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Living with abdominal discomfort and other digestive symptoms is not a walk in the park. It triggers a loop of adverse effects that impact multiple aspects of our daily life and nutritional status. A significant number of the global population suffers from irritable bowel syndrome symptoms worldwide. This blog details the nature of this life-altering condition, its causes, and the effective treatment therapies available.
What is Irritable Bowel Syndrome (IBS)?
IBS or irritable bowel syndrome refers to a collection of gastrointestinal symptoms such as abdominal pain, alterations in bowel movements (diarrhea, constipation), and bloating (feeling of incomplete evacuation, gas). Irritable bowel syndrome is a diagnosis of exclusion, meaning that other gastrointestinal conditions need to be ruled out before labeling it as IBS.
Irritable bowel syndrome may present as a standalone disorder or may be associated with other conditions like anxiety disorder, chronic fatigue syndrome, or major depression. Irritable bowel syndrome symptoms are usually chronic and require long-term management. Despite a large number of people suffering from IBS symptoms, this exhausting condition is not discussed as much due to the personal nature of its presentation.
What are the Types of IBS?
Irritable bowel syndrome is classified into four subtypes or sub-categories based on the nature of the bowel movements. These include:
Irritable Bowel Syndrome – D
IBS-D is characterized predominantly by diarrhea. The bowel movements consist of >25% loose and watery stools and < 25% of hard/ firm stools. IBS-D subtype is also associated with other symptoms like abdominal cramps, urgency, bloating, and frequent bowel movements.
Irritable Bowel Syndrome – C
IBS-C mostly is predominated by constipation, where more than 25% of stools are hard and < 25% are loose/watery. Associated symptoms include pain in the abdomen, straining, bloating, and sparse bowel movements.
Irritable Bowel Syndrome – Mixed
IBS-M is characterized by both constipation and diarrhea. The pattern between the two is unpredictable and leads to much stress and frustration in daily life.
Irritable Bowel Syndrome – Undefined
This type of IBS is considered undefined or unclassified. The bowel movements do not fit clearly in any of the other subtypes. However, abdominal discomfort, bloating, etc., are still present.
How Common is Irritable Bowel Syndrome (IBS)?
Irritable bowel syndrome is a functional disorder and its estimated incidence worldwide is approximately 11.5%. A functional disorder is a condition where the function of an organ or organ system is disrupted without any structural abnormalities. Although IBS is a fairly common medical issue globally only 30% - 40% of patients seek professional intervention due to its symptoms.
IBS is statistically more common in females than in males. Irritable bowel syndrome symptoms in men tend to be less intense comparatively. Men are also less likely to communicate with a healthcare provider about the symptoms of IBS. This disorder impacts productivity and daily social interactions significantly, with many patients suffering from additional mental health issues like anxiety and depression.
What are the Symptoms of Irritable Bowel Syndrome (IBS)?
The main or presenting symptom of irritable bowel syndrome is abdominal pain or discomfort associated with disturbance in bowel movements. The triggers for IBS include certain foods (dairy, gluten, etc.), menstruation, stress, and anxiety. The intensity and combination of triggers and symptoms may vary from person to person. Typical symptoms of irritable bowel disease are:
Abdominal discomfort (pain, cramps, burning)
Bloating and gas
Urgency
Diarrhea
Constipation
Mucous in stools
A feeling of incomplete emptying
Irritable Bowel Syndrome - Women
Irritable bowel syndrome is more common in females. Women are more prone to develop IBS-C or IBS-Mixed. Irritable bowel syndrome symptoms are also more intense in women, especially during menstruation.
Irritable Bowel Syndrome - Men
Men mostly suffer from IBS-D. The symptoms are less severe in males but there is more urgency and a higher frequency of bowel movements.
What causes IBS?
The exact cause of irritable bowel syndrome is not known. People in their teenage years and early 40s are more commonly impacted by this disorder. The risk of developing IBS is higher in individuals with severe infections of the gastrointestinal tract, a history of mental health issues (Anxiety disorders, PTSD, depression, etc.), or food intolerance (gluten).
It is believed that in irritable bowel syndrome, the interaction between the gut and the brain is disrupted, leading to disruption of the gut motility and hypersensitivity of the visceral nerves that supply organs like the large intestine. Research also attributes causes such as food sensitivities, alterations in gut bacteria, etc., to developing irritable bowel syndrome.
How is IBS Diagnosed?
The diagnosis of irritable bowel syndrome is usually a clinical one. The Rome 4 Diagnostic Criteria is used when symptoms suggestive of IBS are present for a minimum of six months.
These criteria are important because they help healthcare providers make a diagnosis and streamline treatment options for individual patients. In the absence of another underlying cause, the Rome 4 Criteria prevent unnecessary testing, provide diagnostic guidelines applicable worldwide, and assist in the early and effective management of IBS.
There is no blood test or investigation available to make a conclusive diagnosis of irritable bowel syndrome. However, in the presence of red flags such as onset after age 50, unexplained and sudden weight loss, GI bleeding, or pain that disrupts sleep, further evaluation to exclude other health issues is warranted.
What is the Treatment for IBS?
Irritable bowel syndrome treatment options include a combination of suitable diet choices, lifestyle adjustments, medication, and cognitive behavioral therapy.
Suitable Diet
Avoiding food that triggers an attack of IBS (gluten, dairy, carbonated drinks, etc.) can improve symptoms and prevent flare-ups. Another option is to try the low FODMAP diet. It is a diet plan for IBS that helps avoid carbohydrates that are difficult to digest. FODMP stands for “Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols”.
Lifestyle Modifications
Regular exercises, relaxation activities, and adequate sleep also help alleviate symptoms of irritable bowel syndrome.
Medications
Medications for IBS include antidiarrheals, laxatives, antispasmodics, antidepressants, etc.
Behavioral Therapy
Cognitive Behavioral Therapy or CBT in combination with other treatment options has a positive impact on IBS symptoms.
