Did you know that Irritable Bowel Syndrome (IBS) is the most commonly diagnosed gastrointestinal condition? About 10 to 15 percent of adolescents and adults in North America have IBS (4). It is also the second most common cause of absence from work after the common cold (1). Yet it is one of the most underdiagnosed medical conditions with about 40 percent of individuals with symptoms of IBS not having a formal diagnosis by a clinician (1).
What is IBS? It is a chronic disorder of the digestive tract that can affect anyone. It affects women more often than men and is more prevalent in people under the age of 50. IBS is found more often in people who have the following health conditions:
- family history of IBS
- fibromyalgia
- chronic fatigue syndrome
- GERD (heartburn)
- functional dyspepsia
- non-cardiac chest pain
- depression
- anxiety
- somatic symptom disorder
- other psychiatric conditions
How does IBS manifest?
The main symptoms of IBS include:
- abdominal pain and cramping
- bloating and gas
- diarrhea or loose stools
- constipation
- alternating diarrhea and constipation
A person with IBS may experience only one or all of the above symptoms. A few other symptoms such as tenesmus (feeling of incomplete emptying), mucus in stools or urgency to have a bowel movement may be present. The severity of these symptoms may range from mild and occasional to severe and frequent. Often, a certain food or psychological stress may trigger the symptoms (2).
What causes IBS?
The exact cause of IBS is still unknown. However, several potential causes and contributing factors have been identified (3):
- early life stress, especially in childhood
- altered communication between the GI and nervous systems
- abnormal peristalsis (contractions) of the intestines
- severe infection of gastroenteritis (stomach flu) caused by a virus or bacteria
- changes in the gut microbes that normally reside in the intestines
How is IBS diagnosed? A specific test that can diagnose IBS does not exist yet. Therefore, IBS is often considered to be a diagnosis of exclusion, meaning other conditions that can have similar symptoms need to be ruled out. Some other conditions that can present with similar symptoms include intestinal parasites, celiac disease or inflammatory bowel disease such as Crohns.
The first step in the correct diagnosis of IBS involves a thorough review of symptoms and medical history by a clinician. Depending on the findings during this review, a clinician will typically order blood and stool tests. In some cases an x-ray, ultrasound and/or CT scan of the abdomen as well as a colonoscopy and/or endoscopy might be necessary. A consultation with a gastroenterologist is common for IBS as well. When someone has symptoms of IBS and other possible conditions have been ruled out, a formal diagnosis of IBS can be made.
What kind of treatment is there for IBS? In individuals with milder symptoms the treatment is usually centered around dietary and lifestyle modifications. Specialized dietary regimens such as low FODMAP or special IBS diet can be effective for many. Regular and consistent physical activity is also highly recommended.
Medications are often used for moderate to severe symptoms, or when conservative treatment does not produce desired results. Complimentary or alternative medicine modalities such as counseling, cognitive behavior therapy, herbal supplementation and acupuncture can also be helpful for some individuals.
References
1) https://www.uptodate.com/contents/irritable-bowel-syndrome-beyond-the-basics?search=ibs&source=search_result&selectedTitle=5~150&usage_type=default&display_rank=5
2) https://www.webmd.com/ibs/guide/digestive-diseases-irritable-bowel-syndrome
3) https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/ symptoms-causes/syc-20360016#:~:text=Irritable%20bowel%20syndrome%20(IBS)%20is,need%20to%20manage%20long%20term.
4) https://pubmed.ncbi.nlm.nih.gov/12190153/#:~:text=Results%3A%20The%20prevalence%20of%20IBS,IBS%20are%20both%20approximately%205%25.
