what is irritable bowel syndrome
Irritable bowel syndrome is a common gastrointestinal condition that affects millions of people.
Irritable Bowel Syndrome (IBS) comprises several different GI symptoms and is not a well-understood condition. Often conservative interventions are effective at controlling the disease.
What is IBS?
Irritable bowel syndrome (IBS) is a common disorder of the large intestine. Being a syndrome means that it encompasses many different symptoms but not every person will display every symptom. These symptoms include bloating, cramping, diarrhea, constipation, and abdominal pain. IBS is usually categorized as “with diarrhea,” “with constipation,” or mixed, meaning both constipation and diarrhea. IBS has a set of diagnostic criteria that includes changes in stool appearance, frequency of passing stool, and occurring for a certain amount of time. IBS should not be confused with inflammatory bowel disease (IBD) like Crohn’s and Ulcerative Colitis, which are far more severe autoimmune conditions that often require prescription interventions to manage.
Causes of IBS
IBS has many causes and is not fully understood. Early life stress, intestinal infection, being female, dysbiosis (microbial imbalance), disordered muscle contraction in the intestinal wall, and nervous system disorders are possible causes of IBS. Research has linked traumatic experiences early in life with an increased risk of IBS. This may be due to the strong connection between the central nervous system (CNS) and the gut. The gut is called the “second brain” because there are as many nerves in the gut as are found in the brain. Scientists theorize that elevated amounts of stress hormones in childhood may change how we respond to stress as adults.
Additionally, stress hormones have various effects on the gut. When our brain perceives a threat, it goes into “fight or flight” mode. This pushes blood flow to the extremities so we may fight or flee. Prioritizing muscles over internal organs means inhibiting activities like digestion and reproduction, which are not considered essential to survival at that moment. Chronic alterations in these stress hormones can lead to constipation from impaired digestion or diarrhea from the feeling of anxiety that adrenaline can cause. The gastrointestinal tract can also swing between extremes as it will overcompensate for constipation, resulting in diarrhea and vice versa.
While it is not totally understood, most of the possible causes of IBS bring us back to a connection between the gut, the brain, emotions, and stress hormones. Disturbed intestinal bacteria is also a possible cause of IBS because the good bugs in our gut help regulate mood and regular bowel movements. Another midlife health article from this month will further explore the functions of beneficial gut flora.
Stress hormones have various effects on the gut.
Ways to manage IBS
IBS usually does not require medication, and the first-line treatments are dietary changes, lifestyle modification, and stress management.
Remember, this is merely an educational article and does not replace your qualified medical provider’s advice. Many people will experiment with an elimination diet to try to identify possible food triggers of their IBS. The most common food allergies are wheat/gluten, dairy/casein, eggs, soy, peanuts, tree nuts, fish, and shellfish. Keep in mind that a true food allergy is typically an immediate response like itching or swelling. These reactions can be life-threatening. Many people experience food intolerance or food sensitivity which is a less severe and more delayed response. Reactions due to food sensitivities can occur up to 3-4 days after ingestion of the food. An elimination diet will take out any common food triggers for at least four weeks and then slowly re-introduce foods one at a time and watch for reactions. This is a good way to get a personalized understanding of your individual reactions. Blood tests for food allergies or food sensitivities are another possible route to look for food triggers. Lifestyle modification includes improving food hygiene. Many of us eat in a hurry and do not adequately chew our food which impairs digestion. Americans are also famous for drinking large amounts of ice water with meals. Digestive enzymes work best in a hot environment, so ice water during meals hampers digestion.
Too much liquid with meals also dilutes our digestive enzymes. Many common dietary habits are also counter-productive to good digestion – eating too quickly, on the run, in the car, while standing over the kitchen sink, eating too much fast or processed food, etc. Food hygiene includes slowing down, chewing thoroughly, avoiding too much liquid at meals, and eating mostly fresh, home-made food. Stress management can take many forms. Improving work/life boundaries may be beneficial. Setting aside time for self-care is often crucial. Many patients benefit from mindfulness training like meditation, yoga, tai chi, journaling, or prayer. Natural healthcare providers can also recommend various tools to improve the stress response, including herbal medicine, acupuncture, and homeopathy.
IBS can be very disruptive to normal life, but there are many ways to manage it effectively. Speak to your healthcare provider for options to improve your quality of life.
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