Irritable Bowel Syndrome is a common functional gastrointestinal disorder, which affects 1 in 7 (15%) people, with most feeling awkward and negatively impacts their personal, professional and social lives (1). So let's chat about it and improve your understanding of the condition.
People with IBS can have debilitating symptoms that can seriously affect their day-to-day life. Symptoms may include one or more of the following: bloating, pain, visceral hypersensitivity, distention (gas/flatulence) or changes in bowel movements (2). Think about how these symptoms can effect someones lifestyle...you may not want to wear your new yoga tights because you're bloated and look 9 months pregnant, you need to plan your day around where you will have quick access to a bathroom or you're a busy mum who is running around after kids and your abdominal pain is so intense that you can hardly get out of bed. These symptoms have a way of manifesting in the most unfortunate situations, which can cause stress and anxiety, which may further exacerbate symptoms and so, the cycle continues. Symptoms can people on an emotional rollercoaster. So, if you have IBS or know someone who does, this article is to help you better understand the condition.
WHAT IS HAPPENING?
In someone with IBS, there is a dysfunction between our gut and brain. Changes in bowel movements (constipation, diarrhoea or both) are thought to be due to a dysregulation of the gut autonomic system, in English, changes in the nerve activity that line the large intestines (2). Whereas symptoms of abdominal pain or discomfort are thought to be due to additional changes in the gut-brain axis, resulting in enhanced bidirectional communication and the nerves that line the intestines becoming hypersensitive and overactive (2). We still do not know the exact cause of IBS, but researchers suggest it is a post-inflammatory and stress-related condition (2).
There is currently no diagnostic tests for IBS. The Rome IV Criteria is used to diagnosis IBS.
This criteria includes:
"having recurrent abdominal pain or discomfort at least 3 days per month (on average ~1/d week) over a period of 3 months and have at least two of the following:
- Improvement in symptoms after going to the toilet
- Onset associated with a change in frequency of bowel movements
- Onset associated with a change in appearance of bowel movements.
Signs and symptoms to have occurred within the last 3 months and to have started at least 6 months before diagnosis"
Individuals are then categorised according to their symptoms as IBS-C (constipation), IBS-D (diarrhoea), IBS-M (mixed-both constipation and diarrhoea) or IBS-U (unknown-doesn't fit into any category).
Other gut conditions, disorders (coeliac disease or inflammatory bowel diseases) and infections must be ruled out first before a delivery of IBS diagnosis is given.
MANAGEMENT OF IBS
Management and treatment is symptom-focussed (1). There are a few ways someone can manage their condition; diet, yoga/exercise, psychological therapies (eg. gut hypnotherapy, stress management) or medications.
The low FODMAP diet is the dietary intervention to identify foods which can trigger symptoms, and is effective in ~70% of individuals (3). This is incredibly complex and should be performed in collaboration with a digestive dietitian or GP who is experienced in this area. It is a short-term diet and definitely should not be followed for a long time as it is restrictive. Many high FODMAP foods are a food source for the 'good' bacteria in our gut to allow them to thrive, they can however trigger symptoms in people with IBS.
If you go down the medications option, remember medications generally have other implications on your health so make sure you and your dietitian work together to find the best option FOR YOU!
IS THERE A CURE?
No, unfortunately there is currently no cure for IBS, symptoms may go and go. This is why it's important to identify triggers and manage these triggers and symptoms.
Though it may sound difficult to find the right treatment or management for you to feel symptom free-it is possible! If you are concerned you have IBS, contact your GP or I am here to help with your nutritional needs, book an online consult here.
I hope you found this helpful. If you know someone who could benefit from this information, please feel free to forward or share this with them.
Thank you for taking the time to read this post,