent bowel movements and may have difficulty passing stools. Stools may be hard and lumpy.
02
IBS with Diarrhoea (IBS-D):
IBS-D is characterized by frequent and loose stools. Individuals with IBS-D may experience a sudden and urgent need to use the bathroom.
03
Mixed IBS (IBS-M):
This subtype involves a combination of both constipation and diarrhoea. Bowel habits may alternate between the two, leading to unpredictable patterns.
04
IBS with Alternating Symptoms (IBS-A):
This is the newest subtype of irritable bowel syndrome (IBS), which involves a fluctuating combination of both constipation and diarrhoea. Bowel habits may alternate between the two, leading to varying and unpredictable patterns.
Other Common Symptoms Include:
Bloating and Excessive Gas: Many individuals with IBS experience bloating, a sensation of increased abdominal fullness or swelling, often accompanied by excessive gas, leading to flatulence (passing gas) or belching. Many describe themselves as looking pregnant when not.
The Diagnosis Dilemma
Diagnosing IBS involves evaluating specific symptoms since no definitive diagnostic tests exist. The World Health Organization (WHO) defines IBS as a functional gastrointestinal disorder characterised by abdominal pain or discomfort associated with defecation or changes in bowel habits. This means that individuals may receive an IBS diagnosis if they experience abdominal pain or discomfort related to bowel movements, occurring for at least three days per month, for a minimum of three months, with the symptoms starting at least six months before diagnosis.
It’s important to note that the severity and combination of symptoms can vary greatly among individuals with IBS. Some individuals may experience mild symptoms that are easily manageable, while others may have more severe symptoms that significantly impact their daily lives.
The precise cause of IBS remains a mystery, yet researchers suggest that various factors play a role in its development:
1. Changes in Gut Sensitivity: People with IBS may have heightened sensitivity to certain stimuli in the gut, such as gas or stool, which can trigger pain or discomfort.
2. Microbial Imbalances:
An imbalance of bacteria in the gut, commonly known as dysbiosis, may contribute to the development of IBS symptoms. The gut microbiome plays a crucial role in digestive health.
3. Abnormal Gastrointestinal (GI) Motility:
People with IBS may experience altered GI motility, causing the muscles of the intestines to contract differently, leading to symptoms like diarrhoea or constipation. This is the text area for this paragraph. To change it, simply click here and start typing.
4. Intestinal Inflammation: Some studies suggest that low-grade inflammation in the intestines may play a role in IBS, although more research is needed to fully understand its significance.
Remember, although there’s no known cure for IBS, many who have worked with me have gained control over their IBS rather than letting it dictate their lives. Understanding triggers is key.
Treatment Options for IBS
While there is currently no cure for IBS, various treatment options can help manage the symptoms and improve the quality of life for those affected. The approach to treatment typically involves a combination of lifestyle modifications, dietary changes, and medical interventions:
Lifestyle Modifications:
– Stress Management: Since stress can exacerbate IBS symptoms, practising stress-reduction techniques such as meditation, deep breathing exercises, or engaging in regular physical activity can be beneficial.
– Regular Exercise: Engaging in moderate exercise, such as walking or yoga, can help regulate bowel movements and reduce symptoms of constipation.
'Understanding your IBS triggers is key'.
Many individuals have achieved control over their symptoms through personalised strategies and support. Understanding and managing triggers play a significant role in navigating the path to improved digestive health and a better quality of life.
Dietary Changes
Understanding Food Triggers:
One essential aspect of managing IBS is recognising food triggers that can exacerbate symptoms. By identifying and reducing the consumption of certain trigger foods, many individuals find relief. Common triggers to be mindful of include high FODMAP foods, such as onion and garlic, caffeinated beverages, fatty or spicy foods, alcohol, and some high-fibre foods. Although fibre may also be one of the best foods to include for your gut health, more on that on another page.
Medications:
For those with constipation-predominant IBS, fibre supplements ‘may’ help regulate bowel movements, but as noted above, it’s crucial to seek guidance from a healthcare professional, as these supplements may worsen symptoms in some individuals. Another option is antispasmodic medications, which can relax the muscles of the intestines, providing relief.
– Probiotic supplements: Certain strains of beneficial bacteria may help restore balance to the gut microbiome and alleviate IBS symptoms.
Important to note: There is a limited amount of evidence on probiotics and their strains. Fermented foods such as sauerkraut, tempeh, and yoghurt are recommended over generic probiotic supplements.
– Medications for Diarrhoea or Constipation: In certain situations, healthcare professionals may prescribe medications designed to alleviate diarrhoea or relieve constipation.
Although there is no known cure for IBS, many who have worked with me have been able to take charge of their IBS rather than being ruled by it. Understanding triggers is key.
If you have been diagnosed with IBS and are ready for a step-by-step plan to feel better, I would love to help. Click below to learn about working with me.
