Irritable bowel syndrome (IBS) is a disorder which leads to abdominal pain and cramping, changes in bowel movements, and also other symptoms.
IBS is not the same as inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis. In IBS, the structure of the bowel is not abnormal.
Causes, incidence, and risk factors
It is not clear why patients develop IBS. It sometimes occurs after an infection in the intestines. This is called postinfectious IBS. There may also be other triggers.
The intestine is connected to the brain. Signals go back and forth between the bowel and brain. These signals affect bowel function and symptoms. The nerves can become more active during stress, causing the intestines to be more sensitive and squeeze (contract) more.
IBS can occur at any age, but it often begins in the teen years or early adulthood. It is twice as common in women as in men.
About 1 in 6 people in the U.S. have symptoms of IBS. It is the most common intestinal problem that causes patients to be referred to a bowel specialist (gastroenterologist).
Symptoms range from mild to severe. Most people have mild symptoms. Symptoms are different from person to person.
The main symptoms of IBS are abdominal pain, fullness, gas, and bloating that have been present for at least 3 days a month for the last 3 months.
The pain and other symptoms will often:
* Be reduced or go away after a bowel movement
* Occur when there is a change in how often you have bowel movements
People with IBS may switch between constipation and diarrhea, or mostly have one or the other.
* People with diarrhea will have frequent, loose, watery stools. They will often have an urgent need to have a bowel movement, which may be hard to control.
* Those with constipation will have a hard time passing stool, as well as fewer bowel movements. They will often need to strain and will feel cramps with a bowel movement. Often, they do not release any stool, or only a small amount.
For some people, the symptoms may get worse for a few weeks or a month, and then decrease for a while. For other people, symptoms are present most of the time.
People with IBS may also lose their appetite.
Signs and tests
Most of the time, your doctor can diagnose IBS based on your symptoms, with few or no tests. Eating a lactose-free diet for 2 weeks may help the doctor check for a possible lactase deficiency.
There is no test to diagnose IBS.
Tests may be done to rule out other problems:
* Blood tests to see if you have celiac disease or a low blood count (anemia)
* Stool cultures to check for an infection
Some patients will have a colonoscopy. During this test, a flexible tube is inserted through the anus to examine the colon.
You may need this test if:
* Symptoms began later in life (over age 50)
* You have symptoms such as weight loss or bloody stools
* You have abnormal blood tests (such as a low blood count)
Other disorders that can cause similar symptoms include:
* Celiac disease
* Colon cancer (cancer rarely causes typical IBS symptoms, unless symptoms such as weight loss, blood in the stools, or abnormal blood tests are also present)
* Crohn’s disease or ulcerative colitis
When you have IBS, eating can seem like a minefield, with your gut ready to react at the slightest provocation. Every new study recommends that you avoid a different food or group of foods, and cooking is not much fun when a simple grocery trip requires an encyclopedic list of forbidden foods and precisely specified supplements.
While it can be a callenge to play meals around an ever-changing grocery list, living with IBS doesn’t mean that you have to subsist on nothing but ground beef and vegetables. You can eat a Paleo diet without eggs, FODMAPS, nightshades, or nuts, and still enjoy your meals!
This pork roast recipe makes a delicious entrée with plenty of leftovers to grab for a quick breakfast or a cold lunch. For a lighter meal, try a shrimp and mango salad or cinnamon chicken (just leave out the onions if you’re eliminating FODMAPs foods). This tuna steak recipe even calls for garlic, a helpful natural antibacterial.
For a rich side dish on long winter evenings, try some roasted acorn squash: this would be a delicious accompaniment to a roast chicken or a nice, juicy steak. Kale chips would make a great snack in the place of unhealthy crackers or cookies.
As you learn more about your specific triggers and intolerances, you’ll be able to add more different types of foods into your diet – after all, if you don’t react to something there’s no reason to avoid it. Everyone’s gut issues are unique: experiment in your own kitchen, and find a way of eating that works for you.
Although doctors continue to research potential treatments for IBS, so far it remains a vaguely defined collection of digestive symptoms classified by elimination: if it isn’t anything else that your doctor can recognize, it’s probably IBS.
The very general nature of the problem demands a very general treatment: maximize your gut health as much as possible by reducing inflammation and healing your gut flora, and identify your trigger foods so you can avoid them in the future.
Someday, you might wake up to a New York Times headline about the cure for IBS, but until then, healing and supporting your gut as well as you can is your best bet for controlling IBS symptoms, so you can look better, feel healthier, and move on with your life.