Irritable Bowel Syndrome (IBS)

Overview

Irritable Bowel Syndrome (also known as IBS) is a disorder of the GI tract that primarily affects the large intestine (also known as the colon). IBS is characterized by gastrointestinal symptoms that usually occur together, including recurring abdominal pain, cramping and changes in bowel habits like loose bowel movements and/or constipation.

Unlike Inflammatory Bowel Disease (IBD), celiac disease, Crohn’s disease and other bowel disorders that can impact the gastrointestinal tract, Irritable Bowel Syndrome doesn’t usually cause inflammation of the colon or visible damage to the bowel tissue. Having IBS symptoms also doesn’t usually increase a patient’s risk of developing colorectal cancer.

The true cause of IBS is unknown. About two-thirds of those with IBS are women, though the reason why IBS is more common in women than men is unknown.
In the U.S., it’s believed that somewhere between 25 and 45 million people suffer from Irritable Bowel Syndrome, though only a small number of people seek medical care for the IBS symptoms they may be experiencing.

Are There Other Names for Irritable Bowel Syndrome?

Irritable Bowel Syndrome is not related to other bowel disorders, including inflammatory bowel disease. However, IBS has been known by several other names in the past, including spastic colon, irritable colon, spastic colitis and mucous colitis.

Symptoms of Irritable Bowel Syndrome

IBS symptoms vary from person to person, and can range from mild to severe. A little over 20% of those with IBS experience severe symptoms. While most people with IBS experience moderate or mild symptoms, the condition can still affect a patient’s quality of life in many ways. Many people with IBS experience bowel symptoms, including recurring diarrhea, constipation on both. Other symptoms of Irritable Bowel Syndrome can include:

• Abdominal pain and cramping, which can be severe
• Gas and bloating
• A feeling of incomplete evacuation (like there’s “something still in there”) after having a bowel movement
• Seeing mucus in a bowel movement
• Worsening symptoms during menstrual periods
• Symptoms that get worse when you’re experiencing stress
• Increased urgency, which is feeling like you of need to have a bowel movement right away

Can IBS Cause Symptoms Outside the Digestive System?

In addition to gastrointestinal issues, some people may also experience IBS symptoms related to parts of the body other than the digestive system. These other symptoms may include:

• Trouble sleeping
• Depression
• Chronic pelvic pain
• Anxiety
• Fibromyalgia
• Migraine headaches

What Are the Different Types of IBS?

IBS can be categorized into four types based on the symptoms:

• IBS with diarrhea (IBS-D): Frequent, loose, watery bowel movements are common in this type.
• IBS with constipation (IBS-C): Characterized by hard, lumpy stools that are difficult to pass.
• IBS with alternating constipation and diarrhea (IBS-Mixed): Also known as IBS-M, this type is characterized by alternating between constipation and diarrhea.
• Unsubtyped IBS (IBS-U): This is the diagnosis when a patient’s bowel habits do not meet the criteria for IBS-D, IBS-C or IBS-M.

What Causes Irritable Bowel Syndrome?

The exact cause of IBS is not known. However, certain factors appear to play a role, and some studies suggest IBS may caused by a combination of issues. It’s believed IBS may be what’s known as a functional gastrointestinal disorder. Functional GI disorders are caused by problems with communication between the brain and the GI tract.

There are also certain issues that are more common in people with IBS, which suggests these problems may be a contributing cause of the disorder. These issues include:

• Physical abuse or sexual abuse in childhood
• Depression
• Anxiety
• Somatic Symptom Disorder, which is characterized by an excessive focus on symptoms like pain and fatigue to the point that it causes severe emotional stress.
• Infection with certain bacteria in the digestive tract
• An overgrowth of bacteria in the small intestine
• Sensitivity to certain foods

What Things Can Trigger IBS Symptoms?

Those with IBS can experience periods where they’re symptoms are mild or absent. But symptoms of IBS can sometimes be brought on by what are called “triggers.” While these are different for every patient, common triggers include:

• Stress: Periods of increased stress don’t cause IBS, but — for reasons medicine doesn’t fully understand yet — stress can trigger symptoms in many sufferers, making symptoms worse or more frequent.
• Certain foods: Many people with IBS experience increased symptoms after eating certain foods and beverages. Whether this is due to food allergy/sensitivity isn’t fully known.

Which Foods Can Trigger IBS?

Foods that commonly trigger IBS symptoms include:

• Carbonated beverages
• Wheat
• Milk and other dairy products
• Citrus
• Cabbage
• Lentils/beans

How Do Doctors Diagnose IBS?

There’s no specific test to diagnose IBS, so a diagnosis is usually made based on the IBS symptoms a patient is experiencing, like abdominal pain, frequent diarrhea and more. As part of your treatment plan, your doctor may perform certain tests to check for damage to your colon and rule out other conditions that can cause symptoms similar IBS. These tests may include:

• Stool sampling tests
• Blood tests
• X-rays
• Colonoscopy

Does Having IBS Increase the Risk Of Colon Cancer?

Irritable Bowel Syndrome can cause severe symptoms including abdominal pain, chronic diarrhea. Many of the symptoms experienced by those with IBS are shared by other conditions that can impact the digestive tract, including serious bowel disorders.

However, despite these similarities, IBS is unrelated to Inflammatory Bowel Diseases like Crohn’s and ulcerative colitis, in that it doesn’t usually cause visible damage to the bowel tissue. Also unlike Crohn’s disease and ulcerative colitis, IBS doesn’t usually increase a person’s risk of developing colon cancer.

Can Irritable Bowel Syndrome Be Cured?

While there is no cure for IBS, the symptoms of irritable bowel syndrome can often be effectively managed with lifestyle changes, dietary changes and medication. The goal of treatment is to provide long-term relief from symptoms and to manage the condition to improve quality of life.

Depending on the symptoms you’re experiencing, you may need to work with a dietitian to create an eating plan that helps you avoid foods that might trigger IBS. You may also need to get regular exercise, reduce stress and get more sleep.

Management & Treatment Options for Irritable Bowel Syndrome (IBS)

While IBS cannot be cured, it is possible for many patients to reduce the frequency of symptoms that impact your quality of life and provide relief long term. Managing IBS can involve a range of techniques, including:

• Changes to your diet, including, eating smaller meals
• Medication, both to relieve symptoms and reduce anxiety and stress
• Avoiding caffeinated beverages like coffee, tea and sodas, as caffeine can worsen IBS-related diarrhea
• Avoiding foods and drinks that overstimulate the intestines, along with common triggers you know bring on flare ups
• Keeping a food diary to help your doctor understand which foods and eating schedules might be causing issues
• Increasing the fiber in your diet, both through food and fiber supplements

Ways to Reduce Your Risk of Developing Irritable Bowel Syndrome (IBS)

While there is no definitive way to prevent yourself from developing IBS, there are steps you can take to reduce your risk. These methods may include:

• Get regular exercise
• Get more and better-quality sleep
• Eat a healthy and balanced diet
• Find ways to reduce and manage your stress levels, including through stress-relievers like yoga or meditation
• Drink plenty of water
• Quit smoking

What is a Low FODMAP Diet for IBS?

Some sufferers of IBS have tried a special eating plan called a low FODMAP diet. Those on a low FODMAP diet avoid certain foods containing carbohydrates called FODMAPs that are hard to digest. Be sure to consult your doctor before starting any new diet.

What Does ‘FODMAP’ Stand For?

FODMAP stands for: fermentable oligosaccharides, disaccharides, monosaccharides and polyols. These are short-chain carbohydrates, a type of sugar that the small intestine doesn’t absorb well. FODMAP foods contain these short-chain carbohydrates.

What Foods Should Be Avoided on a Low-FODMAP Diet?

Many of the foods we eat contain FODMAPs. Examples of FODMAP-containing foods include:

• Certain fruits, including watermelon, apples, plums, apricots, nectarines, blackberries, pears and cherries whether eaten raw, cooked, dried or canned, and drinks that contain the juice of any any of these fruits
• Certain fresh, cooked or canned vegetables, including artichokes, asparagus, beans, cabbage, cauliflower, garlic (including garlic powder or salt), lentils/beans, mushrooms, onions, and peas
• Dairy products, including milk, milk products, soft cheese, yogurt, custard, and ice cream
• Products containing wheat and rye
• Honey
• Foods containing high-fructose corn syrup
• Certain sweeteners including maltitol, sorbitol, xylitol and mannitol