Introduction to IBS
What is Irritable Bowel Syndrome (IBS)?
pain • bloating • gas • diarrhoea • constipation
Some quick facts about IBS
IBS affects 15% of people world wide
In Canada it may affect as many as 13-20% of people at any one time
It can limit production and performance at work
People with IBS often report feelings of low mood, embarrassment and self-consciousness
It can have a debilitating and profound impact on quality of life, affecting social occasions, eating out, vacations, work, relationships and can generally make life more difficult.
Research in the US has shown that IBS results in a significant number of work-related sick days, second only to the common cold.
What is IBS?
IBS is a long-term condition where dysfunction within the gut can lead to pain, gas, bloating, diarrhoea and/or constipation, and/or a change in the appearance of stool.
Sometimes the stool may be pencil thin and more like diarrhoea and sometimes there is constipation with hard pellet like stools.
Most people with IBS have either diarrhoea or constipation, but there are a small group of people who alternate between the two.
How do you know that you have IBS?
The main symptom of IBS is pain. The diagnosis is made on the basis of recurrent abdominal pain occurring on average at least one day per week over the previous three months and accompanied by two of the following: pain related to defecation or a change in stool frequency or in stool form.
Although IBS is now recognised as a condition in its own right, your health care provider may ask you to have other tests. This is because IBS shares many similar symptoms with other health conditions that affect the digestive system and for women, the reproductive system. This helps ensure that you receive the correct diagnosis from the outset.
What causes IBS?
The exact cause of IBS remains unclear. The model of IBS as simply a stress related condition is changing. Research is driving this change as the case builds to support other mechanisms for IBS. Although stress may not be the primary driver of IBS, it can make IBS symptoms worse.
There are intimate connections between the brain and the gut, and an ever-expanding understanding of the connections that pass back and forth between the two. The bacteria and other bugs that live in the gut can also influence the connections in this messaging pathway.
IBS can probably be attributed to a combination of these factors, rather than any one in isolation.
Motility disturbance – disturbance of how food is moved along within the gut
Visceral hypersensitivity – the organs within the abdominal area seems to be more sensitive to pain
Altered mucosal and immune function – permeability changes in the lining of the gut and changes in immune responses in the gut
Altered gut microbiota – change in the balance of the bugs that live in the gut, especially following a gut infection
Altered central nervous system (CNS) processing – this speaks to the two way gut-brain-axis and how the brain and the gut interact
Current Treatment options:
Diet: the low FODMAP approach is the most effective dietary management strategy to date. Three out of four people experience a significant relief of their symptoms.
Gut related hypnotherapy: when applied by a trained psychotherapist, the guided hypnotherapy approach has also been shown to provide a significant improvement in symptoms.
Herbal medicines: some herbs have been shown to reduce some symptoms of IBS. Herbal medicine has a long tradition of use in digestive conditions.
Probiotics: have shown some promise, but are rarely enough on their own.
Medications: medications, both prescribed and over the counter, may control symptoms with varying degrees of success.