Irritable bowel syndrome (IBS) is a common medical condition that is found in a large number of people. Although this condition is very common in older adults, it is also likely to affect people in younger age groups. Irritable bowel syndrome as a medical condition is known to impact as many as 25 to 45 million Americans each year. It has been observed that a large chunk of these people suffering from the condition happen to be women. People usually get affected by this condition either in their late teens or early 40s.
What is irritable bowel syndrome?
Irritable bowel syndrome is primarily a condition impacting the performance and functioning of the digestive system. While the exact cause remains unknown, it can have various symptoms for different people. There is not a specific cure for the condition, however, its symptoms can very well be managed.
Irritable bowel syndrome is caused by a functional disorder that occurs in the gut. A functional disorder indicates an issue with the functioning of a particular part of the body, which is not caused by an abnormality in the structure of the organ. Hence, irritable bowel syndrome is an upset gut with the physical parameters of the organs being in place.
Irritable bowel syndrome causes a mix of reactions that comprises of abdominal discomfort which could also come with some element of pain and serious issues with bowel habits. Both extreme conditions associated with the bowel movements i.e. passing too much or lesser than normal stools could be indicative of IBS. Irritable bowel syndrome could also include having a different form of stool which could be bothersome.
Irritable bowel syndrome is not a fatal medical condition, and it does not subject you to secondary diseases like ulcerative colitis, Crohn's disease, or colon cancer. However, in a number of people irritable bowel syndrome symptoms can last a long time, which to a large extent impacts their everyday living. People suffering from irritable bowel syndrome could miss work more often and may be incapable of keeping up with certain activities, both regular and recreational. Some people may also have brought about changes in their work life including opting for a work from home job, changing their work timings or maybe even quit working completely.
What causes IBS?
As discussed earlier, the exact cause of irritable bowel syndrome is yet ambiguous. It could be the result of over activity of one or more parts of the digestive system. During digestion, muscles and organs involved in the process contract. In case the contraction is unusual, it could cause symptoms like pain to develop. Other symptoms including constipation or loose motions are determined by the area in which the unusual contractions develop.
It is still unclear as to what could be the inherent cause of the over activity that occurs in various parts of the digestive organs. One or more of the below-mentioned factors could be contributing to the abnormal functioning:
- Over activity of muscles and nerves in the abdominal region: This could be a result of certain signals that are transmitted from the brain to the gut.
- Excessive stress or an emotionally disturbing condition could also cause this overactive behavior: A number of people suffering from irritable bowel syndrome often mention that their condition worsens when they are undergoing certain stressful events in their life.
- Food intolerance: Though this is not common, in some cases certain kinds of foods could trigger irritable bowel syndrome in some patients.
- Germs and infections affecting the gut: Irritable bowel syndrome can likely be triggered by just any infection in the gut region. In some cases the symptoms could be triggered by a digestive infection that comes with diarrhea or vomiting known as gastroenteritis. Hence, viruses and germs are likely to irritate the gut so as to result in persisting bowels.
- Being oversensitive to pain: People suffering from irritable bowel syndrome are likely to experience more pain as their abdomen expands compared to those who are not suffering from this condition.
How can irritable bowel syndrome be recognized in a person?
Symptoms like abdominal pain and discomfort are normally signs for a number of medical conditions including irritable bowel syndrome. In the case of irritable bowel syndrome, pain is not consistent and continues to come and go. The frequency and duration for which the pain lasts may vary for each episode. The pain usually settles down after one passes motions or gas. Often, people suffering from symptoms of irritable bowel syndrome describe the pain to be similar to a spasm or colic. The severity can also vary from being mild to highly intense, again depending upon each individual.
Unusual bloating and swelling of the abdomen could also occur in certain intervals. When this happens, a person may pass more gas than they usually do.
Changes in motions: In some people irritable bowel syndrome causes bouts of diarrhea, while in other people it causes severe constipation. In some people there could be alternating episodes of diarrhea and constipation.
Also, the texture of the stools may vary. Bowel movements could be hard as rocks for some people and watery stools for others. In a few cases it could even be a mix of both.
Other symptoms of irritable bowel syndrome include:
- A general feeling of being unwell
- Nausea or vomiting
- Loss of appetite
- Unexplained fatigue or tiredness
- Pain that shoots to the back
- Muscular pains and aches
- Feeling full immediately after eating even little
How is irritable bowel syndrome diagnosed?
There are no definitive tests that help in confirming the diagnosis of irritable bowel syndrome, and a doctor usually confirms the diagnosis of the condition after hearing the symptoms from the patient.
Apart from this, the doctor may suggest certain laboratory tests including a blood or stool test to rule out other underlying medical conditions like Crohn's disease, ulcerative colitis, celiac disease, cancer and other infections in the gut. The symptoms of these underlying conditions are also often confused with symptoms of irritable bowel syndrome and hence tests help in confirming the condition.
Is irritable bowel syndrome considered to be a serious condition?
Although irritable bowel syndrome is not a life-threatening medical condition, it can certainly have some complications. Some of the common complications that could occur due to irritable bowel syndrome include diarrhea and constipation, both of which are common occurrences in this condition and can sometimes result in other complications such as hemorrhoids.
People suffering from irritable bowel syndrome are suggested some dietary changes which requires them to avoid certain foods. This can lead to deficiency of certain vital nutrients and can also cause malnourishment.
The most significant complication that arises from this disease is the way it impacts the quality of a person's life. Various adjustments and changes that someone has to make because of this condition can bring on the feeling of living an unfulfilled or compromised life, which can even result in depression among some people.
Treatment of irritable bowel syndrome (IBS)
Handling IBS symptoms (irritable bowel syndrome) is done by changing your lifestyle and diet, and being equipped with adequate knowledge on the circumstances leading to this common condition.
The proper IBS diet
There is no cover-all IBS diet that caters to each person with this condition while controlling the symptoms at the same time. Your diet will vary depending on the IBS symptoms you’re experiencing, and your reaction to several types of food.
It is important to keep track of the foods that trigger the symptoms and minimizing their intake, but not avoiding them all your lifetime.
IBS patients are instructed to rework the fiber in the diet.
There are two types of fiber: soluble fiber (soluble in water) and insoluble fiber (is not soluble in water).
Foods that contain soluble fiber include:
- Fruit – including apples and bananas
- Root vegetables – such as carrots and potatoes
- Golden flax plant seeds
Foods that contain insoluble fiber include:
- Wholegrain bread
- Nuts and seeds (except golden flax plant seeds)
When it comes to diarrhea, it is vital to moderate insoluble fibers and avoid the extremely fibrous parts in fruits and vegetables.
When you experience constipation, having a larger intake of soluble fibers and more water will be helpful in managing the symptoms. Your health practitioner will advise you about what quantities and types of fibers you are most compatible with after considering your unique symptoms.
Low FODMAP (fermentable oligosaccharides polysaccharides monosaccharide and polyols) diet for IBS
A diet with low FODMAP content is usually recommended for IBS patients who develop long-lasting bloating that occurs frequently.
FODMAPs ferment faster since they are not broken down and absorbed by the gut as thoroughly as they should, causing a release of gases, leading to bloating.
A low FODMAP diet limits foods high in such carbohydrates including some fruits and vegetables or wheat by-products. Such a diet can only be undertaken under the supervision of a dietitian so as to keep it healthy and balanced.
Other diet considerations that may lesson IBS symptoms include:
- Having a normal meal pattern and at regular intervals while not eating hurriedly
- Avoiding very long fasts in between mealtime
- Drinking a minimum of eight cups of water a day – water is especially essential and also increasing your intake of drinks with minimal caffeine
- Restricting your intake of stimulant drinks to a maximum of three cups per day
- Reducing the quantity of alcoholic and carbonated drinks
- Reducing your intake of starch, which opposes digestion in the small intestines and arrives at the colon while intact. This is often found in manufactured or re-heated foods
- Limiting fresh fruit in the diet to three parts a day – half an apple or grapes would be a good portion in a day
- When having diarrhea, avoiding chewing gum and some drinks which contain synthetic sweeteners in sugar free products is helpful in alleviating some of the symptoms
- When bloated, avoiding some cereals and oats has proven to help some people in managing the symptoms of IBS, especially during morning hours
Exercising does relieve some of the symptoms, and your health practitioner can recommend which class of exercise is suitable for your body type.
It may also be helpful to undertake a minimum of 2 hours of cardiovascular and moderate aerobic activity per week. Such exercise should increase heart and breathing rates.
Relieving yourself of stress may reduce the extreme symptoms of IBS. Some important ways to reduce stress include regular relaxation methods; breathing exercises, which may include meditation, some body stretches; yoga and tai chi and regular exercise such as walking, running, or swimming.
If you are severely stressed, it is beneficial to visit a psychotherapist regularly.
This is a food or dietary supplement that contains ‘friendly bacteria’ intended for therapeutic reasons. Such bacteria are believed to restore the existing equilibrium of digestive bacteria when it has been interrupted in the gastrointestinal tract.
There is however little scientific proof to show how and which category of probiotics are helpful and effective, and how much of an advantage they are in taking them.
Some people find that probiotics relieve some symptoms and if you want to try them, do so for a month, while following the manufacturer’s and your doctor’s recommendations.
Several prescriptions can be used in treating IBS, including;
- Antispasmodics – generally these are drugs that suppress or control spasms in the colon, but it is unsure if they actually do help. These drugs can be a bad choice for some people since they have side effects such as drowsiness.
- Laxatives – these have the effect of moving the bowels or aiding in digestion and preventing constipation by making stool softer. Make sure to speak with your doctor before starting laxative treatments. Plenty of fluids should be taken to prevent bulk-forming laxatives from blocking the digestive system. When taking laxatives, start with a low dose while progressively increasing the dose with time. Also, never take laxatives prior to bed unless your doctor recommends otherwise. Side effects of laxatives include bloating but as the dose increases the symptoms will reduce.
- Anti-motility medicines which help to prevent diarrhea
- Low dose of antidepressants – although antidepressants are meant for treating depression, a low dosage can help lower stomach pain and cramping, free of any antidepressant outcomes.
- Linaclotide (linzess) – these are capsules which aid in bowel movement and are taken thirty minutes prior to the first meal of the day on a daily basis, thus preventing constipation. It is not prescribed to people under 17 years old and its common side effect is diarrhea.
It is important to follow your doctors’ orders to when starting IBS treatment, as some of the drugs, including laxatives, can be addictive for your body.
There is proof to support the application of psychological therapy in managing IBS. If after 12 months symptoms persist, psychological intervention might be required to train on methods that can control the condition better.
Such IBS treatment offered includes:
- Psychotherapy – this involves using dialogue with a trained therapist to look into your emotional worries.
- Cognitive behavioral therapy – a therapist studies your beliefs and behavior to help you change your way of thinking while adapting to the syndrome
- Hypnotherapy – a trance-like state is induced to a person’s unconscious mind, leading to a change in the disposition of the mind towards the symptoms of IBS.
Individualizing your prevention
Symptoms of IBS are never pleasing and some find them to be life-altering. Finding a remedy that is suitable for your unique condition is huge progress towards modification of your treatment plan.
People are different and such lifestyle changes should be reached with a doctor’s help to prevent further discomfort.
Other therapeutic techniques
Alternative methods to IBS medication and dietary change include acupuncture and hypnotherapy. Acupuncture may help according to some studies, but only when done by a skilled licensed acupuncturist.
Hypnotherapy induces a state of relaxation of the mind may make the victim feel more positive, thus reducing the pain.
A combination of both may be used, but with experimentation, you can find what suits you best for a healthier life.
The most common symptom linked with IBS is constipation, but abdominal pain is an important sign of IBS to note. The pain is caused by anomalies in the viscosity of bowel habits, which may be chronic constipation or diarrhea.
Some people may develop both but not at the same time. The bowels may also fill with air and swell. Symptoms of IBS are also not steady, and there are instances where it shoots up and sometimes vanish depending on the state of bowel habit.
There are various attempts made to define constipation; medical personnel define it as rigid pellet-like stool. Individuals may think it as the feeling of being difficult in passing stool, or scarce stools.
Difference between chronic functional constipation and IBS
The main difference is that people with IBS have pain in the abdomen due to bowel habit and also have other symptoms which may be similar to constipation.
In functional constipation, it is not necessary that there be abdominal pain, but if present, it is less severe.
Passing of stool is also not at regular intervals as compared to IBS.
How do you live with IBS?
Symptoms of IBS cannot be completely predicted, and they vary with time, making it hard to adapt to life with IBS. There is no sure remedy, but there are several methods that can be used to manage symptoms, although difficult.
Step-by-step intervention between you and the doctor is required to find out what best suits you.
Some measures have been given to help those with IBS and they include:
- Start by getting a diagnosis from the doctor and determining whether or not your IBS symptoms are causing mental distress
- Be adequately knowledgeable about what you can do to manage symptoms and the characteristics of the syndrome
- Be up to date with the most recent IBS treatment developments
- Reduce the consumption or performance of things that tend to make your symptoms more severe 5. Try to find out non-medical techniques that diminish your symptoms, like a change in diet or various relaxation styles
- Always take medication as instructed by your doctor to relieve symptoms, and follow the prescribed information when managing symptoms
Vital changes that shouldn’t be ignored with IBS
Throughout your life you may be predisposed to problems related to IBS, and they can be thought of like a migraine or asthma.
Abdominal problems will be common, but it does not directly mean that they will be there always. The stomach, since it’s the most vulnerable spot, will also be the most affected part in case of an anomaly.
Symptoms of IBS have proved to be an uphill task to manage and the way they interfere with normal life can be discouraging, even after diagnosis and treatment.
It is therefore comforting to know that having IBS does not necessarily expose you to a risk of developing other complications or disorders.
Irrespective of this, it is important to involve your doctor in management of symptoms. IBS neither causes physical damage nor increase the chances of colon cancer development or other gut complications, although it is not a protection against them. Such wrong beliefs should be avoided, as they can cause unnecessary discomfort and visits to the doctor together with unnecessary testing and analysis.
On the other hand, there are two situations that should not be overlooked: A warning sign and increased individual risk.
A red flag symptom is a symptom that has not been adequately explained by IBS, and may cause damage to the gut. Such calls for additional examination. Bleeding and other symptoms may not be alarming, but it is best if the doctor is informed since it can turn out to be another medical condition such as a hemorrhoid, or a tear on the anal sphincter.
However, large quantities of red blood or black stool that is delayed should be considered a medical emergency.
The following are signs that call for attention:
- Unfamiliar but recent symptoms past 50 years
- Blood in stool
- Sundown symptoms which disrupt sleep
- Strange IBS symptoms
- Current use of antibiotics
- A bloodline history of gastrointestinal diseases
When to see a doctor
IBS is generally unpredictable. At instances, symptoms may be calm with long periods with no discomfort, but at other times pain will be so severe that it may interfere with daily life of the patient.
Nevertheless, if there is a change in bowel symptoms from the norm or any severe signs present, visit a doctor.
Sometimes a prescribed drug or a modified diet may cause the change in bowel habits or digestion. A visit to the doctor will help you review your diet, drug, and exercise patterns to lead you to the most appropriate course of treatment for your specific symptoms.