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It's Time To Talk about IBS

It's the thing no one wants to talk about, but it affects 10-15% of adults. It can be so disabling that those who suffer from it miss work, school, and social events. Only the common cold results in more missed workdays. It can severely affect your quality of life. April is Irritable Bowel Syndrome (IBS) Awareness Month, so let's talk about it!

What is IBS?

According to the International Foundation for Functional Gut Disorders (IFFGD), IBS can be a long-term or a recurring digestive disturbance. It usually affects the large intestine, impacting motility and sensation. It results in abdominal pain, diarrhea, and constipation (sometimes both). The pain can be worse after eating and in the morning. It is usually relieved by going to the bathroom. Other symptoms include bloating, mucus in the stool (typically white or yellow), the sensation that you haven't entirely passed the stool, and urgency to get to the bathroom.

What causes it?

The causes of IBS are not fully understood. There may be a genetic component, but there are likely other triggers, such as sensitivity to certain foods, emotional upset, stress, and GI infection. There is likely also a disruption between brain and gut signals, also known as the brain-gut axis. The brain and gut work together to maintain the proper functioning of the bowel, and IBS results in alterations of this communication pathway. New research is looking into gut bacteria, which also may play a role.

How is it diagnosed?

IBS is diagnosed using the Rome Criteria, which evaluates symptoms and the duration of the symptoms. You can read more about the criteria here. It is important to note that other symptoms may be experienced that is NOT typical of IBS. These are known as "alarm symptoms" and should prompt a visit to your doctor. They include blood in the stool, unexplained weight loss, anemia, fever, symptoms beginning at age 50, or a family history of more severe conditions such as colon cancer, celiac disease, or inflammatory bowel disease (Crohn's or colitis).

How is it treated?

IBS can be treated with lifestyle changes and medication if needed. Lifestyle changes may involve a change in diet or stress management, including getting enough exercise and rest. Medications may be necessary if lifestyle changes are ineffective or symptoms flare up. You can read more about medications here.

What About Diet and Food Sensitivities?

Much has been written about various dietary strategies for dealing with IBS. It's difficult to say which plan would work for you, so trial and error may be in order. A daily food diary may help you figure out your trigger foods. You can find an example here.

Some people are sensitive to large, high-fat meals or too much caffeine. Alcoholic beverages may also cause symptoms in others. Foods that can increase gas and bloating include beans, gas-forming vegetables such as broccoli or cauliflower, and dried fruits. If constipation is your main issue, consider a psyllium-based supplement. Lactose intolerance can aggravate IBS—if you think you are lactose intolerant, try removing dairy from your diet for a few weeks and then reintroducing it. Cow's milk and ice cream contain a lot of lactose, so just eliminating those may be enough. You can also use lactose-reduced products or take an over-the-counter lactase enzyme product.

I heard about a diet called FODMAPs. What is that?

In recent years, there has been a lot of interest in the low FODMAP diet for IBS management, which may be very effective for many patients with IBS. We'll take a look into that in our next post!