Imagine going through each and every day with stomach pain, unpredictable and often embarrassing toilet habits, bloating that changes your clothing size and passing gas, unsuited to respectable company. These symptoms may be humorous to those unaffected by irritable bowel syndrome (IBS) but for the up to one in every five people who suffer from IBS it’s certainly no laughing matter. IBS can impact negatively on social-, family- and sex-life as well as work, gym, travel and feelings of well-being. Its symptoms aren’t isolated to the gastrointestinal tract either, often causing lethargy and back pain. To make matters worse, IBS is a chronic condition, with apparently no end in sight. Luckily a few treatments, conventional and natural, can improve symptoms and quality of life in those with IBS.
Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder, meaning symptoms are caused by changes in how the GI tract works rather than changes in the gut’s structure. IBS is a group of symptoms that occur together, not a disease. Although symptoms are frequent, the GI tract does not become damaged.
The most common symptoms of IBS are abdominal pain or discomfort, often reported as cramping, along with changes in bowel habits. Other symptoms of IBS may include diarrhoea and/or constipation, feeling that a bowel movement is incomplete, passing mucus, as well as bloating. A doctor can diagnose IBS by physical examination and taking your medical history. They may need to rule out other conditions by conducting a colonoscopy, x-ray and breath, stool or blood tests.
Getting to the bottom of IBS
The causes of IBS are not well understood. Scientists think that a combination of the physical and mental health problems below could result in IBS.
- Brain-Gut Signal Problems. Problems with brain-gut signals, which control how the intestines work, may cause IBS symptoms.
- GI Motor Problems. The movement of the muscles in the gut wall may be dysfunctional in IBS. They may move too fast, causing diarrhoea; too slowly, causing constipation; or spasm painfully. Some IBS sufferers may experience increased bowel contractions in response to stress or eating.
- Hypersensitivity. People with IBS have a lower pain threshold for bowel stretching, caused by gas or stool, compared with people who do not have IBS. IBS sufferers’ brains may interpret pain differently.
- Mental Health Problems. Scientists don’t know why, but mental or psychological issues like anxiety and depression, are common in people with IBS. Stress often worsens symptoms.
- Bacterial Gastroenteritis. Some people develop IBS after a bout of ‘gastro’ (bacterial gastroenteritis—an infection or irritation of the stomach and intestines caused by bacteria). Scientists aren’t sure why some get IBS and others don’t, but gastrointestinal abnormalities and psychological factors are though to play a role.
- Small Intestinal Bacterial Overgrowth. The small intestine usually doesn’t house many bacteria. Most live in the large intestine (colon). If the small intestine becomes overgrown with bacteria they cause symptoms like gas or diarrhoea. In people with IBS, SIBO specific antibiotics (like rifaximin) appear to be effective, but should be used in combination with probiotics.
- Body Chemicals. People with IBS may have an imbalance in their brain chemicals (neurotransmitters) and gut hormones, which may play a role in IBS. Reproductive hormones appear to worsen IBS problems.
- Genetics. IBS is more common in people with family members who have experienced GI problems. Whether this is heredity, environmental or heightened awareness of GI symptoms, scientists aren’t certain.
- Food Sensitivity. IBS symptoms may be triggered by certain foods – often rich in carbohydrates, spicy or fatty foods, coffee, and alcohol.
Though IBS does not have a cure, the symptoms, and possibly some of the underlying causes, are often managed with a combination of the following:
- Changes in eating, diet, and nutrition. Alcohol, caffeine, eating large quantities (particularly a lot of carbohydrates or fat at once), food intolerances (e.g. fructose, dairy), excessive artificial sweeteners, gas-forming foods (e.g. cabbage, beans) and foods that may irritate the gut lining (e.g. grains, particularly wheat) may worsen IBS symptoms in some people.
- Medications. Laxatives, loperamide (for diarrhoea relief), antidepressants, antispasmodics, lubiprostone and linaclotide (for constipation predominant IBS), and the antibiotic rifaximin.
- Natural medicines. Fibre supplements, anti-inflammatory nutrients (e.g. curcumin, omega-3s), gut healing and regulating ingredients (e.g. glutamine, peppermint, artichoke extract), mood balancing nutrients (e.g. 5-HTP, theanine, melatonin, tyrosine) and probiotics.
- Therapies for mental health problems. Talk therapies (cognitive behavioural therapy, psychodynamic therapy), hypnotherapy and mindfulness training.
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