What Is Irritable Bowel Syndrome (IBS)? An Overview
So you think you might have irritable bowel syndrome (IBS), but you're not exactly sure what it means and you have a tonne of questions racing through your mind. To help I've put together this post and video. And don't worry, it's not all doom and gloom, there are things you can do to manage it!
WHAT IS IRRITABLE BOWEL SYNDROME (IBS)?
Irritable bowel syndrome (IBS) is a surprisingly common disorder that affects the large intestine (colon) and covers a range of colon-related symptoms such as bloating and changes in defecation.
Unfortunately it is a chronic condition that you will need to manage in the long term.
Unlike ulcerative colitis and Crohn's disease, which are forms of inflammatory bowel disease — IBS doesn't cause changes in bowel tissue or increase your risk of colorectal cancer.
Only a small number of people with irritable bowel syndrome have very severe signs and symptoms. However, the mild symptoms can still be really upsetting to deal with and can really affect your quality of life, especially if you don’t feel in control.
WHAT ARE THE SYMPTOMS?
The symptoms of IBS can vary widely from person to person and are often confused for other diseases. Among the most common signs and symptoms are:
Abdominal pain or cramping
A bloated feeling
Distention of the abdomen (swollen tummy)
Excessive gas or flatulence
Diarrhea (IBS-D), Constipation (IBS-C), or Alternating bouts of constipation and diarrhea (IBS-A)
Mucus in the stool
For most people, IBS is a chronic condition. There are times when the signs and symptoms are worse and times when they improve or even disappear completely.
Note! Symptoms that may indicate a more serious condition include:
Abdominal pain that progresses or occurs at night
If you have these it’s important to see you doctor as soon as possible, who will be able to rule out colon conditions, such as inflammatory bowel disease and colon cancer.
HOW COMMON IT IS?
Very! Around 1 in 9 adults have signs and symptoms of irritable bowel syndrome globally. However a lot of people will just put with the symptoms and won’t seek medical help. Partly because in the past there wasn’t much that could be done about it.
HOW IS IT DIAGNOSED?
Generally, IBS is diagnosed by ruling out other conditions and will involve a consultation, examination and a colonoscopy if your Dr thinks it’s appropriate. There is also the Rome IV diagnostic criteria
The Rome IV Diagnostic Criteria* for IBS
Recurrent abdominal pain, on average, at least 1 day per week in the last 3 months, associated with 2 or more of the following:
Related to defecation
Associated with a change in frequency of stool
Associated with a change in form (appearance) of stool
* Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis.
The Dr will also rule out the more dangerous inflammatory conditions mentioned above.
WHAT CAUSES IBS? WHY ME?
The causes irritable bowel syndrome are not very clear and there hasn’t been a great deal of research into it, as it covers such a wide range of varying symptoms. Some potential causes are thought to be:
- Differences in intestinal walls
The walls of the intestines are lined with muscle that contract and relax in a coordinated rhythm as they move food along your digestive tract.
If you have IBS, the contractions may be stronger and last longer than normal, causing gas, bloating and diarrhea. It could also be the opposite, where weak intestinal contractions slow food passage and leading to hard, dry stools.
- Abnormalities in your gastrointestinal nervous system
Abnormalities could cause you to experience greater than normal discomfort when your abdomen stretches from gas or stool.
Poorly coordinated signals between the brain and the intestines can make your body overreact to the changes that normally occur in the digestive process. This overreaction can cause pain, diarrhea or constipation.
- Disruption of gut microbial community
Another possible cause could be a disruption to the communities of microbes (bacteria, viruses, fungi and protozoa) that live in your intestines. These microbes are responsible for digesting and processing a lot of our food, and research has shown people with IBS have changes in their gut bacterial communities. Too many or too few of a particular species could lead to excessive fermentation of certain foods for example.
WHAT ARE THE RISK FACTORS?
Many people have occasional signs and symptoms of irritable bowel syndrome, but you're more likely to have IBS if you:
Are young. IBS commonly onsets between the ages 20 and 45.
Are female. Around twice as many women have IBS than men.
Have a family history of IBS. This could be use to genetics, shared environmental factors and inherited microbiomes (the microbes that live in and on you).
Have a mental health problem. Anxiety, depression, a personality disorder and a history of childhood sexual abuse are risk factors. For women, domestic abuse may be a risk factor as well.
WHAT TRIGGERS IBS SYMPTOMS?
A trigger for one person may be fine for another. Common triggers include:
- Foods. FODMAPs have been found to be a trigger in 75% of people with with IBS.
- Stress. Most people with IBS find that their signs and symptoms are worse or more frequent during particularly stressful times. Stress only aggravates symptoms and doesn't cause them.
- Hormones. Many women find their IBS is worse during or around their periods and as they are twice as likely to have IBS than men, researchers believe hormones may be a factor
- Other Illnesses. Sometimes illness, such as a bout of infectious diarrhea (gastroenteritis) or an overgrowth of bacteria in the intestines can trigger IBS.
WHAT ARE THE POSSIBLE COMPLICATIONS?
Direct complications are very unlikely. But the condition's impact on your overall quality of life may be the most significant complication. If you have IBS you can often feel your freedom and confidence is limited, leading to anxiety or depression.
WHAT CAN I DO ABOUT IT?
Unfortunately there isn't a cure for IBS, but there are things you can do to manage your symptoms. For most people this is enough for them to still enjoy a high quality of life, so don't worry!
Manage stress through various techniques.
Your Dr may prescribe medication in some cases, such as Antispasmodic drugs for abdominal cramps or specific probiotic supplements.
DIET! The Low-FODMAP diet is the most effective and only fully research-backed IBS management option available right now. I’ve found it really helpful so far! You can learn more about the diet here.