What is irritable bowel syndrome?
IBS is a common digestive condition affecting about 10-15% of the entire population. Symptoms include abdominal pain, changes in the appearance or frequency of bowel movements and excessive gas and bloating. In the past, doctors called IBS colitis, mucous colitis, spastic colon, nervous colon, and spastic bowel.
Are there different types of irritable bowel syndrome?
Irritable bowel syndrome with constipation (IBS-C) is a type of IBS where abdominal pain or bloating is associated with constipation. Generally, constipation is when stools don’t pass often enough (less than 3 times per week). Having hard stools or having a feeling of incomplete bowel movement are also signs of constipation.
Irritable bowel syndrome with the diarrhea (IBS-D) is a type of IBS in which abdominal pain or bloating is associated with stools that are often loose or more frequent than usual.
Mixed irritable bowel syndrome is a type of IBS where abdominal pain or bloating is associated with alternating constipation and diarrhea.
What causes IBS?
The exact cause of IBS is not known. In some patients, IBS may start after an infection in the gut. There is also some evidence that if there is imbalance between good and bad bacteria in the gut, it may cause IBS. There may be several other factors including heredity, change in immune system, excessive sensitivity of the gut nerves, etc.
How is IBS diagnosed?
There is no lab test or imaging study that can confirm a diagnosis of irritable bowel syndrome. The diagnosis is based on a set of diagnostic criteria (Rome criteria) and by excluding other causes of the symptoms. As per the Rome criteria the most important requirement for the diagnosis would be abdominal pain and change in bowel habits. If the patients meet the diagnostic criteria and if they don’t have any “red flag”/”alarm” signs or symptoms to suggest another diagnosis, for example weight loss, bleeding, new onset of symptoms in a person who is over 50, then you may not need extensive testing before the diagnosis of IBS.
What is the treatment of IBS?
The good thing about IBS is that it never kills anyone! But the symptoms can be sometimes debilitating and will affect your the quality of life. Although there is no cure for IBS, there are several options including diet, lifestyle changes, supplements, psychosocial therapy, medications, etc.
When it comes to diet, every person is different. There may be certain triggers such as lactose or gluten.
Cutting down on caffeine, alcohol, soda, carbonated beverages often help.
Increasing the amount of soluble fiber such as oats, psyllium, flax may help.
Writing down a food diary to write down what was consumed for breakfast, lunch and dinner and the associated symptoms on a scale of 1-10 will help establish some other trigger foods.
There are special diets such as low-FODMAP diet which is low in certain fermentable sugars and gluten which have shown in clinical trials to benefit some patients with IBS.
Probiotics are foods or pills that contain good bacteria which may promote gut health. As mentioned above, patients with IBS may have imbalance between good and bad bacteria in the gut (altered microbiome or “dysbiosis”). Adding good bacteria in the form of probiotics (IBplus) may help reduce the abdominal discomfort, bloating and gas. Sometimes using the antibiotics to reduce the number of bad bacteria may also help especially in treating the symptoms of bloating and diarrhea.
Anxiety or stress may play a major role in triggering the symptoms of IBS. Examples of psychological therapies include cognitive behavioral therapy, psychotherapy or hypnotherapy. Psychiatric conditions such as anxiety, depression, post traumatic stress disorder (PTSD) are found along with IBS and treating these problems may also improve IBS symptoms.
There are several medication options to treat IBS. Discuss with Dr.Kethu if medications are right for your condition or if you’re IBS can be managed with diet, lifestyle change and natural supplements (IBplus).