IRRITABLE BOWEL SYNDROME

Irritable bowel syndrome (IBS) is often defined as abdominal pain and discomfort with changing bowel habits, in the absence of any other medical explanation for the symptoms.

RISK FACTORS [9]

  • High rates have been seen in the young. Mostly people under the age of 50 years.

  • It has been seen more in females than in males.

  • Oestrogen therapy before or after menopause increases the risk.

  • Having a family history. That is, a first-degree family member who has IBS increases your risk.

  • IBS has been seen to be associated with anxiety, depression and/or other mental illnesses.

  • It has been seen that a history of physical, emotional or sexual abuse can increase the risk.

 

CAUSES [9;10]

The exact causes of IBS are not known but it has been suggested that it is related to difficulties with digestion and increased sensitivity of the gut. The following factors have been seen to play a role:

  • Muscle contractions in the intestine walls which last longer and are stronger than normal can cause gas, bloating and diarrhoea. Contractions which are weak can cause passage of food to be slow which will result in hard and dry stools.

  • Irregularities in the nerves that supply your digestive tract can cause discomfort when your abdomen stretched from gas or stool.

  • Immune system response which causes inflammation that is associated with pain and diarrhoea.

  • Bacteria overgrowth or development of IBS after a bacterial infection (for example, gastroenteritis).

    • NOTE:  gastroenteritis is inflammation of the intestines which is caused by an infection from a virus or bacteria that often causes excessive diarrhoea and/or vomiting. More often seen in children.

  • The gut has bacteria which is characterised as “good”. It is said that with people who have IBS, have changes in the form of these bacteria.

 

SIGNS AND SYMPTOMS

  • Abdominal discomfort

  • Gas /Flatulence

  • Diarrhoea

  • Constipation

  • Bloating

 

COMPLICATIONS OF DISEASE 

 

Health complications arising from IBS include haemorrhoids (aggravated by diarrhoea and/or constipation), depression, weight loss, vitamin and mineral deficiencies, and psychosocial problems such as interference with work, relationships, friends and family.

LIFESTYLE MODIFICATIONS

  • Having a healthy eating pattern is important in managing your IBS. This would reduce the discomfort and pain you are experiencing. [1]

  • Regular exercise may help your digestive system, ease IBS symptoms and improve overall mood. [2]

  • Avoid stress as it may make your symptoms worse. Find ways to reduce stress such as relaxation techniques, deep breathing exercises, yoga, meditations, etc. [2]

  • Having support groups can help you gain different methods on how to manage your symptoms as it would include sharing concerns, managements and experiences. [1]

  • Therapy such as cognitive behavioral therapy can help you develop coping skills and improve overall quality of life. [2]

  • Avoid alcohol and smoking as it will aggravate your symptoms. [2]

  • Ask your doctor about Probiotic supplements. [1]

 

This is an uncomfortable disorder characterized by dramatic changes in bowel movements such as diarrhea or constipation. Everyday activities may become intolerable due to cramps and abdominal pain. Dietary tips can help improve your symptoms, but medical intervention is important for treatment. [3]

DIETARY TIPS [4; 5]

  • Having a high fiber diet helps build the bulk of your stools which shall assist in bowel movement. These include fruits, vegetables and whole grains. Gradually add fiber to your diet. Start low, increase slowly until you reach a point of intolerance.

  • If you experience bloating and diarrhea due to the high fiber, instead of cutting fiber completely from your diet, focus on soluble fiber. These include apples, berries, carrots, oatmeal, beans, etc.

  • Avoid insoluble fiber found in nuts, tomatoes, raisins, broccoli, cabbage, etc.

  • Avoid common offenders such as coffee and chocolate as well.

  • Try to include a gluten free diet to see if your symptoms improve. This will include rye and any type of wheat.

  • Avoid foods which are high in fat such as fried foods and animal fats. Focus more on lean meats, fish and chicken.

  • Prepare foods by grilling, broiling or steaming with little to no oil. Cooking spray can be substituted in the place of cooking oil.

  • Avoid carbohydrates which are difficult for the intestines to digest such as lactose found in milk products, peaches, watermelon, pears, mangoes, plums, nectarines, legumes, high fructose products, wheat, rye, broccoli, brussels sprouts, cauliflower, mushroom, artichoke, etc.

  • Ask your doctor about the FODMAPs diet, which is an acronym for fermentable oligosaccharides, disaccharides, monosaccharide and polyols.

  • When you eat out, try to choose foods which are close to what you eat at home.

REFERENCES

  1. Health Library [Internet]. Lifestyle changes to manage irritable bowel syndrome. Winchester: Winchester Hospital; [updated 2019 Jun 07; cited 2019 Aug 12]. Available from: https://www.winchesterhospital.org/health-library/article?id=19649.

  2. Renlund L [Internet]. 10 Simple dietary & lifestyle changes to Help IBS management. Canada: Dieticians of Canada; [updated 2017 Oct; cited 2019 Aug 12]. Available from: https://www.laurenrenlund.com/2016/11/27/simple-changes-help-ibs-management/.

  3. Moore K, Higuera V [Internet]. IBS diet guide. America: Healthline; [updated 2018 Nov 07; cited 2019 Aug 13]. Available from: https://www.healthline.com/health/ibs-diet.

  4. National Institute of Diabetes and Digestive and Kidney Disease [Internet]. Eating, diet & nutrition for irritable bowel syndrome. America: National institute of Health; [updated 2017 Nov, cited 2019 Aug 13]. Available from: https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/eating-diet-nutrition.

  5. GI Society [Internet]. IBS diet: the foods you can eat. Canada: Canadian Society of Intestinal Research; [update 2019; cited 2019 Aug 13]. Available from: https://badgut.org/information-centre/health-nutrition/ibs-the-foods-you-can-eat/.

  6. Health Matters [Internet]. Everything you need to know about IBS. New York: NewYork-Presbyterian; [updated 2019; cited 2019 Aug 13]. Available from: https://d1nakyqvxb9v71.cloudfront.net/wp-content/uploads/2019/04/ibs-at-a-glance-8.jpg.

  7. Gowan M [Internet]. Causes of IBS- What factors contribute to IBS?. Canada: ND Assist; [updated 2017 Jul 19; cited 2019 Aug 13]. Available from: https://www.nhpassist.com/blog/wp-content/uploads/2017/07/blog-causes4-smaller.jpg.

  8. Bolen B [Internet]. Understanding IBS pain. New York: Verywell health; [updated 2019 Jul 04, cited 2019 Aug 13]. Available from: https://www.verywellhealth.com/thmb/LvV71XReMRvcVQEY5O9cPbbLW8A=/1500x1000/filters:no_upscale():max_bytes(150000):strip_icc()/ibs-pain-locations-1945305-5c04ab7ec9e77c0001dbe853.png.

  9. Mayo Clinic Staff [Internet]. Irritable Bowel Syndrome. America: Mayo Clinic; [updated 2018 Mar 17; cited 2019 Aug 27]. Available from: https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-causes/syc-20360016.

  10. NHS inform [Internet]. Irritable Bowel Syndrome (IBS). United Kingdom: NHS 24; [updated 2019 Jul 26; cited 2019 Aug 27]. Available from: https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/irritable-bowel-syndrome-ibs#diagnosing-ibs.

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