I enjoy meeting other bloggers on blog link-ups and on one of them recently another blogger asked me about IBS. I had not read much about it recently so decided to research and write a post about it . So whether you already know something about IBS, or if it’s new to you, here is that post. Thanks Kat, from KusKat Studio.
IBS, irritable bowel syndrome, is a common gastrointestinal disorder, of unknown cause.
It is distinct from conditions referred to as inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis, which I won’t discuss here.
Currently there is no one generally recognized blood test, scan, image, or other diagnostic test that confirms IBS. Your doctor may order testing to exclude other conditions such as celiac sensitivity, lactose intolerance, or colon cancer.
The symptoms of IBS are not unique , making diagnosis difficult since it can be confused with other conditions.
IBS is defined by
Recurrent abdominal pain averaging 1 day per week for 3 months associated with
- Bowel movements
- Change in frequency of stool
- Change in form or appearance of stool.
The change in bowel habits can be diarrhea, constipation, or a combination of both.
There may be other symptoms-bloating, abdominal distention, flatulence, tiredness, headaches, painful urination, but these are not required for diagnosis.
The Mayo Clinic explains what symptoms may suggest you need tests for other conditions.by your doctor.
The cause of IBS is still uncertain.
At one time doctors believed it was due to overactive muscles in the bowel wall, leading to the once used name “spastic colon.” Current thinking is the nerves to the bowel are hypersensitive and send signals to the brain which then over interprets them as pain. This hypersensitivity may be triggered by food, bacteria, or toxins in the bowel.
An altered immune response to infections may also precipitate the condition. Changes in the number and type of bacteria that live in the bowel has been identified as a possible cause.
The symptoms of IBS may fluctuate and even go into remission spontaneously, so it can be difficult to definitely know what works and what doesn’t. Management can be divided into two categories.
Non-drug treatment options
Regular exercise, such as a daily walk, encourages the bowel to move more efficiently.
Experts recommend changes of food choices as a first step to symptom control.
The Cleveland Clinic offers these general guidelines on eating with IBS.
- Limiting alcohol, caffeine, spicy foods, fat, and gas-producing foods may benefit many with IBS.
- Avoiding or eliminating milk products, fiber, and/or gluten may be considered next if symptoms persist.
Some studies show a low FODMAP diet is especially helpful for bloating whether diarrhea or constipation is the major problem. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols short-chain carbohydrates (sugars) that aren’t absorbed properly in the gut.
Stanford University Medical Center provides this Low FODMAP Diet
(FODMAP=Fermentable Oligo-Di-Monosaccharides and Polyols)
FODMAPs are found in various fruits, vegetables, cereals, breads, dairy, and sweeteners so it can be challenging to know what’s acceptable and what’s not. Using a list such as this one or working with a knowledgeable dietician can make it easier to find what works for you.
Mind based therapies
With IBS, hypersensitive nerves from the gut send pain signals to the brain. Because of this nervous system involvement, one’s thoughts and emotions can both improve and exacerbate symptoms of IBS. Psychological therapies are often recommended- CBT (cognitive behavioral therapy), hypnotherapy, and psychotherapy.
Drug therapy for IBS
Non -prescription drugs used for IBS include
- soluble fiber supplements such as psyllium and laxatives for those with constipation
- anti-diarrhea meds for diarrhea.
Both groups may also get help from probiotics.
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Prescription meds available in the United States specifically for IBS include linaclotide, lubiprostone, eluxadoline , and rifaximin. Drugs originally developed for depression, the TCAs and the SSRIs , also are effective.
What to do if you think you may have IBS
Monitor your symptoms carefully, keeping a written record, for 1-2 months. Take this to your doctor for an evaluation. However if you have these symptoms, see your doctor immediately.
- bleeding in bowel movements
- unexpected weight loss
- profuse diarrhea
- persistent failure to pass stool
- severe, disabling pain
A primary care doctor-a family medicine or internal medicine doctor- can evaluate these symptoms initially, and decide if referral to a GI specialist, a gastroenterologist , is needed for more specialized testing.
The American College of Gastroenterology offers these resources for patients with irritable bowel syndrome.
If you have been diagnosed with IBS
Your doctor likely has already recommended some of the measure I have listed above. If not, and your symptoms are not controlled, then you might want to discuss to see if they are appropriate for you.
Remember, this information and links are provided for your information and are not endorsement, advice ,or treatment. I encourage you to seek care from your personal physician.
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Sincerely, Dr. Aletha