WHAT IS IBS?
Irritable Bowel Syndrome is a chronic gastrointestinal condition characterized by recurrent abdominal pain or discomfort, accompanied by changes in bowel habits. Unlike inflammatory bowel diseases (IBD) like Crohn’s or ulcerative colitis, IBS does not cause visible damage to the intestines but can significantly impair quality of life. As per medical experts, it is basically a disorder of gut-brain interactions (DGBI). DGBI’s are a group of gastrointestinal (GI) disorders that occur from alteration of the interconnected gut-brain pathways without any visible signs of damage to the digestive tract. This can lead to a variety of symptoms such as stomach pain, bloating, nausea, cramping, the feeling of satiety, and others.
As per World Gastroenterology Organization, more than 11% of the total population suffers from this gastrointestinal issue and women in comparison to men below 50 years of age are more likely to develop Irritable Bowel Syndrome. According to National Institute of Health (India), 7 – 10% of the total population in India suffers from this issue.
SIGNS AND SYMPTOMS OF IBS:
- Abdominal pain or cramping is often relieved by bowel movements
- Bloating and gas (considered the most common symptom)
- Change in stool form and frequency, such as painless diarrhoea, constipation, or both
- Mucus in the stool (white or red in colour)
- A sensation of incomplete bowel evacuation
- Unexplained weight loss.
- Fever
- Rectal bleeding
- Nocturnal symptoms
- Steatorrhea
- Gut functional disorder
- Chronic pelvic pain
- Chronic Fatigue Syndrome
- Fibromyalgia in extreme cases
- Anaemia
Additionally, those suffering from IBS also develop comorbid conditions such as headache, backache, gastro-esophageal reflux and genito-urinary symptoms. Moreover, as per doctors, these aforementioned symptoms can also become worse due to factors such as stress, unhealthy lifestyle, consumption of certain foods, or hormonal changes, especially in women during menstruation.
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THE CAUSES OF IBS:
Some of the common factors leading to IBS are as follows:-
- Abnormal gut-brain interaction: The nerves and muscles in the gut may be hypersensitive or poorly coordinated.
- Dysmotility or Altered gut motility: Accelerated or slowed intestinal contractions can cause diarrhea or constipation.
- Gut microbiota imbalance: Dysbiosis or overgrowth of bacteria like SIBO (small intestinal bacterial overgrowth) can exacerbate IBS.
- Post-infectious IBS: A bout of gastroenteritis can sometimes trigger lasting IBS symptoms.
- Emotional Stress and psychological factors: Anxiety, depression, or trauma can influence the gut via the brain-gut axis.
- Food allergy or Dietary triggers: Food such as junk food, fried food, spicy food, caffeine, alcohol, including foods high in FODMAPs (fermentable carbohydrates), can worsen symptoms.
- Intestinal infections: intestinal problems, such as stomach infections, can also lead to IBS
- Genetics or family history
- Visceral hypersensitivity (extra sensitive nerves in one’s gastrointestinal tract).
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TYPES OF IBS:
As per the World Health Organization, IBS can be classified into three categories, namely:
- IBS–D (Diarrhea–predominant IBS) – symptoms include frequent diarrhea
- IBS–C (Constipation–predominant IBS) – symptoms include frequent constipation
- IBS – M (Mixed IBS) – symptoms include alternating diarrhea and constipation
One must also keep in mind that the aforementioned symptoms vary from one person to another, and there is “no one drug fits all” treatment available for IBS. Hence, based on clinical evidence, it can be stated that through proper medication, healthy lifestyle, proper diet and therapy, one can manage the symptoms of IBS.
PATHOGENESIS OF IBS:
People suffering from IBS experience the following conditions:
- Visceral hypersensitivity: Increased sensitivity to pain within the intestines.
- Altered gastrointestinal motility: Irregular muscle contractions in the intestines.
- Low-grade inflammation: Especially in post-infectious cases.
- Microbiome alterations: Changes in gut bacterial composition.
- Dysregulated immune response: In some individuals, immune cells in the gut may become overactive.
- Food sensitivity: such as carbohydrate malabsorption leading to bloating, inflammation, and discomfort.
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In conclusion, to develop effective management strategies for IBS, understanding its pathogenesis is crucial. This involves identifying the complex factors that flares up the condition of IBS in order to establish a personalized treatment approach for IBS patients.
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IBS DIAGNOSIS:
There is no single test for IBS. People having recurrent abdominal pain, bloating, and gas, accompanied with unexplained weight loss, change in stool form and frequency such as spotting mucus in stool at least on an average one day per week during the last three months are advised to consult a healthcare provider for accurate diagnosis. The healthcare provider reviews the symptoms of the patient with the help of a set of diagnostic guidelines known as The Rome IV criteria along with the patient’s medical and family history and then conducts a physical examination.
Additionally, doctors may also conduct lab tests and imaging tests such as blood test, stool test, hydrogen breath test, and colonoscopy, and upper endoscopy, sigmoidoscopy to understand the root cause of the aforementioned symptoms and also to rule out conditions involving inflammation, abnormal growth in one’s gastrointestinal tract and so on.
MANAGEMENT AND TREATMENT APPROACHES:
As per medical experts, IBS symptoms can only be managed through typical treatment options such as medications, lifestyle changes, therapy, and proper diet as till date, there is no clinically approved specific or one drug fits all treatment available for all in the market. Moreover, one must also keep in mind that these aforementioned treatments will help the patients to manage their IBS conditions but not cure it completely.
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DIETARY MODIFICATIONS:
- Increase fiber in diet – fiber rich foods including fruits, vegetables, grains, and nuts should be consumed by IBS patients regularly.
- Reduce intake of dairy products – dairy products such as milk, cheese, should not be consumed. Instead, foods rich in calcium, protein such as fish, broccoli, spinach, should be consumed.
- Omit or reduce the consumption of food that produces gas – cauliflower, cabbage, beans, sprouts, and carbonated soda should be omitted from the diet.
- Avoid gluten – instead consume foods rich in vitamins, irons, and minerals.
- Reduce sugar intake (sugar malabsorption) – macronutrients such as fat, sugar, including alcohol should be consumed in less quantity.
- Opt for low FODMAP diet – reduce the amount of hard-to-digest carbohydrates to go easier on the gastrointestinal tract.
- Drink plenty of water – drink at least 2 liters of water every day in order to keep the gastrointestinal tract well lubricated and healthy.
LIFESTYLE CHANGES:
- Exercise regularly: people suffering from IBS must exercise regularly (such as pedaling a cycle, walking, swimming) for at least 30 minutes a day and minimum 15 days a week.
- Opt for relaxation techniques: yoga, meditation and other form of relaxation techniques can help calm the nervous system and alleviate gut issues.
- Get enough sleep: aim for 8-9 hours of quality sleep every day.
- Seek help of medical professionals such as therapist to reduce factors such as stress that is found to worsen the IBS symptoms.
THERAPY:
As per research, many people suffering from IBS benefit from a therapist. For instance, therapies such as cognitive behavioral therapy, hypnotherapy, and biofeedback help those suffering from IBS to handle their psychological conditions such as stress, anxiety and depression that further triggers the issue of IBS. Apart from that, medications such as antidepressants, laxatives, and probiotics are also recommended by the doctors to ease the symptoms of IBS. Furthermore, many patients opt for alternative therapies such as herbal therapy for IBS treatment.
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EMERGING THERAPIES FOR IBS:
According to medical experts, emerging or new therapies which are currently in the clinical trial stage such as microbiome-targeted therapies, gut-brain modulators, including therapies targeting immune system of the body (immune system modulators) have shown positive result and even looks more effective and promising in comparison to traditional IBS treatment methods.
CONCLUSION:
Living with IBS can be challenging, but there is hope for effective management. By adopting the right strategies such as getting diagnosed early, creating a personalized treatment plan with the help of a doctor and therapist, and following a holistic approach to health can significantly reduce symptoms and improve one’s overall quality of life.
