Do you chronically experience abdominal bloating, gas, cramping, or a mixture of diarrhoea and constipation? You may be suffering from IBS or Irritable Bowel Syndrome.
IBS is a common disorder. While symptoms can be controlled through lifestyle changes, some of the more severe symptoms may need medication.
Read on to learn more about IBS, the symptoms of irritable bowel syndrome, and what to do if you have it.
What is IBS?
Irritable Bowel Syndrome (IBS) or IBS affects the colon or the large bowel (1). It is also referred to as 'irritable colon’ (2).
IBS is a common condition, affecting three out of ten Australians. Worldwide, an estimated 10-15% of people are affected by IBS (3). In Australia, women are more likely to have IBS than men1. Whilst IBS is uncomfortable, it is not usually a life-threatening condition. However, in some people the symptoms may be severe and debilitating (3).
Stronger IBS symptoms may affect one's life, including one's physical, emotional, economic, and social well-being. Symptoms such as diarrhoea and constipation may limit one's personal and professional activities (3).
Many people who experience moderate to severe symptoms report having a poorer quality of life. For instance, studies show that people with IBS tend to miss three times as many work days as compared to those without symptoms. These indicators may also lead to anxiety and depression, which in turn, may worsen IBS symptoms (4).
Symptoms of irritable bowel syndrome
The symptoms of IBS include (1, 2):
- Abdominal pain and discomfort. Stomach bloating
- Chronic diarrhoea
- Chronic constipation
- Alternating between diarrhoea and constipation
- Mucus in one's stools
- The feeling that you have not fully emptied your bowels even after having a bowel movement
However, many of these symptoms may also be caused by other conditions, such as inflammatory bowel disease (IBD), Coeliac disease, and diverticulitis. Being lactose intolerant may also lead you to experience bloating and diarrhoea (3).
To determine whether your issues point to IBS, it is important to consult with your doctor (2). Your medical practitioner may diagnose the condition following a full medical check-up involving blood tests, stool tests, a sigmoidoscopy (wherein a small tube is used to investigate the bowel lining), or a colonoscopy (wherein a tube with a camera is used to investigate the bowel area while the patient is under sedation).
Categories of IBS
There are three categories of IBS, which depends on the symptoms of irritable bowel syndrome, and how one's stool presents (2, 5). These include:
- Constipation-predominant - In this case, the person alternates between constipation and normal stools. They may experience abdominal cramps or aching after eating.
- Diarrhoea-predominant - The person experiences diarrhoea upon waking up in the morning, or after eating a meal. They may need to void their bowels urgently, and may experience incontinence.
- Alternating constipation and diarrhoea - The person experiences both constipation and diarrhoea.
Irritable bowel syndrome causes
The actual causes of IBS are unknown, but IBS flare-ups can arise due to various triggers, and are affected by different factors.
IBS symptoms can be triggered by certain kinds of food (4). While food allergies rarely result in IBS, people who suffer IBS experience worse symptoms when they eat specific foods and drinks, including dairy products, wheat, citrus fruits, beans, cabbage, milk, and fizzy drinks.
Another IBS trigger is stress. IBS sufferers experience worse symptoms when they are undergoing a lot of stress. However stress itself is not thought to be the cause of IBS (4).
Risk factors of IBS
Risk factors for IBS include (4):
- Being under the age of 50
- Being female - Estrogen therapy may also be a risk factor for IBS.
- Family history - both genetics and common family environments, or a combination of both, may trigger IBS.
- Mental health issues - Having anxiety, depression, or histories of trauma may lead to IBS.
How does IBS develop?
Certain factors may play a role in the development of IBS. These include (4):
Abnormalities in the nervous system
Abnormalities in the nerves within the digestive system may result in you experiencing an unusual amount of discomfort when gas or stool travels through the abdomen. Similarly, misfired signals between these nerves and the brain may result in the body overreacting to the normal motions of the digestive process, leading to diarrhoea or constipation (4).
Intestinal contractions are too weak or too strong
Muscle contractions within your intestines cause the food you eat to move along your digestive tract. However, contractions that last longer, or are stronger than usual, may cause bloating, gas, and diarrhoea. On the other hand, weaker than usual muscular contractions can slow down the passage of food, resulting in constipation (4).
IBS can develop after one experiences severe gastroenteritis caused by a virus or a bacteria. IBS may also arise due to an overgrowth of bacteria in the gastrointestinal system.
Stress, especially early in life, may result in more symptoms of IBS.
Changes in the gut microbiota. The gut microbiome is made up of good and bad bacteria that live in the gastrointestinal system. Having a healthy balance of these bacteria promotes better digestive function. However, research shows that the microbes in people suffering IBS may differ from those without it.
How do you treat IBS?
IBS treatment focuses more on relieving or managing symptoms so that those with the condition may go about their days unhindered (7). There are many lifestyle changes that one can do to help relieve symptoms of irritable bowel syndrome.
Here are some lifestyle changes that one can follow to help reduce the symptoms of IBS (6).
Stress can lead to worsening symptoms of irritable bowel syndrome (6). Consider stress-relief techniques such as meditation (9), talking about your concerns to a trusted friend or family member, or with a mental health expert. Psychological therapy and gut-focused hypnotherapy are also suggested treatments for patients of IBS (5). Stress is also exacerbated by lack of sleep, and not eating well.
Drinking six to eight glasses of water a day can help make stools easier to pass. However, it is better to avoid fizzy drinks such as sodas, or caffeinated and alcoholic drinks. These may worsen symptoms.
Staying active can both relieve stress, and help in keeping one's bowel motions regular. Try walking for just thirty minutes a day to help address potential health concerns (9).
Add protein to your diet
Eating more protein may help prevent blood sugar imbalances that result in the growth of bad bacteria in the gut. Protein sources include fish, turkey, nuts, beans, chicken, seeds, and tofu (9).
More fruits and vegetables
Incorporate more fruits and vegetables in your daily meals (9). Fruits and veggies are rich with vitamins, minerals, fibre, and other nutrients that help address gut conditions.
Managing symptoms of irritable bowel syndrome
Constipation is one of the symptoms of irritable bowel syndrome. One can address the constipation symptoms by increasing the fibre in one's diet. This can be done by including seeds, such as pumpkin, flax, and sunflower in your diet (6). Fibre supplements like psyllium, taken with fluids, may also help manage constipation (4).
Diarrhoea can be addressed by eating a healthy diet, and avoiding foods that further trigger diarrhoea like fizzy drinks and caffeine8. It is important to rest and stay hydrated while suffering from diarrhoea. Antidiarrhoeal medication may also be prescribed by your doctor (4).
Avoid food that trigger symptoms
Certain foods can trigger symptoms of irritable bowel syndrome. Here are some foods to avoid or minimize if you are living with IBS:
These include high-gas foods that may result in bloating or gas.
Foods with gluten also reportedly worsen diarrhoea symptoms in IBS sufferers even if they do not have coeliac disease.
Some people also experience digestive problems after eating FODMAP foods (11).
FODMAPs stand for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. These are sugars that are poorly absorbed by the small intestine, and may result in digestive problems like cramping, diarrhoea and constipation, bloating, and gas.
FODMAP foods include dairy-based milk and ice cream, beans and lentils, some vegetables like asparagus, onions and garlic, and fruits like apples, cherries, and peaches.
Supplementation to help manage IBS
While the best way to get the vitamins and minerals we need to keep our gut health up is through our diet, we aren’t always able to get the sufficient amount from our meals alone. Following this, it may be helpful to consider supplementation. Here are some minerals that you can get from supplementation, that help support better gastrointestinal health:
Zinc is an important mineral that supports many of the body's functions, including the digestive system. Many food contain zinc, including meat, fish, cereals, dairy food, and poultry (10).
Zinc supports gastrointestinal health. Having too little or too much of this nutrient negatively affects not only the intestinal barrier, but also shifts in the balance of food and bacteria in the gut. This may lead to diarrhoea and inflammation (12).
Probiotics are live microorganisms made up of various strains of bacteria and yeasts that support the establishment of friendly bacteria in one's gastrointestinal system.
Probiotics support digestive health by helping restore the balance of one's gut ecosystem. Specific strains of probiotics, including Lactobacillus rhamnosus, are able to promote optimal gut ecosystem function, as well as prevent degenerative disorders. Lactobacillus is also able to inhibit bad bacteria as well as improve gastrointestinal barrier function (13).
Probiotics have also been shown to be able to alleviate symptoms of irritable bowel syndrome. For instance, Saccharomyces boulardii has been found to improve the quality of life in individuals with diarrhoea-predominant or mixed-type IBS (13).
Probiotics can be taken in as part of one's diet, through fermented foods. This includes yogurt, pickles, drinks like kombucha and kefir (14).
Curcumin is the active ingredient in turmeric, which has been widely used in traditional Asian medicine, as well as a dietary spice. Curcumin is widely known for its anti-inflammatory and antioxidant characteristics (15).
It also supports gut health through its connection with the gut microbiota. Curcumin has been shown to have a positive effect on gut microbiota, promoting the growth of beneficial strains such as Bifidobacteria, Lactobacilli, and butyrate-producing bacteria. Some studies have also found that curcumin can decrease harmful bacterial strains (16).
It may be challenging to live with IBS, but there are many lifestyle and dietary changes that you can make to help address flare-ups or symptoms of irritable bowel syndrome.
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*Always read the label and follow directions for use. If you experience any symptoms or if symptoms persist, talk to your health professional. Vitamin and/or mineral supplements should not replace a balanced diet.
- HealthDirect. "Irritable bowel syndrome (IBS)". HealthDirect. Published Sept 2020 on https://www.healthdirect.gov.au/irritable-bowel-syndrome-ibs. Accessed Jan 12, 2022.
- Better Health Channel. "Irritable bowel syndrome (IBS)". Better Health Channel. Last reviewed Dec 20 2021 on https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/irritable-bowel-syndrome-ibs . Accessed Jan 12, 2022.
- International Foundation for Functional Gastrointestinal Disorders. "What is IBS?". International Foundation for Functional Gastrointestinal Disorders. Published n.d. On https://aboutibs.org/what-is-ibs/. Accessed Jan 12, 2022.
- Mayo Clinic Staff. "Irritable bowel syndrome". Mayo Clinic. Published Dec 1, 2021 on https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-causes/syc-20360016. Accessed Jan 12, 2022.
- Basnayake, C. "Treatment of irritable bowel syndrome". Australian Prescriber. Published Oct 2 2018 on https://www.nps.org.au/australian-prescriber/articles/treatment-of-irritable-bowel-syndrome. Accessed Jan 12, 2022.
- Jean Hailes for Women's Health. "Irritable bowel syndrome (IBS)". Jean Hailes for Women's Health. Reviewed Jan 15, 2014 on https://www.jeanhailes.org.au/health-a-z/bladder-bowel/irritable-bowel-syndrome. Accessed Jan 12, 2022.
- Mayo Clinic Staff. "Irritable bowel syndrome". Mayo Clinic. Published Dec 1, 2021 on https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/diagnosis-treatment/drc-20360064. Accessed Jan 12, 2022.
- HealthDirect. "Diarrhoea". HealthDirect. Last reviewed June 2021 on https://www.healthdirect.gov.au/diarrhoea. Accessed Jan 12, 2022.
- Health Essentials. "9 Ways to Help Tame Your IBS". Cleveland Clinic. Published Sept 23, 2020 on https://health.clevelandclinic.org/good-for-your-gut-9-ways-to-tackle-ibs/. Accessed Jan 12, 2022.
- Health Direct. "Zinc and your health". Health Direct. Last reviewed March 2021 on https://www.healthdirect.gov.au/zinc. Accessed Jan 12, 2022.
- Veloso, H., "FODMAP Diet: What You Need to Know". John Hopkins Medicine. Published n.d. on https://www.hopkinsmedicine.org/health/wellness-and-prevention/fodmap-diet-what-you-need-to-know. Accessed Jan 12, 2022.
- Angelo, K., "The Role of Zinc: It's More Important than You Think". University of Massachusetts Lowell. Published March 10 2020 on https://www.uml.edu/news/stories/2020/kelleher-zinc-research.aspx. Accessed Jan 12, 2022.
- Riitta Korpela & Leena Niittynen, “Probiotics and irritable bowel syndrome”. National Center for Biotechnology Information. Published Jun 2012 on https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747754/. Accessed Feb 23, 2022.
- Cleveland Clinic. “Probiotics”. Cleveland Clinic. Last reviewed Sep 3, 2020 on https://my.clevelandclinic.org/health/articles/14598-probiotics. Accessed Feb 23, 2022.
- Vitable. "Curcumin". Vitable. Published n.d. on https://research.vitable.com.au/curcumin. Accessed Jan 12, 2022.
- Scazzocchio, B., et. al., "Interaction between Gut Microbiota and Curcumin: A New Key of Understanding for the Health Effects of Curcumin". Nutrients. Published Sept 2020 on https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7551052/. Accessed Jan 12, 2022.