Have you considered that your digestion problems and stomachache could be related to Irritable bowel syndrome? IBS is a common disorder, affecting an estimated 15% of the population. It is one of the several conditions known as functional gastrointestinal disorders. This means the bowel may function abnormally, but tests are normal and there are no detectable structural defects.
IBS is diagnosed by exclusion, which means a doctor considers other alternatives first, performing tests to rule out other medical problems. A careful history and physical examination but a colon and rectal surgeon or other physician is essential. This is done to rule out more serious conditions. The two following criteria are helpful in making a diagnosis:
- Symptoms (described above) occur at least three days a month for three months
- IBS discomfort improves after a bowel movement or passage of gas
IBS is not the same as inflammatory bowel disease (IBD), a more serious condition that causes inflammation in the digestive tract and can result in severe complications.
Symptoms vary from person to person and can range from mild to severe. IBS is a long-term condition, so symptoms may come and go and change over time. The hallmark of IBS in adults and children is abdominal discomfort or pain. The following signs and symptoms also are common:
- Abdominal cramping and pain that are relieved with bowel movements
- Alternating periods of diarrhea and constipation
- Those who mostly have diarrhea as a symptom are considered to have IBS with diarrhea (IBS-D), characterized by sudden urges to have bowel movements, along with loose stools, , frequent stools, abdominal pain and discomfort, gas, and the feeling of being unable to completely empty the bowels. In severe cases of IBS-D, individuals may lose control of their bowels.
- Those who mostly have constipation as a symptom are considered to have IBS with constipation (IBS-C), characterized by passage of hard, lumpy stools, straining during bowel movements, and infrequent stools
- Change in the stool frequency or consistency
- Gassiness (flatulence)
- Passing mucus from the rectum
- Abdominal distension
- Loss of appetite
Though not a symptom of IBS, indigestion affects up to 70% of people with IBS.
No clear answer exists as to what causes IBS. It is believed that the symptoms occur due to abnormal functioning or communication between the nervous system and bowel muscles. Abnormal regulation may result in increased bowel “irritation” or sensitivity. The muscles in the bowel wall may lose their coordination, contracting too much or too little at certain times. While there is no physical obstruction, a patient may feel like cramps are a functional blockage.
- IBS is not contagious, inherited, or cancerous. It occurs more often in women than in men, and the onset occurs before the age of 35 in about half of the cases. IBS occurs in 5% to 20% of children.
- IBS also has developed after episodes of gastroenteritis.
- It has been suggested that IBS is caused by dietary allergies or food sensitivities, but this has not been proven.
- Genetics also is suggested as a potential cause of IBS, but so far a hereditary link has not been found.
- Symptoms of irritable bowel syndrome may worsen during periods of stress or during menstruation, but these factors are unlikely to be the cause that leads to the development of IBS.
All of the following have been identified as possible IBS risk factors:
- Gender: IBS is nearly twice as common in women as men
- Environmental factors
- Genetic factors
- Bacterial activity in the gut
- Bacterial overgrowth
- Food intolerance
- Altered ability of the bowel to move freely
- Oversensitive intestines
- Altered nervous system processing
- Altered hormonal regulation
IBS is not caused by stress or anxiety and is not a mental health disorder. However, stress and anxiety do not cause IBS, but may trigger episodes or makes symptoms worse.
There is currently no known cure for IBS. Medical treatment for irritable bowel syndrome includes antispasmodic medicines, antidiarrheal medicines, antidepressants, laxatives, and other drugs. No single medication works for everyone.
Knowing that IBS is not serious condition may ease a patient’s anxiety or stress. The goal of treatment is to relieve symptoms. There may be some trial and error before an effective approach is found.
- Regular exercise
- Improved sleep habits
- Stress reduction
- Behavioral therapy
- Physical therapy
- Relaxation or pain management techniques
- Dietary changes
Most people with IBS have symptoms only occasionally and the following measures may treat or soothe symptoms during a flare:
- Add fiber to the diet: Fiber theoretically expands the inside of the digestive tract, reducing the chance it will spasm as it transmits and digests food. Fiber also promotes regular bowel movements, which helps reduce constipation. Fiber should be added gradually, because it may initially worsen bloating and gassiness. People with IBS-D should look for foods with more soluble fiber, the type that takes longer to digest (such as that found in oats, beans, barley, peas, apples, carrots, and citrus fruits).
- Drink plenty of water
- Avoid soda, which may cause gas and abdominal discomfort
- Eat smaller meals to help lessen the incidence of cramping and diarrhea.
- Low fat and high carbohydrate meals such as pasta, rice, and whole grain breads may help IBS symptoms (unless the person has celiac disease).
What triggers IBS?
- Many people suffering from IBS are aware of very specific foods that trigger and worsen their symptoms. The person usually learns what trigger foods to avoid.
- Food diaries can be helpful in pinpointing the products causing symptoms to worsen.
- People with IBS usually suffer from both diarrhea and constipation, and different foods are often implicated as triggers.
- Treatment of IBS symptoms often is specific to the individual. There usually is no easy answer to relieve IBS symptoms, but rather a process that involves the patient and doctor working closely together.
- Gluten free diets have been linked in some research to improved diarrhea symptoms; however, this has not been clearly established.
- A subgroup of poorly absorbed carbohydrates referred to as FODMAPs (which stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols) causes symptoms in some people with IBS. FODMAPs are found in many products such as some grains (what, rye), fruits (found in pears, honey, and apples), vegetables (artichokes, onions, garlic), artificial sweeteners, and dairy products (lactose intolerance). Some individuals tend to be sensitive to only some FODMAPs.
- Foods high in fat can worsen diarrhea symptoms.
- In general foods that dehydrate can worsen the constipation symptoms of IBS.
- As with all food intake, some foods might be tolerated in moderation but cause symptoms if ingested in excess.
- One suggested approach is to remove a food or food category, watch and note symptoms, and slowly reintroduce the food back into the diet and track your symptoms (elimination diet).
- Fiber products can help (in case of constipation) or worsen IBS (diarrhea).
- Exercise helps prevent constipation and lack of exercise can worsen it.
- Most people who suffer from IBS notice increased stress and anxiety will worsen their symptoms. Avoiding activities that cause stress or anxiety may prevent IBS symptoms from occurring.
- IBS and its symptoms can be relieved or at least improved with non medical and none food related therapies. Relieving stress and anxiety will help improve IBS symptoms.
- IBS is twice as common in women as in men, leading some IBS experts to believe hormonal fluctuations and changes might play a role in IBS. In addition many women with IBS report an increase in symptoms during and around their menstrual period.
- Some cells in the digestive system are responsive to estrogen and progesterone. These hormones change during the menstrual cycle and could affect the digestive system.
Is there a specific diet plan for a person with IBS?
Diet and lifestyle changes are important in decreasing the frequency and severity of IBS symptoms.
The first thing your doctor may suggest is to keep a food diary. This will help you figure out foods that trigger your symptoms.
- Limit foods that contain ingredients that can stimulate the intestines and cause diarrhea, such as:
- Some vegetables (cauliflower, broccoli, cabbage, Brussels sprouts) and legumes (beans) may worsen bloating and gassiness and should be avoided.
- A high fiber diet may lessen symptoms of constipation.
- Drink plenty of water, and avoid carbonated drinks such as soda, which may cause gas and discomfort.
- Eat smaller meals and eat slowly to help reduce cramping and diarrhea.
- Low fat, high carbohydrate meals such as pasta, rice, and whole-grain breads may help (unless you have celiac disease).
- Probiotic supplements such as lactobacillus acidophilus or prebiotics may help alleviate IBS symptoms including abdominal pain, bloating, and bowel movement irregularity.
- A diet low in FODMAPs (Fermentable Oligo-saccharides, Di-saccharides, Mono-saccharides And Polyols), a group of short-chain carbohydrates, may help relieve IBS symptoms.
What foods should you avoid if you have IBS?
Certain foods may worsen bloating and gassiness. Foods to avoid include cruciferous vegetables and legumes, such as:
- Brussels sprouts
- Bok choy
- Chinese cabbage
- Collard greens
Legumes also may worsen gassiness and bloating, for example:
- Black beans
- lack-eyed peas
- Chickpeas (garbanzo beans)
- Fava beans
- Lima beans
- Red kidney beans
- Soy nuts
Some foods may trigger symptoms of abdominal cramps and diarrhea, including:
- Fatty foods
- Fried foods
- Sorbitol (a sweetener found in many diet foods, candies, and gums)
- Fructose (found naturally in honey and some fruits, and also used as a sweetener)
Eating large meals may also trigger abdominal cramping and diarrhea.