Irritable Bowel Syndrome (IBS)

Irritable Bowel Syndrome (IBS) is a common functional gastrointestinal disorder that affects the large intestine. It's characterized by a group of symptoms that occur together, including abdominal pain, bloating, and changes in bowel habits (diarrhea, constipation, or both). IBS is a chronic condition that requires long-term management.

While IBS can be uncomfortable and affect quality of life, it doesn't cause changes in bowel tissue or increase the risk of colorectal cancer. The exact cause is unknown, but it's thought to involve a combination of factors including gut-brain interactions, food sensitivities, and stress.

IBS symptoms vary from person to person and may include:

• Abdominal Pain or Cramping: Often relieved by bowel movement
• Bloating: Feeling of fullness or swelling
• Gas: Excessive flatulence
• Diarrhea: Loose, watery stools (IBS-D)
• Constipation: Hard, difficult-to-pass stools (IBS-C)
• Alternating Diarrhea and Constipation: (IBS-M)
• Mucus in Stool: White or clear mucus
• Feeling of Incomplete Evacuation: After bowel movement

Symptoms often worsen with:

• Stress
• Certain foods
• Menstrual periods (in women)
• Large meals

Dietary Management:

1. FODMAP Diet:

   • Low-FODMAP diet may help many people
   • FODMAPs are fermentable carbohydrates
   • Work with a dietitian for guidance
   • Elimination and reintroduction phase

2. Fiber:

   • Increase gradually if constipated
   • Soluble fiber (oats, psyllium) often better tolerated
   • Drink plenty of water with fiber

3. Meal Patterns:

   • Eat regular meals
   • Don't skip meals
   • Smaller, more frequent meals
   • Eat slowly and chew thoroughly

4. Food Triggers (common):

   • Dairy products
   • High-fat foods
   • Caffeine
   • Alcohol
   • Carbonated drinks
   • Artificial sweeteners

Lifestyle Modifications:

1. Stress Management:

   • Regular exercise
   • Relaxation techniques
   • Meditation or yoga
   • Cognitive behavioral therapy
   • Adequate sleep

2. Exercise:

   • Regular physical activity helps
   • Reduces stress
   • Improves bowel function
   • Start gradually

3. Keep a Symptom Diary:

   • Track foods, symptoms, stress
   • Identify patterns and triggers
   • Share with healthcare provider

• Persistent symptoms despite self-care
• Symptoms interfering with daily life
• Need for treatment options
• Questions about diet or management
• Symptoms have changed

• Unexplained weight loss
• Rectal bleeding
• Persistent diarrhea
• Severe abdominal pain
• Iron deficiency anemia
• Family history of colon cancer or inflammatory bowel disease

Diagnosis typically involves:

1. Medical History:

   • Symptom pattern (Rome criteria)
   • Duration of symptoms
   • Triggers and patterns

2. Physical Examination:

   • Abdominal examination
   • May include rectal exam

3. Tests to Rule Out Other Conditions:

   • Blood tests (celiac disease, inflammation)
   • Stool tests (infections, blood)
   • Colonoscopy (if indicated)
   • Breath tests (lactose intolerance, SIBO)

Rome Criteria (for diagnosis):

• Abdominal pain at least 1 day/week for 3 months
• Associated with 2+ of:
  • Related to defecation
  • Change in frequency of stool
  • Change in form of stool

Treatment is individualized:

1. Dietary Changes:

   • Low-FODMAP diet
   • Increased fiber (if constipated)
   • Avoid trigger foods
   • Probiotics (may help some)

2. Medications:

   • For Constipation: Fiber supplements, laxatives
   • For Diarrhea: Anti-diarrheal medications
   • For Pain: Antispasmodics, low-dose antidepressants
   • For Bloating: Probiotics, enzymes

3. Psychological Therapies:

   • Cognitive behavioral therapy
   • Gut-directed hypnotherapy
   • Stress management

4. Complementary Therapies:

   • Peppermint oil (may help)
   • Acupuncture (some evidence)
   • Probiotics

While IBS can't always be prevented:

• Manage Stress: Regular stress management
• Healthy Diet: Balanced, regular meals
• Regular Exercise: Helps with stress and bowel function
• Adequate Sleep: Important for overall health
• Identify Triggers: Avoid foods that worsen symptoms

IBS involves:

1. Altered Gut Motility: Intestines contract too strongly or weakly
2. Visceral Hypersensitivity: Increased sensitivity to pain
3. Brain-Gut Axis: Communication between brain and gut
4. Microbiome: Changes in gut bacteria may play a role
5. Inflammation: Low-grade inflammation in some cases

The exact cause varies between individuals, which is why treatment is personalized.

• Often begins in young adulthood
• May be stress-related
• Lifestyle factors important

• Most common age group
• Work and family stress
• Dietary habits established

• Can develop at any age
• May have other health conditions
• Medications may interact

• More common in women
• May worsen with menstrual cycle
• Hormonal factors may play a role

No. IBS is a functional disorder (symptoms without visible damage), while IBD (Crohn's disease, ulcerative colitis) involves inflammation and damage to the intestines.

IBS is a chronic condition, but symptoms can be managed effectively. Many people find that with proper management, symptoms improve significantly or become less bothersome.

Stress doesn't cause IBS but can trigger or worsen symptoms. The brain-gut connection is important in IBS, which is why stress management is a key part of treatment.

Only if you have celiac disease or non-celiac gluten sensitivity. Many people with IBS find relief on low-FODMAP diet, which may reduce gluten-containing foods, but that's different from a strict gluten-free diet.

Some people find probiotics helpful, but evidence is mixed. Different strains may work for different people. It's worth trying, but may take several weeks to see if it helps.