At a Glance: Irritable Bowel Syndrome

Irritable bowel syndrome or IBS is one of the most common diseases that affect the gastrointestinal tract. Here are some facts about irritable bowel syndrome including its causes, risk factors, symptoms, and treatment.

What is irritable bowel syndrome (IBS)？

Irritable bowel syndrome is a condition affecting your digestive system. It is also referred to as a disorder of gut-brain interaction and is linked to issues with how your gut and brain function together. Your digestive tract becomes quite sensitive when this gut-brain interaction is affected and leads to altered gut muscle contractions. As a result, you may get diarrhoea, constipation, and abdominal pain.

What are the different types of irritable bowel syndrome？

Irritable bowel syndrome is classified based on bowel movements. It includes –

IBS with constipation (IBS-C): Stools are hard and lumpy
IBS with diarrhoea (IBS-D): stools are loose and watery
IBS with mixed bowel habits (IBS-M): when you get loose, watery stools with alternating episodes of hard, lumpy stools

What are the causes of irritable bowel syndrome (IBS)？

There is no exact cause for this disease. Certain factors mainly lead to this condition which include –

Infections: Certain infections like gastroenteritis and bacterial overgrowth (surplus of bacteria in the intestines) can lead to this condition
Nervous system: You may experience discomfort, diarrhoea, or constipation if there is insufficient communication between your brain and the nerves in your intestines
Stress: Stress exposure, especially during childhood, increase the chances of developing this disease
Changes in your gut microflora: Changes in the bacteria, fungi, and viruses that generally live in the intestines lead to IBS as they are important for maintaining good health
Dysmotility: Muscle layers line the inside of the intestines which contract to move food through your digestive system. Contractions that are stronger and last longer than usual may cause gas, bloating, and diarrhoea. Weak contractions might hinder digestion and cause stiff, dry stools
Visceral hypersensitivity: Extra sensitive nerves that are present in your digestive tract makes you more prone to disease.

Who's at a greater risk of developing irritable bowel syndrome？

The chances of getting IBS are more if you are:

Below 50 years of age
Having a positive family history
Female: Females are more likely to develop IBS, especially when they are on estrogen therapy before or after menopause
Exposed to stress, anxiety and depression
Having food intolerance (when your body is unable to digest certain foods properly)

What are the primary signs and symptoms of irritable bowel syndrome?

The symptoms of IBS generally include –

Bloating
Abdominal pain or cramps
Bowel movements that are harder (constipation) or looser than (diarrhoea) normal
Loss of appetite
Indigestion

How is irritable bowel syndrome diagnosed？

There are no specific diagnostic tests for IBS. A thorough medical history, physical examination, and testing to rule out other diseases, such as celiac disease and inflammatory bowel disease, are likely to be the first steps taken by your healthcare professional. Additional tests are –

Laboratory tests –

Stool tests: To determine the presence of bacteria, parasites and bile in your stools
Breath test: usually done to find out if there is a bacterial overgrowth in your intestines
Lactose intolerance test: To break down the sugar in dairy products, you require the enzyme lactase. The symptoms of IBS, such as abdominal pain, gas, and diarrhea, may occur if your body is unable to make lactase. You might be asked to forgo milk and milk-derived items for several weeks or your doctor might ask you to take a breath test

Imaging procedures –

Computed tomography (CT scan): This test generates images of your abdomen and pelvis that help your doctor rule out alternative explanations for your symptoms, particularly if you are experiencing abdominal pain
Colonoscopy: This is used to examine the entire length of your colon
Upper endoscopy: In this procedure, a long flexible tube with a camera at the end is inserted through your mouth that allows your provider to see your upper digestive tract. A tissue sample (biopsy) may be collected during an endoscopy. A sample of fluid can be collected to look for bacterial overgrowth

What is the course of treatment for IBS (irritable bowel syndrome)？

IBS can be managed by maintaining a healthy lifestyle and diet. There is no specific therapy, but doctors prescribe certain medications according to their causes and symptoms. These include –

Pain medications: This helps reduce severe pain and bloating (eg. pregabalin)
Fibre supplements: These include supplements like psyllium which help to reduce symptoms of constipation
Antidiarrhoeal medications: This helps to reduce symptoms of diarrhoea. (eg. loperamide)
Anticholinergic medications: These are usually given to get relief from painful bowel spasms
Antidepressants: They include medications like fluoxetine and imipramine which can help ease abdominal pain as well as improve digestion
Rifaximin: This is an antibiotic used to treat bacterial overgrowth
Linaclotide: This drug increases fluid secretion in your intestines and helps you to pass stools more easily
Probiotics: Probiotics are a combination of live bacteria or yeast residing in our bodies that help maintain our gut health

Lifestyle and dietary changes –

Reduce constipation by increasing fibre in your diet through consumption of more fruits and vegetables
Eat at regular times, this will help you to regulate bowel function
Eat smaller meals if you have diarrhoea
Limit milk and cheese products if you have lactose intolerance
Exercise regularly
Try relaxation techniques like meditation, yoga to ease your stress and discomfort
Keep a record of the foods you take so that you can find out which foods are triggering your IBS. Common triggers include wheat, red wine, onions etc.
Try to use a low FODMAP diet – FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. These are short chains of carbohydrates (sugars) that are poorly absorbed by the small intestine.

– Foods rich in FODMAP are dairy-based milk, yoghurt and ice cream, wheat-based cereals, bread and crackers, vegetables like beans, onions, garlic, asparagus and fruits like apples, cherries, pears and peaches
– Low FODMAP foods are egg, meat, almond milk, oats, vegetables like potatoes, tomatoes, and cucumbers and some fruits like oranges, strawberries, and pineapple