Irritable Bowel Syndrome (IBS): Symptoms, Causes & Treatment

Irritable Bowel Syndrome (IBS)

Living with Irritable Bowel Syndrome (IBS) can be daunting and challenging for those affected by this chronic condition. IBS not only affects the physical health of individuals but also takes a toll on their emotional well-being.

Whether you are diagnosed with the condition or have a family member with IBS, it’s crucial to understand the triggers and how to treat IBS. This article can help you with that.

What Is IBS?

Irritable Bowel Syndrome (IBS) has no distinct subtype like inflammatory Bowel Disease (IBD), however, IBS symptoms can vary, and some classifications based on predominant symptoms have been proposed. 

IBS with constipation (IBS-C): People with Ibs-c primarily experience constipation as a predominant symptom. They may have fewer bowel movements than usual, typically less than daily, but you can have a daily bowel motion and still be constipated. Stools may be hard, lumpy, or difficult to pass, and individuals may feel a sense of incomplete evacuation.

IBS with diarrhea (IBS -D): This type of IBS is characterized by frequent episodes of diarrhea. Individuals with IBS-D may have loose stools and may experience an urgent need to have bowel movements than usual, typically more than three per day.

Mixed IBS(IBS-M): This type of IBS involves a combination and both constipation and diarrhea and is the most common type of IBS.

In addition to these classifications, some individuals may experience a subtype called post-infectious IBS (IBS-PI), which occurs after a gastrointestinal infection

IBS-PI is characterized by the development of IBS symptoms following an episode of acute gastroenteritis.

It's important to note that these classifications are not strict categories, and some individuals may experience symptoms that do not neatly fit into any specific type

Each person with IBS may have a unique combination of symptoms and triggers. It is recommended to work with a healthcare professional to manage IBS symptoms and develop an individualized treatment plan.

Symptoms of Irritable Bowel Syndrome

The symptoms of IBS can vary from person to person, and even change for each person especially if you switch between constipation and diarrhea.

 The most common symptoms include:

symptoms of ibs


  • Abdominal pain: This is a common symptom of IBS. The pain or discomfort may be experienced as cramping, aching, or a sense of pressure in the abdomen. The intensity and location of the pain can vary and it may be there occasionally or constantly.
  • Bloating and excess gas: Many people with IBS experience bloating or a feeling of fullness or swelling in the abdomen. It can be accompanied by increased gas production and flatulence. Sometimes people “feel” full but are not bloated and this maybe visceral hypersensitivity, which is more of a feeling of bloating.
  • Changes in bowel habits: IBS can cause alteration in bowel movements. These changes can include:

    Diarrhea: Some people with IBS experience frequent loose or watery stools.

    Constipation: Others may have infrequent bowel movements or difficulty passing stools, which may be hard and dry.

    - Alternating pattern: Some people may alternate between episodes of diarrhea and constipation.
  • Abnormal stool consistency: Stools in IBS can vary from loose and mushy to hard and lumpy. Sometimes it is more of a feeling of incomplete evacuation after a bowel movement.
  • Mucus in the stool: In some cases, people with IBS may notice the presence of mucus in their stools. If this is the case Inflammatory Bowel Disorder (IBD) should be ruled out.

  • Urgency to have a bowel movement: Some individuals with IBS may experience a strong and sudden urge to have a bowel movement, which can be challenging to control.
  • Fatigue and disrupted sleep: IBS can be associated with fatigue and low energy due to nutritional deficiencies. Sleep disturbances, such as difficulty falling or staying asleep, are common for people feeling pain or discomfort.

  • It’s important to note that IBS symptoms can be chronic, recurring over a long period of time. However, they do not typically cause serious complications or permanent damage to the intestines. 

    These symptoms can significantly impact a person’s quality of life and may require medical management. If you are experiencing persistent digestive symptoms, it is recommended to consult with a healthcare professional, experienced with treating irritable bowel syndrome.

    For most people this will not be your doctor, as they don't usually try and investigate the underlying cause once more serious conditions have been ruled out.

Diagnosing Irritable Bowel Syndrome - Rome IV Criteria

Irritable Bowel Syndrome, commonly abbreviated as IBS, is diagnosed based on the Rome IV criteria, which were last updated in 2016. These criteria focus on clinical symptoms, and are as follows:

  1. Recurrent abdominal pain, on average, at least one day per week in the last three months.
  2. The abdominal pain is associated with two or more of the following:

a. It is related to defecation.

b. It is associated with a change in the frequency of stool. 

c. It is associated with a change in the form (appearance) of the stool.

Additionally, for a diagnosis to be made, these criteria must have been fulfilled for the last three months, with symptom onset at least six months prior to diagnosis.

Try-to-Reduce-Foods-High-in-FODMAPs

Triggers for Irritable Bowel Syndrome (IBS) 

Triggers for IBS can vary among individuals, and what triggers symptoms in one person may not affect another. Here are some common triggers that can worsen your IBS symptoms.

Diet: Certain types of foods and beverages can trigger symptoms. Common dietary triggers include fatty or fried foods, spicy foods, gluten, dairy products (for those with lactose intolerance), caffeine, alcohol, carbonated drinks, and artificial sweeteners like sorbitol and xylitol. 

High-FODMAP foods (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) such as onions, garlic, wheat, and some fruits can also trigger for some individuals with IBS.

Stress and Anxiety: Emotional stress and anxiety can often exacerbate IBS symptoms. The gut-brain connection is strong and changes in gut motility.

Also Read: Emotional Stress and Your Digestive Health

Hormonal changes: Many women with IBS find that their symptoms worsen during menstruation due to hormonal fluctuations. Some women may also experience symptom changes during pregnancy or menopause.

Also Read: How To Test Your Hormones

Medication: Certain medications can affect digestive function and trigger IBS symptoms. These may include antibiotics, non-steroidal anti-inflammatory drugs(NSAID), and some antidepressants.

Infection: Gastrointestinal infections, such as bacterial or viral infections, can trigger IBS symptoms. This is known as post-infectious IBS (IBS-PI).

Changes in routine or lifestyle: Sudden changes in routine, such as traveling or changes in sleep patterns, can sometimes trigger symptoms. Lack of physical activity or inadequate sleep can also contribute to symptoms flare-ups.

Food tolerance or sensitivities: Some individuals with IBS may have specific food intolerances or sensitivities that trigger symptoms. Common examples include lactose intolerance, gluten sensitivity (in non-celiac individuals), and sensitivity to certain food additives.

It’s important to identify your personal triggers by keeping a food and symptoms diary to track potential associations. By identifying triggers, you can modify your diet, manage stress levels and make lifestyle adjustments to help minimize symptoms and improve your overall well-being.

What Causes IBS?

The exact cause of Irritable Bowel Syndrome (IBS) is not known. However, several factors are believed to contribute to the development of IBS, including.

Abnormal gastrointestinal motility: The muscles of the intestine may contract more forcefully or more slowly in individuals with IBS, leading to changes in bowel habits and discomfort.

Visceral Hypersensitivity: People with IBS may have an increased sensitivity to pain and discomfort in the intestines. Even a normal amount of gas or stool can trigger an exaggerated sensation of pain or discomfort.

Intestinal Inflammation: Low-grade inflammation of the intestines may contribute to the development of IBS in some individuals. However, this inflammation is not as severe as that seen in conditions like Crohn's disease or ulcerative colitis.

Changes in gut microbiota: The gut is home to a complex community of microorganisms known as the gut microbiota. Alteration in the composition or diversity of the gut microbiota may be associated with IBS. These changes could potentially influence gut function and contribute to symptoms.
Also Read: How Your Gut Microbiome Shapes Your Health

Abnormal gut-brain communication: There is a bidirectional communication pathway between the gut-brain axis, via the Vagus nerve. Disruption in the nervous system can be a trigger in the development of IBS. Stress, anxiety, and other psychological factors can affect gut function and trigger symptoms.

Genetic and environmental factors: There may be a genetic predisposition to developing IBS, as it tends to run in families. SelfDecode genetic reports can help you identify these genes, as well as giving you ideas on how to improve gut symptoms.

Assessing genetic risk factors with SelfDecode

Certain environmental factors, such as infection, early life stress, or traumatic events, may also contribute to the onset or exacerbation of IBS symptoms.

It's important to note that IBS is a complex condition, and the interplay of this factor can vary among individuals. It is likely that multiple factors contribute to the development of IBS, and a specific combination of factors can differ from person to person.

While the exact cause remains uncertain, healthcare professionals focus on managing symptoms and improving the quality of life for individuals with IBS. Your doctor may try various treatment approaches, including dietary modification, stress management techniques, medications, and lifestyle changes.

The key is to identify your underlying cause of IBS, doing a detailed stool test like the GUT Zoomer OR GI Map test and also testing for SIBO can help to identify the cause for you.

Irritable Bowel Syndrome - Assess with GI Map and Sibo Testing

The Treatment Options for IBS

Treating the condition involves focusing on managing symptoms and improving quality of life. At the same time, each person needs to be assessed to find out their individual trigger or cause of their IBS.

The specific treatment approach can vary for each individual, and it may involve a combination of the following strategies:

Lifestyle Modification

Dietary change: Identifying and avoiding trigger foods can help alleviate symptoms. Keeping a food dietician who specializes in gastrointestinal health can be beneficial. Some individuals find relief by following a low-FODMAP diet, which involves restricting certain types of carbohydrates that can trigger symptoms in some people with IBS.

Eating habits: Eating smaller, more frequent meals and avoiding large, heavy meals can help prevent symptoms. Chewing food thoroughly and eating slowly may also be helpful.

Stress management: Stress and anxiety can worsen IBS symptoms, so finding effective stress management techniques, such as relaxation exercises, meditation, or counseling, can be beneficial.

Medications:

  • Antispasmodics: This medication helps reduce abdominal pain and cramping by relaxing the muscles of the intestines.
  • Antidiarrheal medications: For individuals with IBS-D, medication such as loperamide can help control diarrhea.
  • Laxatives: In cases of IBS-C, laxatives may be prescribed to help relieve constipation.
  • Low-dose antidepressants: Certain tricyclic antidepressants and selective serotonin reuptake inhibitors(SSRIs) can help manage abdominal pain, regulate bowel movements, and improve overall well-being. This medication can be prescribed even if you do not have a diagnosed mental health condition.

*Note: these medications are symptom management only and commonly used by conventional doctors, at Planet Naturopath we focus on identifying and addressing the underlying cause so that these medications are not needed.

Probiotics: Some individuals find relief from symptoms by taking probiotics, which are beneficial bacteria that can help restore balance in the gut microbiota. However, the effectiveness of probiotics varies, and not all probiotics may be equally helpful.

It is important to choose probiotics based on research and not something off the supermarket shelf or has good Amazon reviews.

Psychological Therapies

Cognitive Behavior Therapy (CBT)

CBT can help individuals with IBS identify and change negative thought patterns and behavior that contribute to symptoms. It can be particularly helpful in managing stress, anxiety and improving coping skills.

Gut-directed Hypnotherapy

This form of hypnotherapy has shown promise in managing IBS symptoms, particularly for individuals with IBS-D or IBS-M. It involves the use of relaxation techniques to reduce pain and discomfort.

I have found the Nerva Program to be particularly beneficial, this is an app and 6-week course using hypnotherapy to improve the symptoms of IBS.

It’s important to work with a healthcare professional to determine the most appropriate treatment plan for your specific symptoms and needs. Treatments for IBS may require some trial and error to find the most effective approach for symptom control, and regular follow-up with your healthcare provider is crucial to monitor progress and make any necessary adjustments.

How to Prevent IBS

Preventing Irritable Bowel Syndrome (IBS) is challenging as the exact cause of the condition is not well understood. However, there are some strategies that may help reduce the risk of developing IBS or minimize symptoms flare-ups:

Healthy Lifestyle 

Maintain a balanced diet: Eat a well-rounded diet that includes a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats. Avoid excessive consumption of fatty or processed foods as they may trigger symptoms.

Stay hydrated: Drink an adequate amount of water throughout the day to help maintain regular bowel movements and prevent dehydration.

Regular exercises: Engage in regular physical activity as exercise can help regulate bowel movements and reduce stress.

Manage Stress

Stress management techniques: Practice stress-reducing techniques such as relaxation exercises, deep breathing, meditation, or yoga. Find activities that help you unwind. 

Prioritize self-care: Engage in activities that you enjoy and that help you relax. This could include hobbies, spending time with loved ones, or engaging in activities that promote mental health.

Identify and Manage Triggers

Keep a symptoms diary: Track your symptoms and possible triggers to help identify patterns or specific foods or situations that may worsen your symptoms. Avoid or minimize exposure to identified triggers.

Gradual dietary changes: If certain foods or food groups trigger your symptoms, consider working with a registered dietician to make gradual dietary modifications that suit your specific needs and help manage symptoms.

Avoid smoking and excessive alcohol consumption

Both smoking and excessive alcohol intake can irritate the digestive system, potentially worsening IBS symptoms. If you smoke, consider quitting and consuming alcohol in moderation or avoid it altogether.

It’s important to note that these preventive measures may not guarantee the prevention of IBS or eliminate symptoms, as the condition’s exact cause is unknown.

How Is IBS Diagnosed?

The diagnosis of IBS is typically made based on the presence of characteristic symptoms and the exclusion of other conditions that may cause similar symptoms. There is no specific test to definitively diagnose IBS, but the diagnostic process usually involves the following steps:

Medical History

Your healthcare provider will review your medical history and ask about your symptoms, their duration, and associated factors or triggers. They may also inquire about your family history of digestive disorders.

Physical Examination

A physical examination may be performed to check for any sign of underlying conditioner abnormalities.

Symptoms evaluation

Your healthcare provider will assess your symptoms to determine if they meet the diagnostic criteria for IBS. The Rome criteria are commonly used guidelines for diagnosing functional gastrointestinal disorders, including IBS. 

According to the Rome IV criteria, IBS is diagnosed when abdominal pain or discomfort is present for at least three months, along with two or more of the following: improvement with bowel movements, change in stool frequency, or change in stool form.

Test to rule out other Conditions

There are no specific laboratory tests or imaging studies to diagnose IBS, but your healthcare provider may order certain tests to exclude conditions that may have similar symptoms. 

These tests may include blood tests to check for signs of inflammation, celiac disease, or other condition, as well as stool tests to rule out infection or malabsorption issues. 

In some cases, additional tests like colonoscopy or imaging studies may be performed to evaluate the intestinal tract and rule out disease.

It’s important to note that the diagnostic process may vary depending on individual circumstances, and additional tests may be required based on specific symptoms or clinical judgment.

When To See Your Doctor

It is recommended to see a doctor if you are experiencing persistent or recurrent digestive symptoms that do not resolve with diet changes.

While IBS does not cause serious complications, it can significantly affect your quality of life and may require medical management. 

Here are some situations in which it is advisable to seek medical attention:

Frequent or severe abdominal pain: If you are experiencing persistent or severe abdominal pain interfering with your daily activities, it is essential to consult a healthcare professional. This will help determine if there is an underlying cause for your symptoms or if they are related to IBS.

Unexplained weight loss: Significant and unintentional weight loss can be a concerning symptom. If you are losing weight without trying or have noticed a significant change in your appetite, you should see a doctor for further evaluation.

Blood in the stool: Blood in your stool can indicate various conditions, some of which may be unrelated to IBS. If you notice blood in your stool or experience rectal bleeding, it is important to seek medical attention to rule out colon cancer.

Onset of symptoms after age 50: If you are over 50 and have recently developed digestive symptoms, it is vital to see a doctor to rule out other potential causes. The risk of certain gastrointestinal conditions, such as colon cancer, increases with age.

Symptoms that progressively worsen: If your symptoms are gradually worsening over time or becoming more frequent and severe, it is recommended to consult with a healthcare professional for further evaluation.

New or concerning symptoms: If you are experiencing new or unusual symptoms that you are not previously discussed with a healthcare professional, it is advisable to seek medical advice.

Remember that a healthcare professional experienced in gut health is best equipped to evaluate your symptoms, provide an accurate diagnosis, and develop an appropriate treatment plan. They can rule out other potential causes and help manage your IBS symptoms.

You can schedule your consultation by clicking the button below. I have 15+ experience of in helping patients with IBS and other digestive issues.

Conclusion

Irritable Bowel Syndrome, or IBS, is a common disorder affecting the small and large intestines. It is characterized by a group of symptoms, including abdominal pain, bloating, change in bowel habits, and discomfort.

The exact cause of IBS is not fully understood, but it is believed to involve a combination of factors.

IBS is a condition can be managed effectively, and if you address the underlying cause can lead to long term resolution. It is important to consult with a healthcare professional experienced in gut health if you suspect you have IBS or are experiencing persistent digestive symptoms. They can provide accurate diagnoses, rule out other potential conditions, and guide you in developing an individualized treatment plan tailored to your needs.
With proper management and support, most individuals with IBS can effectively manage or eliminate their symptoms and lead healthy life.

Understand the underlying triggers behind your Irritable Bowel symptoms by ordering the GI Map stool test. You can include a consultation so that we can help you with a plan to get your digestive health back on track.

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