I know this April has started off far from normal for all of us, but I want to still highlight that April is IBS Awareness month. The topic of our bowel patterns is not often discussed at dinner parties, but abnormal digestion in the form of IBS is more common than what most people are aware of. Irritable Bowel Syndrome (IBS) is the most common functional gastrointestinal disorder that often accounts for nearly 40% of gastroenterology visits(1). It is estimated that about 10-15% of the world population has IBS(1). However, that number may be underestimated due to several people not seeking care for their symptoms or a delay of diagnosis.
WHAT IS IBS?
Several people assume that their digestive issues they face is something that they just have to "deal" with, that it's their "normal". However, it is important to know and ask your physician if your symptoms might be IBS.
Irritable Bowel Syndrome (IBS) is defined as abdominal pain or discomfort that is associated with altered bowel habits (diarrhea and/or constipation) for at least 1 day per week that has been happening for longer than 3 months with the absence of organic disease, such as Celiac Disease. (2) People who have IBS often complain of:
Gas
Bloating
Constipation, Diarrhea, or both
Abdominal Cramping
With IBS, your colon looks normal, it is just not functioning properly. It is a lasting condition that impacts the function of your gut, mainly the large intestine (the colon), small intestine, and the motility and sensation in the gut. This process is controlled by our brain, which is why you may hear it referred to as the brain-gut axis. IBS is not known to cause lasting damage to your intestines, and is not linked to Irritable Bowel Diseases (IBD) such as Crohn's or Ulcerative Colitis. Although some people with IBD may have IBS as well.
DIAGNOSIS
There is no test that confirms you have IBS. Your doctor will run through your medical history, do a physical exam, and possible blood tests and/or stool tests, or various other images or procedures.
Once other conditions have been ruled out, your physician will often do a check list of symptoms often using the Rome IV Diagnostic Criteria:, which is:
You must have had abdominal pain lasting on average one day a week in the past three months. And also include at least 2 or more of the below criteria:
Pain and discomfort are related to a bowel movement (either increasing or improving the pain).
Associated with a change of frequency in stool.
Stool consistency is altered: the color, shape, firmness of stools.
Keep in mind, signs of possible more serious conditions are: blood in stool, fever, nausea with vomiting, unintentional weight loss, fever.
WHO IS AT RISK FOR IBS?
There is no known cause for IBS, and the symptom severity varies person to person. But IBS is typically found in:
Women: About 60-65% of people who have IBS are women. (3)
Young Age: typically diagnosed under the age of 45 years old.
Have had recent gastroenteritis.
TREATMENT
Although there is not a cure for IBS at this time, the symptoms can be well controlled. Depending on the severity of symptoms, IBS can impact your daily activities, relationships, stress, and overall quality of life.
Symptoms typically worsen with certain types of foods and increased stress. In order to manage your IBS, it is helpful to:
Identify food triggers: This varies person to person. Often times there are certain types of short chain carbohydrates that ferment and cause gas, bloating, and changes to your bowel patterns referred to as high FODMAP foods. Some people are not able to tolerate lactose, or large and high fat foods. Treatment is very individualized. Keep a food diary along with your symptoms and meet with a registered dietitian to help you identify your food triggers, and appropriate diet and/or supplements to ensure adequate nutrient needs are met.
Manage Stress: Stress can make the symptoms worse. It can be beneficial to meet with a licensed counselor or psychologist for cognitive behavioral therapy to discuss strategies for coping, and improve regulating your emotions to decrease your IBS symptoms.
Be sure to seek professional help from your physician, a registered dietitian, and psychologists to help manage and control your symptoms. You know your body and mind the best, so be sure to speak up to ensure your care team can work with you to take control of your IBS.
REFERENCES:
1.Canavan, C., West, J., Card, T. The epidemiology of irritable bowel syndrome. Clinical Epidemiology. 2014; 6: 71-80. doi: 10.2147/CLEP.S40245
2. Brandt LJ, Chey WD, Foxx-Orenstein AE, et al.; American College of Gastroenterology Task Force on Irritable Bowel Syndrome. An evidence-based position statement on the management of irritable bowel syndrome.Am J Gastroenterol. 2009;104(suppl 1):S1–S35
3.International Foundation for Gastrointestinal Disorders. Statistics for IBS. https://www.aboutibs.org/facts-about-ibs/statistics.html. Accessed on April 7, 2020.