Irritable bowel syndrome (IBS) involves abdominal pain or discomfort that’s usually associated with constipation, diarrhea, or both, and most often bloating. IBS is not a disease unto itself, but a symptom with hundreds of possible causes. No single test exists to diagnose IBS, and there is no unifying treatment, yet 15-20% of Americans suffer from it and IBS is the most common diagnosis made by gastroenterologists. The medical community tends to lump everyone with a digestive complaint together under the IBS umbrella; it’s a way of saying, “You don’t feel well, yet everything looks fine.” But those suffering from IBS are affected by real symptoms and will indicate that things are not fine, regardless of how normal their colonoscopies, endoscopies, or labs may appear. Stress is often deemed as the root cause of IBS, but many other factors are usually involved, including diet, medication use, and underlying undiagnosed conditions. Although stress may contribute to IBS symptoms it’s usually not the only cause.
SYMPTOMS
IBS Symptoms vary for each individual but most often include:
- Abdominal pain or discomfort
- Constipation
- Diarrhea
- Bloating
- Gas
CAUSES
IBS is a description of your symptoms (your bowel is irritable), not what’s causing them (why is your bowel irritable?). Although the causes of IBS can be difficult to identify, if you take a prudent assessment of your symptoms, history, and lifestyle, you may find many potential explanations. Multiple factors are often at play— for example, food allergies, plus side effects from your antidepressant and poor diet. Potential causes of IBS symptoms include:
- Aerophagia (air swallowing)
- Antibiotic use
- Bacterial overgrowth (dysbiosis)
- Bile acid malabsorption
- Bile gastritis
- Carbohydrate malabsorption
- Celiac disease
- Constipation
- Crohn’s disease
- Diet
- Diverticulosis
- Eating disorders
- Eosinophilic gastroenteritis
- Food allergies
- Fructose malabsorption
- Gallbladder dysfunction
- Gallstones
- Gastroparesis
- Gluten intolerance
- Helicobacter Pylori
- Infections
- Lactose intolerance
- Leaky gut syndrome
- Liver disease
- Medication side effects
- Motility disorders
- Microscopic colitis
- Parasites (especially Giardia and Blastocystis hominis)
- Small intestinal bacterial overgrowth (SIBO)
- Stress
- Thyroid disorders
Arriving at the root of what’s causing your IBS may be a long journey that requires persistence, patience, and an open mind, but one that’s well worth it for your digestive and overall wellness. IBS causes real symptoms and suffering, and therefore it’s essential to figure out why your symptoms are occurring, rather than accept IBS as the diagnosis and resign yourself to a life of pharmaceutical intervention.
DIAGNOSIS
There is no test that confirms or denies a diagnosis of IBS, and the cause(s) can vary tremendously from person to person. IBS is a set of symptoms rather than a definitive disease or diagnosis, and it is frequently referred to as a diagnosis of exclusion: your doctor can’t find anything else wrong, therefore it must be IBS. Because IBS has many possible causes, testing for conditions that may be at the root of your IBS are often helpful. One of the most important conditions to test for is celiac disease since many IBS sufferers have undiagnosed celiac disease or gluten sensitivity. Even if the test is negative, trialing a gluten free diet is strongly recommended. Testing for colon cancer, parasites, inflammatory bowel disease (Crohn’s and ulcerative colitis), SIBO, and lactose intolerance may also help in diagnosing the cause of your IBS symptoms.
TREATMENT
Prescription Drugs
The conventional treatment approach to IBS is to alleviate symptoms using prescription drugs, not unearth and remediate the underlying cause. Most of the medications—including the psychiatric drugs that are frequently prescribed since most of the body’s feel-good hormone, serotonin, is housed in the gut—have side effects and aren’t particularly effective. Most IBS medications are ones that are lifetime prescriptions and only treat the symptoms of IBS, not the root cause. The following recommended treatments can be important steps in curing IBS symptoms:
Restoration of Microbial Balance
Recent findings show alterations in the microbiome as a major contributor to IBS. This offers exciting promise for new ways to address symptoms through restoration of microbial balance through diet and medicinal foods. A robust probiotic containing Bifidobacterium lactis, also known as Bifidobacterium animalism, has proven beneficial for abdominal discomfort and bloating in some people with constipation-predominant IBS, although probiotics are always more effective when accompanied by dietary change.
Lifestyle Modifications
Because IBS is often a result of physiological and psychological factors, it is important to explore the areas of diet, exercise, and stress reduction in your daily life which can help tackle your IBS in both the physical and mental arenas. Gut hypnotherapy (GHT), a type of hypnotherapy that focuses on gut and digestive conditions and has proven successful in treating IBS, is used to relieve stress. It has been found to be an effective therapy for IBS in several studies, and superior to medical treatment alone. Quality of life outcomes are improved with GHT, and it has a long-term positive effect, even in difficult to treat cases of IBS. Although stress may not be the root cause of your IBS, it may be contributing to your IBS symptoms. The reality is that no two patients experience IBS in the same way. What works for your friend may not work for you. Some patients use many remedies, from the FODMAP diet to prescription anti-spasmodics to psyllium husk and probiotics.
Bottom line: What works best for IBS is what works for you. Incorporating dietary strategies, lifestyle changes, and mind-body techniques are the ideal places to start if you’re looking for innovative and integrative solutions on your quest for digestive wellness.
