(Tiny Tips) – Irritable bowel syndrome (IBS) is a gastrointestinal disorder that affects the small and large intestines, causing symptoms such as abdominal cramping and changes in normal bowel habits.
Irritable bowel syndrome is considered a gut-brain interaction disorder that causes communication problems between the brain and gut, leading to increased gut sensitivity and muscle contractions.
IBS does not cause permanent damage to the digestive tract or increase the risk of colon cancer, unlike inflammatory bowel disease (IBD), which is sometimes confused with IBS but is not It’s a completely different disease. Still, IBS can be frustrating and sometimes debilitating, affecting a person’s physical, emotional, and social health.
Signs and symptoms of irritable bowel syndrome
IBS symptoms may include:
- Abdominal pain, cramping, or bloating
- Excess gas
- Diarrhea or constipation or alternating episodes thereof
- Mucus in stool
But not all irritable bowel syndrome is the same. There are different types:
- Diarrheal irritable bowel syndrome (IBS-D), which may be accompanied by loose, watery stools
- Irritable bowel syndrome with constipation (IBS-C), in which stool may be lumpy and hard
- IBS with mixed bowel habits (IBS-M), including symptoms of diarrhea and constipation
Irritable Bowel Syndrome Causes and Risk Factors
Researchers don’t know exactly why some people develop irritable bowel syndrome, but they speculate that early life stress, changes in gut microbes and abnormalities in the nerves in the gut may play a role.
The connection between the brain and the gut
Millions of nerve cells line the lining of the gastrointestinal tract, almost like a second brain. Known as the enteric nervous system, it controls digestion and tells the intestines when to contract, move, and secrete fluid. There is growing evidence that the brain and gut communicate through this vast neural network.
“When we describe our emotions, we tend to say we feel sick or sick, or that it makes us feel sick to our stomachs, which makes sense because our emotions seem to come from our gut,” says Judith Scheman, PhD, the director of behavioral medicine at Cleveland Clinic’s Digestive Disease and Surgery Institute in Ohio.
Some experts believe that irritable bowel syndrome is caused by a breakdown in communication. “We all have physical reactions to stress, and some of us have physical reactions in the gut, such as diarrhea or constipation, while others experience headaches or back pain,” says Dr. plan.
The problem is that the stress response in the gut creates a vicious cycle, where stress causes symptoms and vice versa, also known as a feedback loop. “Every time you go around it, it gets worse, like a downward spiral,” Sherman said.
Gut microbial imbalance
The gut is home to millions of microorganisms, and while they usually protect against infection and support the immune system, research shows that an imbalance may lead to irritable bowel syndrome.
Viral or bacterial infections that affect the gastrointestinal tract, such as gastroenteritis, salmonella, Escherichia coli (E. coli), and Clostridium difficile (C. diff), may lead to post-infectious irritable bowel syndrome, or irritable bowel syndrome Symptoms disappear after the infection occurs. For most people, post-infectious irritable bowel syndrome is temporary, but symptoms may last from a few weeks to a year.
Other research shows that some people with IBS also suffer from small intestinal bacterial overgrowth (SIBO), a condition in which bacteria in the small intestine overgrow, causing bloating, stomach pain, and gas. A review published in March 2017 in the journal Gut & Liver found that 4 to 78 percent of people with irritable bowel syndrome also suffer from SIBO.
Antibiotics and nutritional interventions, such as supplements and a lactose-free diet, can help relieve the symptoms of SIBO.
Risk factors for IBS
IBS can occur at any age, but people under 50 are at higher risk. If you have a family member with IBS, your chances of developing IBS are increased.
Women are more likely to suffer from this condition than men. Although the cause is still debated, some research suggests that sex hormones, specifically estrogen and progesterone, are also present in the digestive tract and contribute to irritable bowel syndrome – which may trigger flare-ups.
There is also evidence that people with irritable bowel syndrome tend to suffer from mood disorders such as depression or anxiety. “There’s a lot of overlap between the two,” says Dr. Jeffrey Baumgardner is a gastroenterologist in Santa Rosa, California. “A significant number of people with IBS also have a history of some form of abuse — emotional, physical or sexual abuse.”
PhD. Baumgardner also believes that irritable bowel syndrome is related to the way people handle stress, although research has not shown why.
Possible causes of irritable bowel syndrome
Just as IBS can vary from person to person, symptoms of IBS can be triggered by a variety of factors, including:
- Certain foods or food ingredients, such as milk and dairy products, citrus fruits, cabbage, wheat, and carbonated beverages.
- Stress: Although stress is not a direct cause of symptoms, research shows that it can worsen symptoms and cause them to become more severe and frequent.
- Hormones: Taking estrogen therapy before or after menopause increases the risk of irritable bowel syndrome.
While it may take a few tries to figure out what’s causing these symptoms, your doctor can help you manage them.
How is irritable bowel syndrome diagnosed?
Although there is no standard test to diagnose irritable bowel syndrome, doctors may order tests such as blood or stool tests, upper endoscopy, or colonoscopy to rule out serious conditions such as celiac disease, inflammatory bowel disease, and colon cancer .
Once other diseases have been ruled out, doctors often resort to the so-called Roman criteria. This is a set of symptom criteria that helps doctors make an accurate IBS diagnosis.
According to the latest revised “Rome IV”, symptoms such as abdominal pain have occurred at least one day a week on average in the past three months, and are accompanied by at least two of the following other symptoms:
- Abdominal pain associated with bowel movements
- Changes in stool frequency
- Changes in the appearance of stool
How long does irritable bowel syndrome last?
IBS is a chronic disease that requires long-term treatment. But proper treatment and lifestyle changes can help control symptoms.
Irritable Bowel Syndrome Treatment and Medication Options
There is no one-size-fits-all treatment for IBS. Most people with irritable bowel syndrome try different treatments before finding one or more combinations that work. One option is to understand how IBS affects your diet, mood, stress levels, and other aspects of your life.
Your doctor may recommend the following strategies:
- Dietary changes
- Drug
- Psychotherapy (talk therapy)
- Complementary and integrative medical methods such as acupuncture and meditation techniques
Depending on your symptoms, any combination of these options may be part of your treatment strategy.
Drug selection
If you have constipation, your doctor may recommend fiber supplements. The American College of Gastroenterology (ACG) recommends using soluble fiber (but not insoluble fiber) to relieve symptoms of IBS in its 2021 Clinical Guidelines for the Treatment of IBS.
Some medications are specifically approved for use in certain people with irritable bowel syndrome.
If you have diarrhea:
- Viberzi (eluxadoline), which reduces muscle contractions and fluid in the intestines and improves muscle tone in the rectum.
- Xifaxan (rifaximin), an antibiotic that reduces bacterial overgrowth.
For constipation:
- Amitiza (lubiprostone) and Linzess (linaclotide) increase fluid secretion in the small intestine, making bowel movements easier.
Antidepressants may also be prescribed, especially if you suffer from depression and stomach pain.
Alternative and Complementary Therapies
New evidence suggests that acupuncture, yoga and mindfulness meditation can help reduce stress and may help relieve irritable bowel syndrome symptoms.
Another way to cope with stress is cognitive behavioral therapy (CBT), a type of psychotherapy that focuses on issues related to symptoms. CBT targets the brain-gut connection, which is thought to be a major cause of IBS symptoms.
Gut-directed hypnotherapy, designed to control your body’s response to changes in irritable bowel syndrome symptoms, research shows promising results by reducing the gut’s response to mood swings and stress and changing the way the brain interprets signals from the gut.
Change your eating habits
For people with irritable bowel syndrome, it can be difficult to determine which foods are likely to cause symptoms. A food diary can help you identify foods you should avoid.
Following a diet such as a low-FODMAP diet (FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols – poorly digested carbohydrates that can cause gas, bloating and diarrhea) can also help relieve symptoms.
A low-FODMAP diet includes eating less foods containing lactose (found in dairy products); fruits such as apples, pears, and cherries; cruciferous vegetables such as broccoli and cauliflower; beans; and sugar-free gum and mints.
According to the ACG, the low-FODMAP diet can only be followed for a limited time. If you decide to follow a low-FODMAP diet, be sure to do so under the supervision of a doctor or a registered dietitian who specializes in gastrointestinal diseases.
According to the ACG, peppermint oil can be used to relieve symptoms of irritable bowel syndrome.
Peppermint oil contains L-menthol, an ingredient that can help relieve painful cramps in the gastrointestinal tract. Some studies show that taking enteric-coated peppermint oil capsules by mouth can be safe and effective in relieving abdominal pain and general symptoms of irritable bowel syndrome.
There is limited evidence to support the use of probiotics to relieve symptoms of irritable bowel syndrome, and the ACG recommends against using probiotics to relieve symptoms.
Prevention of Irritable Bowel Syndrome
You can’t prevent irritable bowel syndrome, but certain lifestyle changes can help reduce the frequency and severity of symptoms.
To stop IBS symptoms before they appear, dietary changes are often crucial. Depending on the type of IBS you have, you may want to talk to your doctor about limiting or avoiding foods that cause bloating (carbonated drinks, wheat, fruits and vegetables), foods containing gluten, and FODMAPs.
Better management of stress can also help prevent irritable bowel syndrome. Counseling, meditation, and yoga are all helpful stress-reduction techniques and activities.
Complications of irritable bowel syndrome
Chronic constipation or diarrhea from irritable bowel syndrome can lead to hemorrhoids.
Living with IBS is complex and challenging in its own right. Although irritable bowel syndrome does not permanently damage the digestive tract, it can take an emotional and psychological toll, especially when it comes to sex. Symptoms can appear at any time, making you fear something embarrassing will happen, and can easily ruin your mood.
Consider some of these suggestions:
- Talk to your partner about your fears.
- Learn stress management techniques to help you relax.
- Avoid trigger foods on days when you plan to be intimate.
- Take medications to relieve pain, bloating, and diarrhea so you have one less thing to worry about.
Research and Statistics: Who suffers from irritable bowel syndrome?
An estimated 25 to 45 million Americans suffer from irritable bowel syndrome, with women about twice as likely as men to suffer from it.
Research into irritable bowel syndrome is ongoing—we still don’t know what causes it, and even diagnosis is difficult because symptoms overlap with those of other conditions and there are no clear tests. But Barry Marshall, MD, an Australian doctor who won a Nobel Prize for discovering the link between stomach ulcers and Helicobacter pylori, developed a way to diagnose irritable bowel syndrome by listening to the sounds in the digestive tract.
In the Noisy Gut Project, Marshall and his team of researchers are testing a vocal cord that can listen and record what’s going on in the gut. The recordings were then fed into an artificial intelligence system that compared the sounds of the irritable bowel syndrome colon to those of a healthy colon.
Related diseases and possible causes of irritable bowel syndrome
For years, experts have believed that mood disorders such as anxiety and depression can worsen irritable bowel syndrome. However, recent research into the brain-gut connection (mentioned above) suggests that this connection also goes in the other direction – an irritated gut may send signals to the central nervous system, causing mood swings.
Stress—the body’s response to physical and emotional changes, stress, and challenges—is another condition associated with IBS. Stress activates certain neurotransmitters in the brain, stimulating pain signals in the gut and exacerbating irritable bowel syndrome.
Research suggests that the chronic pain disorder fibromyalgia may also be linked to irritable bowel syndrome.
Inflammatory bowel disease (IBD) is a condition whose symptoms partially overlap with those of irritable bowel syndrome, but they are completely different conditions. For one thing, IBS is more common than IBD, affecting about 25 to 45 million Americans, while IBD affects about 3 million U.S. adults.
Often classified as Crohn’s disease or ulcerative colitis, IBD is associated with an abnormal response of the body’s immune system. The lining of the intestines becomes inflamed and ulcers form, which over time can lead to permanent damage to the digestive tract. These conditions often require medication and may even require hospitalization and surgery.
FAQs about Irritable Bowel Syndrome
What is Irritable Bowel Syndrome (IBS)?
IBS is a common gastrointestinal disorder characterized by a combination of symptoms, including abdominal pain, bloating, gas, and changes in bowel habits (diarrhea, constipation, or both). It is a chronic condition that affects the large intestine (colon) but does not cause structural damage.
What are the common symptoms of IBS?
Common symptoms of IBS include abdominal pain or discomfort, changes in bowel habits (diarrhea, constipation, or alternating between the two), bloating, gas, and mucus in the stool. Symptoms can vary in severity and may come and go over time.
What causes IBS?
The exact cause of IBS is not fully understood, but it is believed to result from a combination of factors, including abnormal gut motility, sensitivity to certain foods, stress, and changes in gut bacteria. Genetics and a history of gastrointestinal infections can also play a role.
Is there a cure for IBS?
Currently, there is no cure for IBS. However, symptoms can be managed and improved through lifestyle changes, dietary modifications, stress management, and, in some cases, medications prescribed by a healthcare provider. Treatment is typically tailored to the individual's specific symptoms and needs.
How is IBS diagnosed?
IBS is diagnosed based on the presence of characteristic symptoms and the exclusion of other medical conditions that could be causing similar symptoms. Healthcare providers may perform tests, such as blood tests, stool tests, and imaging, to rule out other conditions. In some cases, they may perform a colonoscopy or endoscopy.
Resources We Love
About IBS, from the International Foundation for Functional Gastrointestinal Disorders (IFFGD)
The IFFGD, a nonprofit organization, works with patients, families, healthcare providers, and researchers to increase awareness and understanding of gastrointestinal issues and to improve digestive health. Their page Living with IBS delves into the challenges that people with IBS may face, from traveling to navigating holidays to being pregnant.
This online community is great for IBS patients looking for support and connection. Community forums directly address a range of IBS issues, and you can also find resources on living with IBS, including patient diaries, and a podcast that includes conversations with patients, researchers, GI doctors, and dietitians.
For clear, accurate health information, the Mayo Clinic is one of Everyday Health’s trusted go-to sources. Their comprehensive coverage of IBS goes beyond the basics, with tips on how to prepare for an appointment to discuss IBS with a gastroenterologist and what questions to ask.
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
In addition to in-depth review of symptoms, treatment, and how to manage IBS, the NIDDK’s site also offers the latest on clinical trials potentially available to IBS patients.
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