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Irritable bowel syndrome (IBS) is a very common global disorder, affecting 13 to 20 percent of Canadians and 10 to 15 percent of people in the United States. IBS is difficult to diagnose, partly because it is a functional disorder, meaning that there are no visible signs of disease in the intestines, and it also mimics other diseases which must be ruled out. In some quarters, IBS has garnered the undeserved reputation as a “fake” disease that has unfairly stigmatized those people who suffer from it.
IBS is a gastrointestinal disorder affecting the large intestine. Symptoms include abdominal pain, bloating, cramping, diarrhea or constipation, or both. To date, there is no cure for this chronic condition, so people who have it must learn to manage it.
Although the cause of IBS is not known, there are several factors that do appear to have a role in its development, including early life stress, especially stress experienced in childhood, as well as a tendency to experience abnormal muscular contractions in the wall of the large intestine. Some cases of IBS develop after a severe intestinal infection caused by bacteria or a virus. Other factors include abnormalities in the nerve supply to the intestines as well as in the gut microbiome, which appears to differ from the intestinal flora found in those with normal gastrointestinal systems.
You are more likely to develop IBS if you are younger than age 50, you are female, there is a history in your family of IBS, or if you have mental health issues such as anxiety or depression. Complications of IBS can include the development of hemorrhoids caused by prolonged diarrhea or constipation, self-reported poor quality of life, and the development of a mood disorder such as anxiety or depression. People who suffer from IBS miss more than three times as much work as people who do not have the disorder, which undoubtedly contributes to their self-reported poor quality of life.
People who suffer from IBS often have foods that seem to exacerbate their symptoms. The relationship between food and IBS is unclear, as it does not seem to be a true food allergy. Certain foods seem to cause more problems than others for people with IBS. These foods include dairy products, beans, citrus fruits, cabbage, wheat, and carbonated drinks. There also appears to be a link between IBS and Leaky Gut Syndrome.
If you think you might have IBS, you should see your doctor, as your symptoms might indicate a more serious underlying disease, and these need to be ruled out. Diagnostic procedures such as a colonoscopy, upper endoscopy and an X-ray, or CT scan of your abdomen may be recommended. Lab tests can include tests for lactose intolerance, a breath test for bacterial overgrowth, and a stool test for bacteria or parasites. Once you are confident in your diagnosis, you still need to remain vigilant for any changes such as weight loss, rectal bleeding, vomiting, difficulty swallowing, or persistent pain that is not relieved by a bowel movement or passing gas. IBS itself does not increase your risk of colorectal cancer.
Treatment is focused on the relief of symptoms with the goal of making life as normal as possible for the patient. Mild symptoms can often be managed by stress reduction in combination with avoiding trigger foods, staying well hydrated, eating a diet rich in high-fiber foods, and getting regular exercise and enough sleep.
Your physician may also recommend the elimination of certain foods such as those with gluten (even if you don’t have true celiac disease), high gas-producing foods such as alcohol or carbonated beverages, or certain carbohydrates known as FODMAPs containing lactose, fructose, fructans, and others.
More severe symptoms may require medications such as fiber supplements, antidiarrheals, and antidepressants or even medications specifically developed for IBS. There are also promising experimental treatments being developed such as fecal transplantation of the intestinal flora from someone with a healthy gut microbiome.
