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Is IBS Real? What if you have been diagnosed?
Irritable bowel syndrome (IBS) is the most frequently diagnosed functional gastrointestinal disorder in primary and secondary care. It is characterised by abdominal discomfort, pain and changes in bowel habits that can have a serious impact on the patient’s quality of life. IBS is particularly problematic as a label because it provides no effective guidance on next steps. Mainly because the IBS label implies that you have found the problem and it is unnecessary to look for a root cause or specific treatment. IBS is not a cause, it is only a description of your symptoms.
What Is IBS and How to Know if You Have It?
Irritable bowel syndrome (IBS) a common diagnosis of a condition that affects the digestive system, i.e., the large intestine. If you suffer from this condition you are probably experiencing signs and symptoms like stomach cramps and pain, gas, diarrhoea, bloating, and constipation. Unfortunately, this disease can be a lifelong chronic condition which can be quite frustrating and influence the quality of your life.
The pathophysiology of IBS is not yet completely clear. Genetic, immune, environmental, inflammatory, neurological and psychological factors, in addition to visceral hypersensitivity, can all play an important role, one that most likely involves the complex interactions between the gut and the brain (gut-brain axis).
The diagnosis of IBS can only be made on the basis of the symptoms of the Rome IV criteria:
Recurrent abdominal pain, on average, at least 1 day per week in the last 3 months, associated with 2 or more of the following criteria: – Related to defecation – Associated with a change in frequency of stool – Associated with a change in form (appearance) of stool Criteria fulfilled for the last 3 months with symptom onset at least 6 months before diagnosis.
Certain symptoms such as gastrointestinal bleeding, unexplained weight loss, and age were selected to be used as referral guidelines for further medical testing (e.g. colonoscopy) to rule out colon cancer and inflammatory bowel disease.
This means everything else is labelled as IBS but the problem is that there are countless other identifiable (and treatable!) gastrointestinal disorders and triggers responsible for IBS symptoms, beyond the very severe colon cancer and inflammatory bowel disease.
IBS Signs and Symptoms
The signs and symptoms of IBS can differ and vary from person to person. The symptoms can get worse, but sometimes they can either improve or disappear altogether.
Here are the most common IBS symptoms:
• Stomach pain, cramps, and bloating which is usually relieved by passing a bowel movement
• Constipation or diarrhoea, or sometimes both
• Traces of mucus in the stool and excess gas
When to Seek Medical Help?
You should see a doctor if you experience a change in bowel habits or some of the IBS symptoms or signs that last for a long time and are persistent. Such changes can suggest other serious health issues like colon cancer.
Seek instant medical help if you experience some severe and more-serious symptoms which include:
• Night-time diarrhoea
• Rectal bleeding
• Iron deficiency
• Swallowing difficulties
• Persistent, not relievable pain
• Weight loss
• Unexplained vomiting
What can Cause IBS?
Even though the exact cause of Irritable bowel syndrome is still unknown, many different factors can affect this syndrome:
• Nervous System
Your digestive system may have some nerves abnormalities that may cause significant discomfort when your stomach stretches due to gas or stool. And, your body can also overreact to changes and result in pain, constipation, or diarrhoea if the signals between the intestines and brain aren't coordinated.
• Intestine Muscle Contractions
Layers of muscle are covering the walls of the intestines which contract every time food passes through the digestive tract. Such contractions are normal. But, if you have ones that are stronger or persistent they may cause gas, diarrhoea, or bloating. On the other hand, weak contractions can lead to dry and hard stools because they slow down food passage.
• Severe Infection / Gastroenteritis
Gastroenteritis is yet another cause of IBS. It is a common condition that causes diarrhoea and vomiting which are a result of a bacterial or viral stomach bug. Or, people may suffer from IBS as a result of bacterial overgrowth, i.e., excess of bacteria in the intestines.
• Intestine Inflammation
Surprisingly but true, some people who suffer from irritable bowel syndrome tend to have an increased number of immune-system cells in their intestines. And, whenever these cells are active and respond to some 'immunity threat' pain and diarrhoea may appear.
• Microflora Changes
Last but not least, microflora refers to the good bacteria present in the intestines which are crucial for being healthy. And, according to research people who suffer from IBS experience changes in the bacteria in the gut. In other words, they have different microflora from healthy people.
What Can Trigger IBS?
The signs and symptoms of Irritable bowel syndrome may be triggered by:
• Stress
As we already mentioned, you can relieve IBS symptoms by reducing stress. So, it is entirely logical to conclude that stress can lead to experiencing more severe IBS signs and symptoms. However, stress cannot cause IBS but only aggravate signs and symptoms.
• Food
Even though it is still unexplained, food intolerance and allergies may have an impact on experiencing IBS symptoms. Indeed, allergies rarely cause IBS, but the symptoms can get worse after the consumption of certain foods or drinks like citrus fruits, beans, dairy products, cabbage, wheat, carbonated drinks, or milk.
• Hormones
The reason why hormones are believed to have the ability to trigger IBS signs and symptoms is that women are twice more likely to have IBS when compared to men. In fact, women pointed out that their signs and symptoms are more severe around or during their menstrual period. So, experts concluded that hormonal changes can also trigger IBS.
What Puts You at Risk of Having IBS?
Several factors increase the risk of suffering from Irritable bowel movement, including:
• Age - people under 50 are more likely to suffer from IBS
• Gender - women who experience hormonal changes or are undergoing an oestrogen therapy
• Genes - people who have relatives having IBS
• Mental health - people who suffer from anxiety, depression, or other mental health issues
Complications and Prevention
Several complications may occur due to IBS. For example, experiencing persistent and chronic diarrhoea or constipation can lead to having haemorrhoids. IBS is usually connected to having a poor quality of life and mood disorders.
You can help to prevent or relieve IBS flare ups, signs and symptoms by managing stress and eating plenty of fresh vegetables such as leafy greens.
You can try counselling, biofeedback, progressive relaxation exercise, mindfulness training, mindful eating or whatever else works for you.
If you have been diagnosed with IBS, I recommend finding a functional practitioner to work with that can identify and treat your specific underlying causes, because there is always a reason for your symptoms
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