Irritable Bowel Syndrome (IBS) and the Symptoms That Come Along With It
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Key Facts
- IBS is a chronic gut disorder with discomfort and bowel changes, but no visible damage.
- IBS is categorized by bowel habits: constipation (IBS-C), diarrhea (IBS-D), mixed (IBS-M), and post-infectious.
- IBS involves a “brain-gut axis” problem, with disrupted communication between the brain and gut.
- IBS is diagnosed using Rome criteria and by ruling out other conditions.
- IBS treatment is personalized and includes diet, medication, therapy, and lifestyle changes.
Imagine waking up with abdominal pain or having your day ruined by unpredictable bowel habits. For millions of people worldwide, this isn’t just hypothetical – it’s their daily reality of living with Irritable Bowel Syndrome (IBS). Affecting around 5-10% of people globally (some estimates even higher at 9-23%) [6] [8], IBS isn’t life threatening but it can certainly turn your life upside down.
Table of Contents
- What is Irritable Bowel Syndrome (IBS)?
- What’s Happening in Your Body?
- Diagnosing IBS: What to Expect
- Risk Factors
- Treatment Options
- Living with IBS
- Closing Thoughts
- References
What is Irritable Bowel Syndrome (IBS)?
IBS is a chronic gastrointestinal disorder that affects the large intestine, causing abdominal discomfort and changes in bowel habits. Unlike other gut related conditions, IBS doesn’t cause visible damage or inflammation in the digestive system. Instead it affects how your intestines function, leading to abdominal pain and changes in bowel movements, such as diarrhea, constipation or a mix of both [1].
Types of IBS
Doctors classify IBS into different types based on your bowel habits:
- IBS-C: Mainly constipation.
- IBS-D: Mainly diarrhea.
- IBS-M: A combination of both.
- Post-Infectious IBS: Occurs after a severe intestinal infection.
Knowing your IBS type helps your healthcare provider choose the right treatment for you, especially if you mistakenly assume that it can be somehing different like Small Intestinal Bacterial Overgrowth (SIBO) and Small Bowel Obstruction.
IBS Signs could include:
- Abdominal Pain: Central symptom, relieved after going to the bathroom.
- Bowel Habit Changes: Constipation, diarrhea or sometimes both.
- Symptoms Come and Go: IBS has periods of flare ups followed by calm phases [1].
- Other Symptoms: Bloating and gas may accompany IBS and healthcare professionals consider these when diagnosing and managing the condition.
What’s Happening in Your Body?
IBS is often described as a problem with the “brain-gut axis” and the gastrointestinal tract. Essentially your brain and gut are constantly communicating. With IBS this communication gets a little mixed up. Several factors contribute to this disruption:
- Gut Microbiome Changes: Imbalances in good and bad bacteria in your gut.
- Increased Intestinal Permeability: Also known as “leaky gut” where your intestines become overly sensitive and reactive.
- Altered Brain-Gut Signals: Stress and emotions strongly impact how your gut behaves [4], [7].
Rather than one single issue, IBS is a combination of symptoms caused by multiple factors, making it tricky but manageable [4]. The Rome IV criteria are used to diagnose IBS based on specific symptoms.
Diagnosing IBS: What to Expect
Doctors use specific criteria called “Rome criteria” to diagnose IBS. According to these criteria, your doctor will look for:
- Repeated episodes of abdominal pain.
- Changes in stool appearance or how often you go to the bathroom.
Before officially diagnosing IBS, your doctor will rule out other digestive conditions to ensure the correct diagnosis [5], [6]. This process often includes laboratory tests and imaging tests, although there is no specific test to diagnose IBS. Doctors will also rule out other serious diseases such as inflammatory bowel disease and colon cancer to ensure a comprehensive evaluation.
Diagnostic Tests and Procedures
Diagnosing IBS can be challenging as there is no definitive test to diagnose the condition. A healthcare professional will start with a complete medical history and physical exam to rule out other conditions such as celiac disease, inflammatory bowel disease (IBD) and colon cancer. Diagnostic tests and procedures may include endoscopy, colonoscopy, X-rays, CT scans, blood tests, stool tests and urine tests.
The goal of these tests is to rule out other conditions that may be causing the symptoms, not to diagnose IBS directly. A diagnosis of IBS is made based on the presence of specific symptoms such as abdominal pain or discomfort associated with a change in bowel habits and the absence of other conditions that may be causing the symptoms.
Risk Factors
Several factors can increase your chances of developing IBS:
- Stress and Mental Health: Anxiety and depression often accompany IBS.
- Past Infections: Some people develop IBS symptoms after recovering from a gastrointestinal infection.
- Genetics: IBS sometimes runs in families.
- Dietary Triggers: Certain foods can irritate your gut and worsen symptoms.
- Family History: A family history of inflammatory bowel disease can be a factor in the diagnosis of IBS. These symptoms can range from mildly annoying to severely impacting your daily life, making everyday activities difficult and affecting your emotional well-being [2], [3].
Treatment Options
Since IBS symptoms vary from person to person, treatment plans are highly individualized. Effective management usually combines:
- Dietary Changes: Many find relief by following a low-FODMAP diet which limits certain carbohydrates that trigger symptoms. Making diet changes under the guidance of a healthcare professional, especially a dietitian, is crucial in managing symptoms.
- Medication: Depending on your IBS type, medication might include laxatives for constipation or antidiarrheals. Certain medications like tricyclic antidepressants can help reduce pain associated with IBS.
- Psychological Therapies: Techniques like Cognitive Behavioral Therapy (CBT) can significantly reduce symptoms by addressing stress and anxiety.
- Lifestyle Changes: Simple practices like regular exercise, proper sleep routines and mindfulness exercises can make a big difference.
The goal is to find a balanced approach that suits you, improving overall comfort and life quality. The aim of treatment is to improve symptoms and quality of life.
Alternative Medicine and IBS
Alternative medicine and therapies like acupuncture, herbal supplements and mind-body therapies may be used to manage IBS symptoms. Some people with IBS find that alternative therapies like probiotics, peppermint oil and relaxation techniques help reduce symptoms and improve quality of life.
However, it’s essential to talk to a healthcare professional before starting any alternative therapies as some may interact with other medications or have side effects. A low FODMAP diet which involves limiting certain types of carbohydrates may also be recommended to manage IBS symptoms. Certain probiotics like Bifidobacterium and Lactobacillus may also help reduce IBS symptoms.
Living with IBS
IBS is frustrating but it doesn’t have to control your life. IBS patients experience a range of symptoms that can vary in severity. Understanding the gut-brain connection, managing stress, watching your diet and staying active can reduce symptoms. More targeted therapies are evolving as researchers dig deeper into IBS, giving hope to millions who live with this challenging but manageable condition.
Many patients report having family members with similar symptoms, so there may be a genetic link. By working with healthcare professionals and following evidence-based approaches, many people find significant relief and regain control of their daily lives.
IBS and Mental Health
IBS is often associated with mental health conditions like anxiety, depression and stress. People with IBS are more likely to experience mental health issues and vice versa. The gut-brain axis, which is the communication network between the gut and the brain, plays a key role in the development and management of IBS symptoms.
Stress, emotional abuse and other mental health factors can trigger IBS symptoms so it’s essential to address mental health issues as part of IBS treatment. Cognitive-behavioral therapy (CBT), mindfulness-based stress reduction and other therapies may be recommended to manage stress and anxiety associated with IBS.
Closing Thoughts
Remember, you are not alone in your journey with IBS. Numerous resources, support groups, and educational programs are available to provide guidance and assistance. By collaborating with healthcare professionals and actively seeking out the latest research and treatment options, individuals with IBS can effectively manage their symptoms, enhance their quality of life, and regain control over their health and well-being.
References
[1] Ford, A. C., Sperber, A. D., Corsetti, M., & Camilleri, M. (2020). Irritable bowel syndrome. Lancet (London, England), 396(10263), 1675–1688. https://doi.org/10.1016/S0140-6736(20)31548-8
[2] Silva, A. C., Pimenta, M., & Guimarães, L. S. (2009). Small bowel obstruction: what to look for. Radiographics : a review publication of the Radiological Society of North America, Inc, 29(2), 423–439. https://doi.org/10.1148/rg.292085514
[3] Bower, K. L., Lollar, D. I., Williams, S. L., Adkins, F. C., Luyimbazi, D. T., & Bower, C. E. (2018). Small Bowel Obstruction. The Surgical clinics of North America, 98(5), 945–971. https://doi.org/10.1016/j.suc.2018.05.007
[4] Tong, J. W. V., Lingam, P., & Shelat, V. G. (2020). Adhesive small bowel obstruction - an update. Acute medicine & surgery, 7(1), e587. https://doi.org/10.1002/ams2.587
[5] Rami Reddy, S. R., & Cappell, M. S. (2017). A Systematic Review of the Clinical Presentation, Diagnosis, and Treatment of Small Bowel Obstruction. Current gastroenterology reports, 19(6), 28. https://doi.org/10.1007/s11894-017-0566-9
[6] Azagury, D., Liu, R. C., Morgan, A., & Spain, D. A. (2015). Small bowel obstruction: A practical step-by-step evidence-based approach to evaluation, decision making, and management. The journal of trauma and acute care surgery, 79(4), 661–668. https://doi.org/10.1097/TA.0000000000000824
[7] Tai, F. W. D., & Sidhu, R. (2023). Small bowel obstruction: what a gastroenterologist needs to know. Current opinion in gastroenterology, 39(3), 234–241. https://doi.org/10.1097/MOG.0000000000000924
[8] Aka, A. A., Wright, J. P., & DeBeche-Adams, T. (2021). Small Bowel Obstruction. Clinics in colon and rectal surgery, 34(4), 219–226. https://doi.org/10.1055/s-0041-1725204
[9] Cappell, M. S., & Batke, M. (2008). Mechanical obstruction of the small bowel and colon. The Medical clinics of North America, 92(3), 575–viii. https://doi.org/10.1016/j.mcna.2008.01.003
