Irritable bowel syndrome (IBS) cannot be called a disease. It is rather a group of symptoms that arise due to certain changes in the functioning of the gastrointestinal tract. These symptoms of IBS are so common and similar to other digestive problems that most people don’t go to a doctor, leaving IBS cases undiagnosed and untreated. Some of the common symptoms of IBS include stomach pain, diarrhoea, constipation and bloating and gas.
Normally, food gets digested and moves in the colon with the help of intestinal muscles that contract and relax in a coordinated fashion. But in people with IBS, this muscle contraction and relaxation is not coordinated, resulting in longer than normal contractions. This causes the food to move forcefully through the intestine, leading to symptoms like bloating, diarrhea and stomach pain.
The exact cause of uncoordinated muscle contraction and relaxation is not understood. But, researchers believe that some physical as well as mental health problems can trigger IBS.
1. Food habits: Many patients with IBS have reported that their symptoms worsen after eating foods rich in carbohydrates and fats. Some people complain after eating spicy foods, milk products and beans while others can’t tolerate beverages like coffee and alcohol. It is believed that symptoms of IBS may result due to weak absorption of sugars or bile acids that help fats to break down and eliminate wastes from the body.
2. Mental health: Studies have found a link between people with anxiety, stress, depression or other psychological problems and development of IBS. However, the establishment of the link is yet unclear. Probably, hormonal changes under such stressful conditions lead to changes in bowel movement and digestive health.
3. Genetics: Although it’s not clearly known, the link between IBS and genes exists. It has been observed that people whose family members suffer from intestinal problems often show the symptoms of IBS.
4. Infection: People who already have a weak digestive system may experience worse IBS symptoms. Some patients who have an intestinal infection (gastroenteritis) may also develop symptoms of IBS. This is called post-infectious IBS. The reason is not clearly understood.
Here are some common symptoms associated with IBS:
- Stomach pain
- Stomach cramps
- Diarrhea or constipation
Other signs that may indicate IBS include:
- Urge to defecate
- Painful and straining bowel movement
- Feeling of incomplete bowel movement
- Passing clear fluid called mucus that protects the tissues in GI tract
IBS is not a life-threatening condition but living with IBS can be frustrating as it may lead to other debilitating conditions like hemorrhoids. So, if you have been suffering from any of the above any digestive problem for more than 3 months, you should seek help from a specialist. Because the symptoms of IBS also tend to overlap with symptoms of other intestinal disorders, it is always better to get a check up done if:
- You start losing weight without any obvious reason
- Bloating is not relieved for a long while
- You notice blood in your stool
- You feel fatigued all the time
There is no specific test that can confirm IBS. Diagnosis is based on what symptoms you describe to the doctor. The doctor may suspect IBS if you have symptoms like stomach pain, gas and bloating for at least 3 days every month over a period of 3 months. (Read: 10 reasons for bloating or abdominal gas you didn’t know about)
To confirm IBS, your doctor may ask you to take some blood tests. These tests are often recommended to rule out presence of other serious diseases.
- A blood test may be done to check if you are suffering from celiac disease or low blood count due to anemia.
- A computed tomography (CT) scan may be recommended to rule out internal injury and other causes of the symptoms.
- A stool test may be done to rule out the possibility of intestinal infections
- A colonoscopy (viewing the rectum and colon) may be required for older patients to eliminate inflammatory bowel disease (IBD)
IBS does not have a definite cure. But there are different ways in which the symptoms of IBS can be treated.
The most common trigger of IBS is food sensitivity. Therefore, majority cases of IBS can be managed as well as prevented by bringing certain changes in eating habits. There is no specific diet for IBS that should be followed as such. But the following changes in eating habits may help:
- Drink enough water
- Avoid eating spicy foods and foods rich in fats
- Avoid coffee and tea if you think it triggers your symptoms
- Control your portion size. Instead of having one large meal at a time, divide it into smaller meals over the day
- Do not overeat
- Exercise regularly
- Sleep for at least for 7 hours
Dr Ashwin Mallya, gastrointestinal and hepatobiliary surgeon at Sir Ganga Ram Hospital, New Delhi, offers some additional tips that will help people with IBS:
- Some people have found that giving up milk and dairy products has helped them
- Eat more fruits, fiber-rich food and green leafy vegetables
- Probiotics have also been shown to provide relief.
- It is a good idea to keep a food diary which can help you correlate the food you eat and your IBS symptoms.
- In any case, if your symptoms are getting worse and are affecting your bowel movements, it is a good idea to go for a colonoscopy.
If IBS symptoms are regular in your case, you should avoid taking any over-the-counter medication. There is no single medicine that can tackle all the symptoms of IBS. But, your doctor may prescribe:
- Antispasmodics like alverine citrate and mebeverine to relieve abdominal cramps
- Hyperosmotic or lubricant laxatives for constipation
- Antidiarrhoeals such as Loperamide to ease boating and cramps
- Antibiotics like rifaximin, in case of an infection
- Antidepressants to reduce the effect of stress and other related factors that may have triggered the condition
People with IBS are often suggested mental therapies to reduce stress in life. These therapies usually involve relaxation and stress-management techniques that improve focus and reduce anxiety and depression (Read: Hypnosis could cure Irritable Bowel Syndrome!)
Alternative treatments like herbal remedies, homeopathy and acupuncture do show positive effect on quality of life of IBS patients, but there is no convincing evidence for the same.