Everything you need to know about Irritable Bowel Syndrome

IBS patients may experience both diarrhoea and constipation. Women tend to exhibit more symptoms around the time of menstruation. Menopausal women experience fewer symptoms.

What is IBS?

Irritable bowel syndrome (IBS) is a common condition in the community. It can present with abdominal pain, cramps, bloating, excess gas, diarrhoea, constipation or both.

 While the majority of people with IBS have minor symptoms, a small percentage of patients can have severe signs and symptoms. Some people can manage their symptoms by changing their diet, lifestyle, and stress levels, while others require medication and counselling.

 The signs and symptoms of IBS vary, but the most common include abdominal pain, cramping, or bloating associated with passing a bowel movement or changes in the bowel movement. Bloating and increased gas or mucus in the stool are frequently associated symptoms.

 Some of the symptoms, such as weight loss, nighttime diarrhoea, rectal bleeding, iron deficiency anaemia, unexplained vomiting, difficulty swallowing, and persistent pain that isn’t relieved by passing gas or a bowel movement, are more serious signs and symptoms and sometimes can imply a major underlying condition like colon cancer. Hence, it is very important to get any of these symptoms evaluated by a qualified gastroenterologist rather than assuming these to be related to IBS.

 The severity and duration of IBS symptoms vary from person to person. Symptoms typically last at least three months and occur at least three days per month. IBS patients may experience both diarrhoea and constipation. Women tend to exhibit more symptoms around the time of menstruation. Menopausal women experience fewer symptoms.

Causes of IBS

Contractions of the intestine’s muscles: The intestines are lined with layers of muscles that contract as food passes through the digestive tract. Stronger and longer-lasting contractions can cause gas, bloating, and diarrhoea. Weak intestinal contractions can cause food passage to be slowed and hard, dry stools to form.

 Nervous System: Inadequately coordinated signals between the brain and the intestines can cause the body to overreact to normal digestive process changes, leading to pain, diarrhea, or constipation.

Severe infection: IBS can develop after a severe bout of diarrhoea (gastroenteritis) caused by bacteria or a virus. IBS might also be associated with a surplus of bacteria in the intestines (bacterial overgrowth).

Early Life Stress: People who have been exposed to stressful events, particularly as children, are more likely to develop IBS symptoms. 

 Microbe changes in the gut: Changes in bacteria, fungi, and viruses, which are normally found in the intestines and play an important role in health, are some examples. According to research, the microbes in people with IBS may differ from those in healthy people.

Microbe changes in the gut: Changes in bacteria, fungi, and viruses, which are normally found in the intestines and play an important role in health, are some examples. According to research, the microbes in people with IBS may differ from those in healthy people.

Risk Factors

  • People under the age of 50 are more likely to suffer from IBS.
  • If someone has a family history of IBS, genes, or a combination of genes and environment, may play a role.
  • Anxiety, depression, mental health issues, and a history of sexual, physical, or emotional abuse may also be risk factors.
  • Many people who suffer from moderate to severe IBS have a low quality of life.
  • IBS symptoms can lead to depression or anxiety.

Triggers

Food allergies or intolerances play an unknown role in IBS. However, many people experience worse IBS symptoms when they consume certain foods or beverages, such as wheat, dairy products, citrus fruits, beans, cabbage, milk, and carbonated beverages. Most people with IBS experience worse or more frequent signs and symptoms during periods of increased stress.

Types of IBS

The different types of IBS are classified based on the various bowel movement problems, which also affect treatment because certain medications are only effective for certain types of IBS. The types of IBS include: 

  • IBS with constipation (IBS-C)
  • IBS with diarrhea (IBS-D)
  • IBS with mixed bowel habits

How is IBS diagnosed?

A medical history and physical exam are the first steps in diagnosing IBS. The doctor will ask you questions about your symptoms, such as bowel movement pain, frequency of change in bowel movement, change in poop appearance, how frequently the symptoms occur, when the symptoms began, what medications you are taking, and any stressful events in your life.

Other tests may be required to confirm the diagnosis depending on the symptoms. The following tests may be recommended to rule out other medical conditions:

  • Flexible Sigmoidoscopy or Colonoscopy
  • Upper Endoscopy
  • X Rays
  • Blood Tests
  • Stool Tests

IBS Treatment

Although no single therapy is effective for everyone, IBS treatment plans can be tailored to the individual’s requirements. Dietary and lifestyle changes are common treatment options.

Dietary changes: 

  • Increase your fibre intake by eating more fruits, vegetables, grains, and nuts.
  • Supplemental fibre, such as Metamucil or Citrucel, can be added to the diet.
  • Every day, drink eight ounces of water.
  • Avoid caffeine from coffee, chocolate, teas, and sodas.
  • Because lactose intolerance is more common in people with IBS, limiting cheese and milk consumption is critical, and calcium should be obtained from other sources such as broccoli, spinach, salmon, or supplements.

Activity Changes: 

  • Regular Physical Activity
  • No smoking
  • Eat smaller meals more frequently
  • Make a list of the foods that cause IBS flare-ups, such as red peppers, green onions, red wine, wheat, and cow’s milk

Medical Changes

  • If you have depression, anxiety, and severe abdominal pain, you may be prescribed antidepressant medication.
  • You could try probiotics to help alleviate your symptoms.
  • If the symptoms do not improve, you may require additional tests to determine the underlying cause of the symptoms.

Can IBS be prevented?

If you have IBS, you can prevent flare-ups by avoiding triggers. Generally, dietary and physical activity changes improve symptoms over time. Identifying the triggers, on the other hand, can aid in the prevention of IBS. Certain foods can cause IBS, so an exclusion strategy for triggering diets is usually recommended. Counselling, psychotherapy, or guided meditation can help you manage stress, while progressive relaxation exercises can help your muscles relax in the body.

About Author –

DR. KIRAN PEDDI,

Consultant Medical Gastroenterologist

About Author

Dr. Kiran Peddi

MRCP (UK), FRCP (Lon), CCT Gastro (UK), Fellowship in Advanced Endoscopy and IBD (Aus)

Consultant Medical Gastroenterologist

Yashoda Hopsitals

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