What is IBS?

Irritable Bowel Syndrome or IBS is the new term on the block. Let’s understand in a very crisp way about IBS. Gastrointestinal Issues can be divided into two categories - Organic GI Issues and Functional GI Issues. While organic issues are characterized by biochemical signals that have measurable physiological changes, functional GI issues have been termed as “not explainable by structural abnormalities” These issues consist of a group of lifestyle disorders which are characterized by symptoms like abdominal pain, bloating and the traditional pathology is not able to deliver measurable results

In simple terms, functional GI issues are syndromes or lifestyle disorders which can be managed in life. Irritable Bowel Syndrome is one such functional disorder that develops in the intestines and can cause abdominal pain, bloating, constipation, gastritis, diarrhoea and a few other disturbances. 

Types of IBS

Before jumping to find out IBS treatment, let us first understand the different types of IBS - 

• IBS-D (Diahhrea is predominant)
• IBS-C (Constipation is predominant)
• IBS-M (Both constipation and diarrhoea persist)

Symptoms

The different symptoms of IBS are -

• Change in the frequency of bowel movement - Diarrhea, Constipation and sometimes both
• Abdominal Pain and cramping
• Bloating and swelling of the stomach
• Flatulence
• The urgency to release bowels

What exactly happens inside the stomach?

To find the right Irritable Bowel Syndrome Treatment, we need to understand what goes on in the intestines during IBS. In a non-IBS Patient, the colon muscles in the intestines contract and relax at a natural rhythm enabling easy passing of food. In some cases, the muscle spasm occurs and they begin to contract stronger than regular causing pain. This spasm can be triggered by very mild stimulations like eating, gas, certain foods etc. 

There are huge amounts of nerve endings present in our gut. Sometimes in IBS patients, the nerve endings are more sensitive which can lead to more bloating and more discomfort with a small amount of gas. 

Causes of IBS

There is no exact cause of IBS, however different factors are known to have strong correlations with IBS symptoms

Food intolerances and insensitivities - Consumption of trigger food is known to have a correlation with IBS. Many people observe their IBS flaring up when they intake certain foods.

Muscle Spasm - Intestinal muscle spasms can lead to IBS of all types. When the contractions are stronger, it can cause pain, bloating and gas and when the contractions are weaker, it can lead to constipation

Food poisoning or infections - Bacterial or viral infections can lead to gastroenteritis which can weaken the gut lining and cause IBS

Stress - The gut-brain axis plays a major role. A weak gut-brain connection can result in bloating, diarrhoea and pain in response to digestive processes. Stress is known to create bowel urgency and worsens IBS symptoms

Gut Imbalance - Many times the bad bacteria supersede the good bacteria in the gut which leads to a lot of imbalance that can trigger IBS symptoms.

Treatment

Does IBS cure exist? Can IBS bloating be resolved? What about IBS D or IBS C treatment? These are the most important questions in the mind of the patient. Irritable Bowel Syndrome treatment is more management than cure. 

Let’s look at how IBS can be managed

• Deep Diagnosis -  The first step is to consult a doctor and have a deep diagnosis of the case. A lot many times symptoms of Organic issues can look similar to the IBS issues and a patient might overlook them. However, it is important to consult a doctor to check for any red flags.
• Nutrition - Nutrition is one of the most important aspects of managing IBS. Identification of trigger foods, and consumption of foods which contain bacteria. The addition of healthy foods, elimination of trigger foods and eating a wholesome diet are of extreme importance
• Exercise - Walking, Yoga, Swimming, and Running are known to manage IBS symptoms and relieve issues like bloating, gastritis etc
• Stress Management - Mindfulness is of extreme importance. The first step is acceptance followed by an attitude change towards IBS. IBS cannot be cured with a single pill and is an issue that needs to be managed. A relaxed mind can help in curbing certain symptoms. 

So when it comes to IBS bloating treatment or IBS cramps treatment, the answer is always managing the symptom.

Here are some of the most asked questions around IBS

1.What really is IBS? And what are the different types? 

IBS or irritable bowel syndrome is a chronic gut condition that affects the digestive system. It impacts the gut-brain interaction and is characterised by altered bowel movements and abdominal pain or cramps.

 The 4 main types of IBS are classified per bowel habits:

• IBS-D (Diarrhea)
• IBS-C (Constipation)
• IBS-M (Mixed with diarrhea and constipation)
• IBS-U (Unclassified with varying symptoms)

IBS can be quite a difficult diagnosis, that can affect overall quality of life and is often associated with conditions such as depression and anxiety – which can actually make it worse.

2. What causes IBS? 

There is no single cause for IBS, it can vary from person to person. Factors that can play a role include:

• Infection
• Stress
• Increased gut sensitivity
• Changes in gut muscle contraction 
• Gut microbiome alterations
• Genetic factors/predisposition

For some people, the symptoms develop slowly over time and for some, they build up more rapidly so it can really vary across individuals! 

3. What are the typical symptoms of IBS?

 Symptoms of IBS can vary but usually persist for a long time. These can include:    

• Abdominal pain/cramps
• Diarrhea
• Constipation
• Bloating
• Urgent stools
• Acidity
• Reflux
• Incomplete stool emptying
• Anxiety
• Fatigue
• Headaches 

4. How is IBS diagnosed?

 In terms of diagnosis, there is no definitive test for IBS. Diagnosis usually involves looking at individual symptoms, and medical history and eliminating other gut conditions such as celiac disease, and inflammatory bowel disease. 

Rome criteria can be used to diagnose IBS, which defines it as recurrent abdominal pain and discomfort averaging at least 1 day a week in the last 3 months, coupled with 2 or more of these criteria:

• Pain and discomfort related to defecation
• A change in the frequency of stools,
• A change in stool consistency

If your symptoms have been persisting, it would be best to speak with your doctor or gastroenterologist to proceed with the appropriate tests which can include stool tests, and blood tests to understand what’s going in. IBS diagnosis need not be limited to these criteria e.g. if the pain has been around for less time, still worth investigating under medical guidance.

We know that in IBS there is no damage to the gut tissue, but in other gut conditions there can be. Therefore, diagnosis is key to ensure that any tissue damage is being treated.

5. What next – in terms of diet to manage IBS?

Diet can play a big role, there’s no one fixed solution for all patients with IBS though. It becomes individualised as per your symptoms, and type of IBS.

In general, some common triggers and gut irritants can include:

• Alcohol, smoking
• Caffeine
• Fatty/deep-fried foods
• Artificial sweeteners like in diet sodas, drinks, food additives like MSG

As a starting point, can focus on

• Having regular meals through the day, avoiding long gaps
• Adequate fibre intake, spread out throughout the day ie. Veggies, fruits, whole grains, nuts, seeds etc. Note with fruits, having a high intake can be difficult for some to tolerate so limit to 3 single serves a day.
• Hydration

As per individual symptoms, different strategies can be more impactful:

• For constipation focus on soluble fibre, including foods like oats, chia seeds, dals, potatoes and consider psyllium husk powder 
• For diarrhea, limiting stimulants such as caffeine, alcohol

Depending on the symptoms, and severity it may be required to explore a low FODMAP diet. Note this is not a long-term solution, the low-FODMAP phase is to be carried out for 2-6 weeks as per when symptoms reduce followed by a gradual reintroduction to evaluate individual food triggers.

6. How about lifestyle factors, do they help manage IBS?

Yes, definitely the following can play a big role:

• Sleep, having a good sleep routine, with adequate sleep each night
• Exercise and regular activity can help
• Stress can really impact gut functioning, via the gut-brain axis. It can be more than worthwhile to incorporate strategies to help you manage stress e.g. meditation, scheduled downtime, journaling or speaking with a professional

7. What should be the next steps after diagnosis with IBS?

It’s important to seek out medical advice and build your own understanding of your IBS symptoms and management. Remember, there’s no fixed treatment pattern here! Speak with your doctor and consult with a gastroenterologist to work on your individualised plan as well as a dietitian specialising in IBS/digestive concerns to work on dietary modifications.

It can also be worth exploring government and organisation websites for trustworthy information and resources to increase your own knowledge and understanding.