5 Things You Should Know About IBS

By Ernst Lamothe Jr.

Physician Dasha Moza, an internal medicine specialist with Rochester Regional Health

It’s a condition that often is difficult to both talk about and experience. However, both aspects are the reasons why it is too often in the shadows and why people need to understand its impact.

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that affects the large intestine. Signs and symptoms include cramping, abdominal pain, bloating along with diarrhea and constipation. While the cause of IBS is not clear, symptoms arise from a variety of factors including a sensitive digestive tract and changes in muscle contractions in the gut. 

IBS may also be known by other names such as irritable bowel, irritable colon or also a nervous stomach, because strong emotions can aggravate its symptoms although they do not cause them. 

In the United States, approximately 10% – 15% of the adult population suffers from IBS symptoms, according to the American College of Gastroenterology.

“IBS is quite prevalent in the population especially in young females. Understanding the symptoms, treatment and prognosis of IBS can help the patients and physicians optimize therapy and avoid over investigation,” said physician Dasha Moza, an internal medicine specialist with Rochester Regional Health.

Moza discusses five aspects of IBS that people should understand.

1. Difficult to talk about

Irritable bowel syndrome can have many symptoms; the cardinal symptom is abdominal pain felt in the lower abdomen. Pain and bowel problems vary in severity from person to person. Like other chronic pain disorders, IBS is very burdensome when symptoms are more severe. Yet the mental strain of having a disorder no one fully understands and wants to talk about can be just as difficult as the physical effect.

“It can be hard to discuss since it is a relatively new entity and we are still in the nascent phases of learning about it. At this point, we do not have a cure for IBS and there is no magic pill for it. Treatment requires a bit of experimentation with the different therapies that are available. That can sometimes make IBS frustrating to treat and to discuss,” said Moza.

2. Stigma

Those who battle the condition also must overcome stigma and stereotypes along the way of getting the help they need. Everything from people saying it is 100% mental and “all you need to do is deal with it” to making light of the condition in real life or movies and television.

“One misconception amongst patients and some healthcare professionals is that having IBS means that your symptoms are not real. That is not true,” said Moza. “The symptoms that IBS causes are 100% real, we are just not able to explain them completely with the knowledge and understanding that we have at this time.”

3. Symptoms

Symptoms of IBS usually include abdominal pain associated with bowel movements, chronic diarrhea or constipation, alternating between constipation and diarrhea associated with abdominal pain, worsening of symptoms with stress and lack of nocturnal symptoms, said Moza. Symptoms which may indicate other diagnoses include recurrent vomiting, bloody diarrhea, weight loss and fevers to mention a few and should be investigated appropriately.

The exact cause of IBS is unknown. Possible causes include problems with bowel muscle contraction and movement of food through the digestive tract, overly sensitive colon or issues with the immune system of the nerves in the digestive tract which deregulates communications between nerves in the brain and gut. Several studies have assessed the prevalence of mental health problems among treatment seeking IBS patients. About 40% to 60% of people with IBS had met formal diagnosis for mental problems particularly anxiety and depression. But that also means a large percentage do not have a mental health problem, meaning it cannot be dismissed as a psychiatric problem.

4. Hope without a cure

Despite all the scientific developments, there is still no cure for the disease. Doctors recommend a change in the lifestyle and eating habits. Home remedies or lifestyle changes include dietary changes such as avoiding food triggers like spicy or fatty foods and a specific psychological treatment called cognitive behavior therapy. Doctors may suggest gut-directed medications if the symptoms do not improve through simple lifestyle change and cognitive behavior therapy treatment if symptoms remain refractory to first-line medications.

“Treatment depends on the predominant symptoms. For constipation predominant IBS, we use fiber supplementation, PEG 3350 laxatives and other prescription laxatives such as Linaclotide or Lubiprostone,” said Moza. “For diarrhea-predominant IBS, treatment includes fiber supplementation to bulk up the stool, as needed. Diet changes, dairy avoidance and keeping a food and symptoms journal have also been found to be helpful in teasing out any specific triggers for the symptoms and providing relief. Learning better methods of coping with stress through psychotherapy has also been shown to help with the global IBS symptoms.”

5. Family history

Often occurrence of this condition is seen in people in their late teens to early 40s. It is also said that it may affect multiple people in a family. Women can be twice as likely than men to suffer IBS.

“IBS is not a typically inherited condit

ion that we think of, but genes can certainly play a role as well as the environment in a family including diet and stress,” said Moza. “Gut bacteria vary between people and we know that certain bacteria are associated with more symptoms of IBS. Our diet and lifestyle affects the type of bacteria in our gut which can be a factor of our family or the people we cohabit with.”