Irritable Bowel Syndrome

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irritable bowel syndrome
Everyone has a stomachache from time to time, but IBS is different.

As the name suggests, the occasional upset stomach – either from too-greasy food or from a passing illness – is part of the human condition. Generally, patients or doctors are able to pinpoint the condition and remedy it quickly. Irritable Bowel Syndrome, or IBS as it is commonly referred to, is different, chronic, and very painful. Common symptoms of IBS include bloating, abdominal tenderness, stomach cramps, diarrhea, and constipation either on a chronic basis or as the condition becomes acute.

IBS: What’s It All About?

At one time, IBS was referred to as having a ‘spastic colon’ but current medical terminology embraces the larger pattern of episodes, and therefore it is correct to call the condition Irritable Bowel Syndrome. IBS is a condition which affects the colon or large intestine.

While there is there is much emerging research in the field, doctors have not uncovered why people with IBS experience difficulty with bowel movements. The condition falls roughly into two categories: a patient is classified as having IBS-D if the bowel moves too fast and causes diarrhea, and as having IBS-C if the bowel moves too slowly and causes constipation. The speed at which waste is processed determines how much fluid is absorbed or not absorbed, leading to the diagnosis of the two classifications.

Paraphrasing Steven Field, MD, a gastroenterologist and clinical assistant professor of medicine at New York University School of Medicine in New York City, generally people have a tendency toward experiencing one set of symptoms or the other although there are some that experience both conditions.

IBS: Episode Triggers

While doctors don’t know the exact causes of IBS, there seem to be two general antecedents: foods (or groups of foods) and stress. People with IBS tend to experience ‘flare ups’ or situations of acute distress when they eat greasy food. There is also a high incidence of lactose intolerance among people with IBS. Lactose intolerance is a condition where people have difficulty breaking down the sugars (lactose) that naturally occur in milk and dairy products.

One of the most useful things that a patient can do to help pinpoint triggers is to keep a food journal, noting everything that is eaten and drank, for at least two weeks prior to visiting the doctor. Patients quite often skip this step, but being able to look over an accurate description of foods eaten and compare with movement patterns often reveals patterns that we don’t recognize when they occur.

In regard to stress, the condition has been shown to have a major negative impact on IBS. Although stress is largely a mental condition, the colon is connected to your brain through the nervous system. In fact, the feeling of ‘butterflies in the stomach’ is a stress response manifesting itself in the colon.

IBS: Leading Theories on Causes

As we stated earlier, research has not clearly shown why some people suffer from IBS although medical research has several working theories. Foremost among them is the ‘serotonin’ theory. Serotonin is a chemical in the brain that has long been known to regulate mood. Surprisingly, only 5% of the body’s serotonin resides and regulates mood; the remaining 95% resides in the gut wall cells. Serotonin’s role in the gut is to regulate contraction, bowel movement, and the transfer of fluid in and out of the bowel walls.

If there is an abnormal amount of gut serotonin, or if serotonin uptake at the cellular level is abnormal, the result is abdominal pain, cramping, and changes in bowel habits – most often leading to loose movements. Quite often antidepressants – many of which alter serotonin production, function, and uptake, can help relieve IBS symptoms.

A competing theory is that patients with IBS are experiencing an imbalance of gut bacteria. Some patients respond well to antibiotic treatment.

IBS: Who Is Affected

IBS can affect patients of any age, but is most common in patients aged 18 – 35. One theory as to why this is, posits that that patients in this age bracket experience a lot of lifestyle, financial, emotional, physical, and familial stressors. (i.e. post-secondary, career search, marriage, children, home-buying, etc.) All these changes contribute to stress, which is of course a factor in the management of IBS. IBS is also more commonly seen in women.

Patients in their 40s, 50s, or 60s can also experience IBS symptoms. If this is the case, your doctor will advise ruling out more serious colon diseases like diverticulosis or cancer before labelling diagnosing the symptoms as IBS.

If you suspect IBS, it’s important that you visit your doctor. In order for them to rule out any other diagnoses, be sure to include the following information as it may be relevant to your diagnosis:

  • blood in your stool
  • fevers
  • weight loss
  • symptoms that awaken you from sleep
  • foreign travel

Your doctor will ask for a food journal and a detailed description of symptoms in order to make the correct diagnosis. Likely, they will order blood and possible fecal tests for findings like anemia or other abnormalities.

While IBS can be extremely uncomfortable and does limit some lifestyle choices, it isn’t degenerative and doesn’t lead to more serious diseases. Keeping a food journal can help patients pinpoint trigger foods to avoid. Actively engaging in stress management techniques like praying, meditation, physical activity, ensuring quality sleep, doing yoga or Tai Chi, or talking to a counselor can help limit the amount of stress you experience, which in turn may lessen the impact that IBS has on your life.

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