Living with Irritable Bowel Syndrome (IBS)

Irri­ta­ble bow­el syn­drome (IBS) is a func­tion­al dis­or­der of the colon that caus­es a vari­ety of uncom­fort­able gas­troin­testi­nal symp­toms. In addi­tion to affect­ing between 25 – 55 mil­lion peo­ple in the Unit­ed States, IBS is the sec­ond high­est cause of ill­ness-relat­ed work absences. Dur­ing nor­mal diges­tion, your brain and gut work togeth­er to send sig­nals to your hor­mones, nerves and the good bac­te­ria found in your gut to acti­vate the mus­cles of your colon. When you are expe­ri­enc­ing an IBS episode, these sig­nals become jum­bled, caus­ing the mus­cles of your diges­tive tract to become tense. This leads to symp­toms such as con­sti­pa­tion or diar­rhea, gas and stom­ach cramp­ing. IBS symp­toms and their sever­i­ty vary by per­son, but often include:

• Stom­ach pain or cramp­ing, usu­al­ly in your low­er abdomen, that improves after a bow­el movement
• Stom­ach bloat­ing or gas
• Changes in bow­el move­ments, includ­ing shape and frequency
• Feel­ing unable to com­plete­ly emp­ty your bowel 
• Vis­i­ble mucus in your stool
• Nau­sea with or with­out vomiting

IBS symp­toms account for near­ly one-third of all vis­its to diges­tive health spe­cial­ists, or gas­troen­terol­o­gists, each year. IBS can be dif­fi­cult to diag­nose, as it does­n’t cause phys­i­cal signs of inflam­ma­tion or the for­ma­tion of ulcers and oth­er abnor­mal­i­ties with­in your diges­tive tract. IBS is often diag­nosed only after oth­er diges­tive dis­or­ders have been ruled out.

Dif­fer­ent types of IBS can be clas­si­fied based on the symp­toms you are experiencing.

• Con­sti­pa­tion-pre­dom­i­nant IBS (C‑IBS) is the most com­mon type, account­ing for about half of all IBS cas­es. Com­mon symp­toms include stom­ach dis­com­fort such as bloat­ing, cramp­ing and con­sti­pa­tion. You may have C‑IBS if you reg­u­lar­ly pro­duce less than three bow­el move­ments per week.
• Diar­rhea-pre­dom­i­nant IBS (D‑IBS) affects about one-third of those with IBS with com­mon symp­toms includ­ing stom­ach pain, fre­quent diar­rhea and increased bow­el-move­ment urgency. You may have D‑IBS if you pro­duce 12 or more bow­el move­ments in a week.
• Alter­nat­ing con­sti­pa­tion and diar­rhea (A‑IBS) is the least com­mon type of IBS. While it is only found in only about 20 per­cent of peo­ple with IBS, its symp­toms tend to be more fre­quent and severe. A‑IBS caus­es alter­nat­ing episodes of con­sti­pa­tion and diar­rhea, often accom­pa­nied by stom­ach pain.

In addi­tion to being dif­fi­cult to diag­nose, IBS trig­gers are dif­fer­ent for each per­son. IBS episodes are often asso­ci­at­ed with one or more of the fol­low­ing factors:

• Diet: Almost two-thirds of peo­ple with IBS expe­ri­ence diet-relat­ed episodes. Com­mon food-relat­ed trig­gers include caf­feine, gluten, lac­tose, processed foods and foods high in fat.
• Gut Health: The amount and type of bac­te­ria present in your gut can have a sig­nif­i­cant impact on your diges­tive sys­tem and its abil­i­ty to func­tion normally.
• Hor­mones: Shifts in hor­mone lev­els can trig­ger an IBS episode. Women com­mon­ly expe­ri­ence wors­en­ing symp­toms on or around their month­ly cycle.
• Mood: Changes in your mood includ­ing anx­i­ety, depres­sion or stress can cause an IBS episode.
• Sleep habits: Near­ly half of indi­vid­u­als with IBS expe­ri­ence dif­fi­cul­ty sleep­ing and increased fatigue. Poor sleep can increase your chances of hav­ing a flair-up the next day.

While the exact cause of IBS is unknown, there are sev­er­al fac­tors that can increase your risk of devel­op­ing IBS, including:

• Age: IBS is more com­mon in indi­vid­u­als under the age of 50.
• Fam­i­ly his­to­ry: You are more like­ly to devel­op IBS if oth­er mem­bers of your fam­i­ly also have the disorder.
• Gen­der: Women are twice as like­ly as men to devel­op IBS, which is like­ly due to hor­mon­al dif­fer­ences between the genders.
• Infec­tions: While rare, you can devel­op IBS symp­toms after con­tract­ing a stom­ach bug or gastroenteritis.
• Men­tal health con­di­tions: Anx­i­ety, depres­sion and oth­er men­tal health con­di­tions can increase your risk.

Treat­ment for IBS is based on your symp­toms and indi­vid­ual trig­gers. It can be help­ful to keep a food jour­nal and track your symp­toms and their sever­i­ty to iden­ti­fy pat­terns and trig­gers. Diet and lifestyle changes may help min­i­mize your symp­toms, including:

To help alle­vi­ate gas, bloat­ing, stom­ach pain, diar­rhea or con­sti­pa­tion, adjust your diet to lim­it the amount of FODMAPs (car­bo­hy­drates found in cer­tain foods like wheat and beans), dairy and processed foods.

• Eat small­er, more fre­quent meals rather than a few larg­er meals each day.
• Test or intro­duce new foods into your diet when your symp­toms and stress lev­els are low.
• Slow­ly increase your fiber intake to help reg­u­late your bow­el move­ments. If you expe­ri­ence diar­rhea, opt for sol­u­ble fibers like black beans, broc­coli, brus­sels sprouts and sweet pota­toes. If you suf­fer from con­sti­pa­tion, try insol­u­ble fibers includ­ing nuts, seeds, lentils and oat bran. Some sol­u­ble fibers like psyl­li­um, flaxseed and fenu­greek (com­mon­ly found in breads, cere­als and rice cakes) can be effec­tive for those who strug­gle with both diar­rhea and constipation.
• Avoid diges­tive stim­u­lants like alco­hol, caf­feine or sugar.
• Reg­u­lar exer­cise can help reg­u­late diges­tion and your bow­el move­ments, espe­cial­ly if you suf­fer from chron­ic constipation.
• Drink plen­ty of water, at least 8 – 10 glass­es per day.
• Iden­ti­fy ways to man­age anx­i­ety and stress.
• Your doc­tor may rec­om­mend you take a dai­ly pro­bi­ot­ic to help main­tain the amount of good bac­te­ria present in your gut.

Depend­ing on the sever­i­ty and fre­quen­cy of your symp­toms, IBS can have a sig­nif­i­cant impact on your qual­i­ty of life. Due to its unpre­dictabil­i­ty, liv­ing with IBS can cause increased anx­i­ety and may lead to social avoid­ance or iso­la­tion. It’s impor­tant to remem­ber that IBS is not caused by leav­ing your house. With some prepa­ra­tion and anx­i­ety man­age­ment tech­niques, IBS should not pre­vent you from doing the things you enjoy.

Ways to regain con­trol of your life and health when liv­ing with IBS include:

• Talk­ing with your friends and fam­i­ly about your con­di­tion, as well as your dietary and sup­port needs.
• Allow­ing extra time to take bath­room breaks if needed.
• Iden­ti­fy­ing where bath­rooms may be avail­able and hav­ing a plan to stay calm until you can reach one.
• Trav­el­ing with med­ica­tions, wipes and even a change of cloth­ing; any­thing that will pro­vide you with addi­tion­al peace of mind.

If you’re expe­ri­enc­ing symp­toms that may be caused by IBS, espe­cial­ly if they are impact­ing your dai­ly life, your pri­ma­ry care physi­cian may refer you to a gas­troen­terol­o­gist. Your physi­cian and gas­troen­terol­o­gist will work with you to rule out oth­er diges­tive orders, iden­ti­fy your spe­cif­ic trig­gers and devel­op a treat­ment plan that is right for you. If your symp­toms don’t improve with diet and lifestyle mod­i­fi­ca­tions, you may be pre­scribed med­ica­tions to help man­age your symptoms.

Learn more about our team of board-cer­ti­fied Gas­troen­terol­o­gists, or to make an appoint­ment call 630−717−2600.