What is Irritable Bowel Syndrome (IBS)?
What is IBS?
Irritable bowel syndrome (IBS) is a functional bowel disorder (FBD). Functional bowel disorders are diagnosed using symptom criteria, and after the exclusion of other gastrointestinal diseases, such as celiac disease and inflammatory bowel disease (IBD).
How common is IBS?
IBS is estimated to affect 7 to 15% of the population worldwide. Here in Canada, it is estimated to affect 12% of the population [1]. It is more common in women than men, and tends to be diagnosed more commonly in those under 50 years of age.
Symptoms of IBS
IBS symptoms can vary from person to person, and can be unpredictable.
Common symptoms of IBS include:
• lower abdominal pain or discomfort
• altered bowel habits (diarrhea, constipation, or a combination of both)
• bloating (the feeling that there is an inflated balloon in the abdomen)
• excessive passage of wind (also known as gas)
• distension (a visible increase in abdominal girth).
These symptoms often wax and wane, and symptom severity varies within and between individuals [2, 3].
Causes of IBS
The precise cause of IBS is unknown, but likely to be multifactorial. Current research suggests the following factors are likely to contribute to the development of IBS:
• altered gastrointestinal (GI) motility
• visceral hypersensitivity
• impaired perception and processing of information by the brain
• low grade inflammation
• immune system activation
• intestinal permeability
• alterations in the gut microbiota [4].
Additionally, certain foods, stress, and hormonal changes may trigger symptoms.
Diagnosis of IBS
There are currently no tests available to adequately diagnose IBS. IBS should be diagnosed by a medical doctor, who should take a careful history and use the Rome IV criteria.
These criteria allow IBS to be classified by predominant symptom type, into:
• IBS-C (constipation predominant)
• IBS-D (diarrhea predominant)
• IBS-M (mixed bowel habits)
• IBS-U (unclassified).
**Important**
Please do not self-diagnose. IBS shares many symptoms with other diagnoses including but not limited to inflammatory bowel disease (Crohn’s and Colitis), diverticular disease, ovarian and colon cancers, pelvic floor disorders, endometriosis, endocrine disorders, pancreatic exocrine insufficiency, and bile acid malabsorption. It is important these are ruled out before beginning a treatment plan for IBS.
Managing IBS
While there is no cure for IBS, there are many strategies to help manage IBS symptoms.
Dietary changes, such as modifying the types and amounts of fibre in one’s diet, reducing alcohol, caffeine and fat, and increasing hydration. Some individual may choose to follow an elimination diet such as the low FODMAP diet.
Certain medications may also be prescribed to help with symptoms. For example, anti-diarrheals, or anti-spasmodics may be prescribed for IBS-D. Laxatives or 5-HT4 receptor antagonists may be prescribed for IBS-C. And anti-depressants are often prescribed to treat pain!
Lifestyle changes including exercise and stress management [ yoga, meditation, deep breathing], as well as different types of therapy can be used to help with the physical and psychological challenges of managing this difficult condition.
What do I do if I think I have IBS?
Step 1 - see your family doctor!
[P.s. I understand the challenge if you don’t have a family doctor right now in ON, but it is really important to have a formal diagnosis before seeking treatment].
Please refrain from making any dietary changes or otherwise before undergoing any tests, as that may interfere with the results. Your doctor will conduct all the necessary tests needed to formulate an accurate diagnosis.
If IBS is confirmed, and your MD believes that diet or lifestyle is affecting your condition, you can book an appointment to work with me here!
References:
2. Hungin, A.P., et al., The prevalence, patterns and impact of irritable bowel
syndrome: an international survey of 40,000 subjects. Aliment Pharmacol Ther,
3. Boeckxstaens, G.E., et al., Phenotyping of subjects for large scale studies on
patients with IBS. Neurogastroenterol Motil, 2016. 28(8): p. 1134-47.
4. Drossman, D.A. and W.L. Hasler, Rome IV-Functional GI Disorders: Disorders of
Gut-Brain Interaction. Gastroenterology, 2016. 150(6): p. 1257-61.