What is Irritable Bowel Syndrome (IBS)?
Irritable Bowel Syndrome ( IBS) by itself is not a disease, rather it is a functional disorder of the bowels which leads to the occurrence of a group of symptoms. The common symptoms include, increased gas, altered bowel habits, intolerance to certain foods, and stomach bloating.
IBS usually occurs during late teens or during mid-40s. This disorder is considered to be chronic and needs long-term management.
If you notice any of these symptoms, it would be wise to consult your family physician or a general doctor. Depending on the severity of your symptoms, you may be referred to a gastroenterologist, and even be asked to see a psychologist, since a large number of IBS patients seem to suffer from stress and anxiety as well.
How does IBS occur?
The muscles in the intestines move the food we ingest from the stomach to the rectum. The movement of the food through the gastrointestinal tract is also known as motility. The muscles in the intestines contract and relax in a gentle rhythm which allows the food to move through the intestines in a predictable pattern. However, in patients with IBS, the muscles contract vigorously and for longer periods of time. This not only disrupts the movement of the food through the intestine but also causes pain to the person. If the movement of the food is slow the person experiences constipation, and when it is fast he experiences diarrhoea.
It is very usual for patients with IBS to alternate between constipation (IBS-C) and diarrhoea (IBS-D).
Besides people with IBS have nerve endings in the digestive tract which are more sensitive than normal. Therefore, little bubbles of gas which are normal for most people can be quite painful for IBS patients.
During a usual attack of IBS, the patient feels cramps in the stomach. He may experience bloating of the stomach and pass more gas than usual. Following this, there could be about of constipation or diarrhoea.
The person usually feels like visiting the toilet immediately after food.
After a visit to the toilet, it is very normal for an IBS patient to feel that he was unable to empty his bowels completely. This leads to repeated visits to the toilet.
Most of the patients feel a rush to visit the toilet immediately after mealtime, especially during, or after breakfast.
Who is prone to IBS?
Though doctors have not been able to determine the exact cause of IBS, they have observed certain common factors among people who suffer from IBS. Thus, they have concluded that the presence of certain factors put some people at a higher risk of developing IBS. The risk factors include:
- Being a Female: Women seem to suffer from IBS more than their male counterparts. They especially complain more of the symptoms during their menstrual periods.
- Genetic Factors: Some studies show that genes may be responsible for IBS. It seems to run in families and especially first degree relatives are twice more likely to develop IBS symptoms.
- Psychological problems: If something in your gut does not feel right, it probably isn’t. It has often been observed that stress, anxiety and depression go hand in hand with IBS. Approximately 60% of IBS patients meet the criteria for various psychiatric disorders such as chronic anxiety, depression etc.
- Medications: People taking certain drugs such as anti-depressants, some antibiotics, and drugs made of sorbitol are more prone to IBS symptoms.
What is the cause of IBS?
Although the exact of IBS has not yet been ascertained by the doctors, there are some common factors they agree upon which can predispose one to develop IBS. The factors include:
- GI Motility Problems: Motility is the movement of the food through your gastrointestinal tract. When the motility in the colon gets affected, meaning the motility is either slow or too fast, IBS occurs. If the motility is slow you experience constipation, and when it is fast you experience diarrhoea. Usually, the stress in the stomach is felt immediately after eating food.
- Certain Foods: Some foods are known to cause IBS symptoms. Patients sometimes complain of aggravation in symptoms after consuming certain foods such as fatty foods, spicy foods, beans, cauliflower, cabbage, milk and dairy products, chocolate, and alcohol.
- Genetics: According to some researchers genes may be responsible for IBS. This disorder is often seen to run in families, especially among immediate relatives.
- Hormones: Women are seen to suffer more from IBS than men, and especially complain of aggravation in the symptoms during the monthly menstrual cycles. According to research, hormones such as like estrogen and progesterone may be the reason behind the flare-up of IBS symptoms.
- Stress: Whenever there is a disturbance in the balance of mind, body, and brain, stress occurs. In IBS there is an increased gastrointestinal response to stress which arises from the complex biological interaction between the brain and gut. Excessive anxiety, fear, anger, or depression can trigger changes in the brain and stimulate exaggerated gut responses.
The causes of stress can be varied such as:
- Diet - Processed foods, dairy products, alcohol, certain fruits and vegetables can cause IBS symptoms to aggravate.
- Hormonal changes - For example, women complain of aggravated IBS symptoms during their the monthly menstruation cycle.
- Physical - Any illness or a surgery can trigger IBS. Intensive exercises such as running, weightlifting, football, can cause stress to the body and aggravate IBS symptoms
- Psychological stress - Incidents such as loss of job, divorce, death of a loved one, history of sexual or emotional abuse can trigger symptoms of IBS.
What are the symptoms of IBS? How is IBS diagnosed?
The symptoms of IBS include:
Since there are no definitive physical symptoms which can exclusively point towards IBS, the diagnosis is more of a ruling out process of other disorders which could cause the symptoms, such as celiac disease, ulcerative colitis, Crohn’s and other gastrointestinal diseases.
Based on the severity of your condition the doctor will suggest a few tests, which can include imaging tests and laboratory tests.
Some symptoms which warrant additional tests include:
- persistent fever
- abdominal pain which continues even after bowel clearing
- bleeding from the rectum
- persistent vomiting
- continuous diarrhoea
- sudden weight loss
The imaging tests suggested by the doctor may include:
- Colonoscopy: a colonoscope is a 4-foot long tube with a camera and a light at its tip. This is inserted through the anus into the rectum to check the length of the colon.
- Flexible sigmoidoscopy: in which a thin flexible tube is used to examine the lower part of the colon.
- CT scan: A CT scan can produce 2-dimensional images of a 'slice' or section of the internal organs of the body. Taking images of the lower part of the body such as the abdomen and pelvis can help to rule out any other causes of abdominal pain.
- X-ray: X-ray images of your colon may be taken.
- Lower gastrointestinal (GI) series: also known as barium enema is a test in which your colon is filled with barium sulfate, via an enema through the rectum.The barium will make your large intestine more visible on an x-ray.
The laboratory tests include:
- Blood tests: can help rule out Celiac disease.
- Stool test: can help rule out possibilities of infection, parasitic infections,
- Breath test: helps in detecting overgrowth of bacteria which usually occurs in IBS patients.
- Lactose intolerance test: lactase is an enzyme our bodies secrete to digest whole milk and break down lactose which is the sugar which gives milk its taste. If for some reason the body does not produce this enzyme symptoms similar to IBS occur. This test can rule out the possibility of lactose intolerance.
What are the complications of IBS?
The complications of IBS can affect the patient not only physically, but also mentally and emotionally. The complications include:
What is the treatment of IBS?
Depending on whether you have IBS-C or IBS-D your doctor may prescribe the required medicines. You will be suggested to make dietary changes based on your particular condition, such as eliminating high gas foods from your diet like cabbage, broccoli, and cauliflower and certain raw fruits. The doctor may advise you to increase the intake of soluble fibre-rich fruits and vegetables, such as oranges, strawberries, blueberries, cucumbers, and carrots if you suffer from IBS-D. If you suffer from IBS-C he may suggest you increase the intake of insoluble fiber, such as vegetables like zucchini, broccoli, cabbage, leafy greens, grapes, and root vegetables, and whole grains like, bran, brown rice, cereals, and rolled oats.
The doctor may also prescribe fiber supplements such as psyllium or methylcellulose, and anti-diarrheal and anti-spasmodic medications.
Anti-biotics will be prescribed if there is an overgrowth of bacteria in your intestines.
The doctor may also advise you to consult a counsellor or psychiatrist if you suffer from depression.
If you are an IBS patient you, you may want to consider including regular exercise into your daily regimen. Exercise will not only make your body feel re-invigorated but will also make your gut healthy and strong. In fact, exercising is vital for an optimally functioning gut.
You need to consult with your doctor before you plan on any exercise regimen.
You can opt for swimming, cycling, aerobics, and cardiovascular exercises. These are great methods to dispel stress.
You can also practise traditional forms of stress release exercising methods such as Yoga, or Tai Chi. These methods are known to make a person calm and relaxed which automatically results in a gut that is strong and healthy.
Regular deep breathing exercises and meditation forms such as Vipassana can work wonders in relieving IBS symptoms.
Questions answered by trusted doctors
Did you know?
The Most Common GI Disorder
IBS is the most common functional gastrointestinal (GI) disorder in the world. The worldwide prevalence rates range generally in the area of 10–15%.
33% of the IBS patients have a family history of IBS. First degree relatives are twice as likely to have IBS.
Females Suffer From IBS More Than Males
IBS is more common in females than in males.
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