Everything You Need To Know About IBS

Have you suffered from bloating, abdominal pain, and diarrhea or constipation? You may have even been evaluated by a gastroenterologist and had other conditions ruled out. If so, you were likely told that you had IBS. 

Irritable Bowel Syndrome, or IBS, is an incredibly common disorder, with the condition impacting 15% of the world’s population, and up to 45 million people in the United States alone. Although the exact causes are unknown, experts believe it results from how the gut, nervous system, and brain interact.

What is IBS?

IBS can have a major negative impact on your quality of life, but there are lots of strategies you can employ to help reduce, or even eliminate, its influence on your life. 

The exact cause of Irritable Bowel Syndrome is unknown. One group of studies suggest that it may be linked to a history of foodborne illness, especially among women. Other studies suggest that it is linked to an unhealthy or unbalanced gut microbiome. It may be that both are true, as infectious gastroenteritis does lead to a compromised microbiome. 

Some social and physical issues are common in people with IBS, and there is reason to believe that these may have a role in causing IBS. 

1. Early life trauma, like physical, psychologic and sexual abuse.
2. Anxiety and mood disorders, like anxiety and depression.
3. A history of bacterial infection in the gut. 
4. A history of Small Intestinal Bacterial Overgrowth, or SIBO, a disorder in which there is an increase in the presence of colonic bacteria in the small intestine. 
5. Spastic intestines, or hypersensitive nerve connections in the gut. 

What are the symptoms of IBS?

Irritable Bowel Syndrome can be an incredibly uncomfortable and upsetting condition. Some of the most common symptoms include:

• Pain and cramping

One of the most common symptoms of IBS is pain and cramping in your gut. Your digestive system and brain communicate through a pathway called the gut-brain axis. Patients with IBS seem to have a disruption in this communication, especially when under stress. This disruption causes your gut to become uncoordinated, leading to abdominal pain and diarrhea and/or constipation. 

• Diarrhea

Diarrhea is another very common sign in IBS sufferers. Research has shown that patients diagnosed with IBS tend to have over double the number of bowel movements a week compared to those without. These bowel movements can often be quite sudden and may even cause incontinence or inability to get to the bathroom in time. This can create significant distress, which tends to make your IBS symptoms worse! This is likely due to the distortion of signals between your gut and brain. Your digestion time becomes irregular, meaning that your food passes more quickly through your digestive tract, and before much of the water can be drawn out by your intestines. 

• Constipation

Paradoxically tied with diarrhea for the most common symptom, constipation occurs in almost 50% of sufferers. In fact, most IBS patients fluctuate between periods of diarrhea and constipation! This happens for the same reasons as diarrhea; the irregular digestion time sometimes causes the food to go more slowly through your digestive tract, allowing it to absorb more water from the stool, causing constipation.

• Bloating

IBS can also lead to an increased perception of gas in the gut, which can result in you feeling bloated and very uncomfortable. While we all experience gas and bloating, studies show patients with IBS perceive greater discomfort levels with the same amount of gas production. Bloating is often one of the most persistent symptoms of the condition, especially with patients who tend to have more constipation than diarrhea. In fact, people with more IBS-linked bloating tend to have a worse outlook on their disease than those with less. 

• Intolerance to food

While the exact causes of IBS remain unclear, 70% of people have admitted that they have found that a particular food triggers their symptoms. These intolerances are not the same for everyone; everyone has their own trigger foods. 

Some common food triggers include dairy products and caffeine, as well as foods high in processed carbohydrates and alcohol. Many IBS sufferers find that spicy foods are a major trigger, so avoid eating these if you find that that is the same for you. Drinking too many soft drinks, coffee, and alcoholic beverages is also known to increase the severity and frequency of the symptoms.

• Fatigue

Over 50% of those people diagnosed with IBS have found that they are more fatigued and experienced low stamina while undertaking tasks they usually do. About 38% of IBS patients also suffer from some form of sleep disturbance. Interestingly, patients with poor sleep also describe having worse symptoms the next day. 

Managing IBS

There is no simple medication that will eliminate Irritable Bowel Syndrome. Lifestyle changes, however, can help to relieve and eliminate symptoms. 

• Learn what foods aggravate your IBS. 

One of the most effective things to do is to keep a diary of when you have symptoms and what foods seem to trigger them. 

Your diary should have 3 columns: 

• one for your symptom flares, 
• one for what you’ve eaten in the past 24 hours, 
• one that details your stress levels or emotional state. 

This will help you decide what to avoid and should reduce the number of times that you experience a flare-up. 

Look for patterns in your symptom diary: are particular foods always causing a reaction? or is it a particular emotional state? If you see a food is constantly triggering your symptoms, reduce or eliminate it and see what happens. Emotions are just as likely to give you IBS symptoms, whether you are in a hurry, on your menstrual cycle, or just having a particularly hard day. 

• Eat quality food.

You should also pay close attention to the types of foods you’re eating. Making sure you’re consuming a variety of fruits, vegetables, grains, legumes and nuts can help to populate your microbiome with beneficial bacteria, which will help improve your microbiome health and improve the gut brain connection. Where possible, always use fresh and healthy ingredients when cooking and avoid consuming too much dairy, fatty and processed foods.

• Eat to control your IBS.

While fiber is essential to gut health, many people suffering with IBS may experience worsening of symptoms with fiber rich foods.  But instead of just giving up on fiber, enlist the help of a registered dietitian that specializes in gut health so they may help you. 

One method of controlling your symptoms is trying a low FODMAP diet.  FODMAPs are foods that are more likely to cause fluid retention and gas production. This diet is made of an elimination phase and a reintroduction phase. Reintroduction is done gradually to help identify your trigger foods.  The confusing part of all of this is that high FODMAP foods are not bad for us; in fact they’re incredibly healthy for the gut microbiome. Our gut microbiome uses FODMAPS as a fuel source, which they digest and ferment in the colon. This fermentation process increases gas production. 

So the high FODMAP foods are not to blame! It is our gut’s inappropriate response and sensitivity to these foods that makes us feel uncomfortable. FODMAP foods are incredibly beneficial to our health, and eliminating them completely over a long period of time can lead to increased imbalance in our gut microbiome. To ensure proper nutrition and a controlled elimination and reintroduction phase, a Low-FODMAP trial should only be done under the supervision of a registered dietitian.

• Reduce your stress

Stress is a major contributor to IBS, so managing it can eliminate many of IBS’s symptoms. There are many different relaxation and stress management techniques out there, and all have been shown to be equally effective at controlling IBS. 

One simple technique for stress management is box breathing: 

• inhale for 4 seconds, 
• hold your breath for 4, 
• exhale for 4, 
• hold for 4 seconds, 
• repeat. 

This simple method helps to slow your breathing and can calm you when you’re anxious or overwhelmed. 

There are more formalized practices to relieve stress too.

• • Long-term yoga practice has been shown to have many positive effects, including a more generalized feeling of well-being. 
  • A well designed and executed meditation/mindfulness practice has been shown to be comparable to more traditional therapies when dealing with mood disorders.  
  • Acupuncture and massage therapy have also been shown to help patients with IBS.

• Get professional help.

You don’t have to treat or deal with your IBS alone. Having a strong patient-provider relationship has been shown to improve patient outcomes when dealing with IBS. A nutritionist can help you with designing a healthy and symptom-reducing diet.  If you are really struggling with IBS and have found that changes to your diet and lifestyle have not helped, a licensed gastroenterologist can help you as well. 

While many of these medications are over-the-counter, you should still consult with your doctor before starting any new regiment. People can respond differently to certain drugs, and some drugs can interact in dangerous ways with prescriptions you’re on.

Need help with your gut health?

If you have been diagnosed with Irritable Bowel Syndrome, or you are experiencing an increasing number of symptoms, it can be very tough to know where to turn to. If you want to maximize your gut health, you can download the Doctor Méndez Gut Health Guide here or book an appointment with her today to get help!