Irritable Bowel Syndrome

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Irritable bowel syndrome (IBS) is a distressing and uncomfortable condition caused by erratic bowel movements and stomach cramps. It is surprisingly common and its ultimate cause is not completely understood. Read more to know more about IBS and available treatments to reduce or relieve its symptoms.

What is Irritable Bowel Syndrome?

Irritable bowel syndrome is characterized by bouts of diarrhea or constipation with stomach cramps. Bouts last for days and then followed by months of reduced or no symptoms, and then occurs again. Many patients describe IBS as bothersome as symptoms often occur repeatedly without warning.

IBS can be described as a condition where your body simply loses control over bowel movements. Unlike other digestive conditions, IBS is not caused by inflammation or bleeding in the intestines. In almost all cases, there is nothing wrong in the digestive tract that could cause symptoms.

Doctors are still unsure how and why IBS occurs. What they do know is that IBS is very common, affecting around 10% to 15% of adults. Although largely harmless, its symptoms often prompt patients to seek treatment.

IBS is different from inflammatory bowel diseases or IBD, which cause inflammation and actual damage to the intestines. Doctors diagnose IBS by examining your symptoms and doing tests to make sure your symptoms are not caused by other conditions.

There is no specific cure for IBS. The good news is there are remedies to relieve symptoms. These remedies are very helpful for patients to continue daily activities. With careful monitoring and prompt action to symptoms, most people with IBS are able to live a normal life.

Symptoms of IBS

The classic IBS symptoms are repeated bouts diarrhoea, constipation, or both. You may also experience painful stomach cramps. In most cases, stomach cramps go away after having a bowel movement. The appearance and consistency of the stools may also change. Other symptoms of IBS include bloating, gas, and distended abdomen.

Doctors classify IBS into four types:

IBS-C – IBS with constipation, classified as having hard or lumpy stools at least 25% of the time and loose stools or diarrhea less than 25% of the time.

IBS-D – IBS with diarrhea, classified as having loose stools at least 25% of the time, and hard lumpy stools less than 25% of the time.

IBS-M – also called mixed IBS, is given to cases where there are equal bouts of diarrhea and constipation.

IBS-U – also known as unsubtyped IBS. It is given to IBS cases that do not resemble previously mentioned types. It is also used to describe IBS cases where diarrhea or constipation occur less than 25% of the time.

Causes of IBS

The ultimate cause of IBS is not fully understood. Experts have several theories about how IBS develops. Some may have problems digesting certain sugars or fats, which explain why some have symptoms right after eating spicy, fatty, or carb-rich foods, or after drinking coffee or alcohol. Others may have problems in the digestive system, particularly the nerves, that cause the gut to become more sensitive or have abnormal motility that causes symptoms.

IBS may also be caused by problems in neurotransmitters or hormones as symptoms tend to worsen during menses, while the onset of menopause tends to reduce symptoms. Genetics may also play a role as IBS is more common in people with family history of digestive system problems.

Bacteria may also play a role in IBS. There could be a hidden bacterial infection that causes symptoms. Others may have what is called small intestinal bacterial overgrowth, a condition where the gut becomes overpopulated with bacteria, causing the production of excessive gas that results to symptoms of bloating and diarrhea.

Dietary approaches to IBS

Since IBS is mainly a digestive condition, changes in diet may provide relief. Many cases of IBS respond well to dietary interventions. Among the easiest you can do is identify triggers. Avoidance of triggers means that less likelihood of having symptoms. Food triggers may depend on what type of IBS you have. Here are commonly reported triggers in people with IBS with constipation:

  • Dairy, especially cheese
  • White bread and cereals made from refined flour
  • Chips, cookies, and other processed foods
  • Eating high protein foods like fish, red meat, or poultry
  • Coffee, alcohol, and soda
  • Here are the triggers often reported by individuals suffering from IBS with diarrhea:
  • Carbonated drinks
  • Large meals
  • Chocolate
  • Caffeine
  • Fructose or sorbitol
  • Fried and fatty food
  • Dairy

Aside from avoiding triggers, you may try an approach called a low-FODMAP diet. FODMAP stands for ’fermentable oligo-, di-, monosaccharides and polyols,' and these are sugars that absorb water and trigger fermentation. Reducing intake of FODMAP may reduce bloating, gas, and diarrhea. To do a low-FODMAP diet, all you have to do is avoid the following foods:

  • Fructose-rich foods such as honey, corn syrup, agave, and sweet-tasting fruits
  • Ice cream, cookies, soft drinks, and commercial foods items made with corn syrup
  • Artichokes, cashews, mushrooms, pistachios, and watermelon
  • Wheat, garlic, and onions
  • Legumes such as beans, lentils, soybeans, and nut seeds
  • Fruits with pits and seeds, such as apples, pears, avocados, cherries, figs, peaches, and plums

There is good evidence that low-FODMAP may reduce symptoms in some cases of IBS.iiiiii Note that low-FODMAP diet does not work for everyone with IBS, but it is worth a try.

Supplements for IBS

Certain supplements are helpful for relieving symptoms of IBS. Here are some recommended supplements:

  • Psyllium husk – is a source of natural soluble fiber and a study shows it works better than bran in relieving IBS symptoms.iv
  • Lactobacillus acidophilus – is a good bacteria found naturally in the digestive system. Additional supplementation is known to reduce stomach cramps in people with IBS.v
  • Green tea – is rich in substances that subside inflammation, which may have a beneficial effect on symptoms. As inflammation may have something to do with IBS, taking green tea might be helpful.vivii
  • Fennel – is a spice rich in polyphenols that have antioxidant properties.viii There is evidence that essential oil from fennel seeds may improve IBS symptoms.ix
  • Ginger – is a hot but fragrant spice that is an effective remedy for bloating and gas, so it is quite useful for people with constipation type IBS.x
  • Vitamin B1 – also known as thiamine, is absorbed in the intestines. People with IBS may have to take this vitamin to avoid deficiency, which can result to beriberi.
  • Omega 3 – this fatty acid has strong inflammation-lowering properties, which makes it beneficial for IBS. A study showed that people with low levels of omega-3 in the diet tend to have more severe IBS symptoms compared to those with good levels.

 

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i Low-FODMAP Diet for Treatment of Irritable Bowel Syndrome. Gastroenterol Hepatol (N Y). 2012 Nov; 8(11): 739–745. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966170/

ii A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology. 2014 Jan;146(1):67-75.e5. doi: 10.1053/j.gastro.2013.09.046. Epub 2013 Sep 25. https://www.ncbi.nlm.nih.gov/pubmed/24076059

iii Efficacy of the low FODMAP diet for treating irritable bowel syndrome: the evidence to date. Clin Exp Gastroenterol. 2016 Jun 17;9:131-42. doi: 10.2147/CEG.S86798. eCollection 2016. https://www.ncbi.nlm.nih.gov/pubmed/27382323

v Irritable bowel syndrome. University of Maryland Medical Center. http://umm.edu/health/medical/altmed/condition/irritable-bowel-syndrome

vi Low-grade inflammation plays a pivotal role in gastrointestinal dysfunction in irritable bowel syndrome World J Gastrointest Pathophysiol. 2010 Aug 15; 1(3): 97–105.

Published online 2010 Aug 15. doi: 10.4291/wjgp.v1.i3.97 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3097950/

vii Irritable Bowel Syndrome Is Positively Related to Metabolic Syndrome: A Population-Based Cross-Sectional Study PLoS One. 2014; 9(11): e112289.

Published online 2014 Nov 10. doi: 10.1371/journal.pone.0112289 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4226513/

viii Culinary Herbs and Spices: Their Bioactive Properties, the Contribution of Polyphenols and the Challenges in Deducing Their True Health Benefits. Int J Mol Sci. 2014 Oct; 15(10): 19183–19202.

Published online 2014 Oct 22. doi: 10.3390/ijms151019183 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4227268/

ix Curcumin and Fennel Essential Oil Improve Symptoms and Quality of Life in Patients with Irritable Bowel Syndrome. J Gastrointestin Liver Dis. 2016 Jun;25(2):151-7. doi: 10.15403/jgld.2014.1121.252.ccm. https://www.ncbi.nlm.nih.gov/pubmed/27308645

x Chapter 7The Amazing and Mighty Ginger https://www.ncbi.nlm.nih.gov/books/NBK92775/

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