IBS, A Sneaky GI Disorder

Did you know IBS sneakily affects more than 35 million Americans?¹ Irritable Bowel Syndrome (IBS) is a type of functional gastrointestinal tract (GI) disorder affecting bowel movement with around 75% of the cases affected being undiagnosed.² While it is not a chronic disease, IBS causes pain and discomfort affecting the quality of life.

Three categories of IBS include:

• IBS with constipation (IBS-C) over a quarter of stool is hard or lumpy
• IBS with diarrhea (IBS-D) over a quarter of stool is loose or watery
• IBS with mixed bowel habits (IBS-M) a mix of IBS-C and IBS-D

"Everyday I'm in constant discomfort from the bloating. It really affected my daily function, where I would have to take many long breaks throughout the day to ease the pain." ~ J.L.

The interaction between the gut and brain is believed to be affected in individuals with IBS.³ The gut can become more sensitive and change bowel movements causing abdominal pain and bloating resulting in different types of stool. The condition often affects individuals before 50 years of age with women being twice as likely to get IBS than men. While it is unsure how it is developed, certain problems may cause IBS such as emotional stress and anxiety, food intolerance, and bacterial infection of the GI tract.³ A large-scale genome study done in the UK found 6 genes susceptible to IBS with 4 of the genes associated with mood and anxiety disorder.⁴ Other studies have found low FODMAP diet helps reduce symptoms and/or psychotherapy which can also improve everyday life.^5,6

How do we treat IBS?

Currently, there is no treatment for IBS but there are several ways to approach IBS to manage the symptoms. Managing IBS results in multifactorial (several) strategies, not just a one-size-fits-all approach. It varies from person-to-person and therefore is an individualized process.

• Stress
• Gut-brain connection
• FODMAP
• Probiotics and fibers
• Medications

Stress

In clinical and experimental studies, acute or chronic stress impacts the intestine's sensitivity.⁷ it is important to understand what is causing the stress and how to manage it. Again, it is individualized and everyone has different strategies for managing stress that works best for them. Some ideas for managing stress include meditation, deep breathing and counseling.

Psychotherapy is another way to help manage stress. It was found to have great improvement in GI symptoms as well as mental health and quality of life in individuals with IBS.⁸ Overall, cognitive behavioral therapy (CBT) has the greatest improvement in daily function. Reaching out to a licensed therapist or counselor on different management plans can be an effective way for people to alleviate and cope with IBS symptoms.

Gut-Brain Connection

Interestingly the gut and brain interact with each other. A positive or negative response from the brain to the gut can result in changes to the digestive system. Improving the gut-brain connection can alleviate the symptoms. Some ways to improve the connection can be slowing down intake time, reading, or strategies to decrease stress or any of the above strategies under stress can help.

FODMAP

Fermented oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) are certain types of carbohydrates that are harder to digest. Following FODMOPS can decrease the fermentable carbohydrate thus decreasing some IBS symptoms like pain, bloating, and gas. Some low FODMAP foods are black beans, broccoli, brussel sprouts, tomatoes, oranges, papayas, and blueberries.⁹ On the other hand, some high FODMAP foods would be garlic, onions, mushrooms, avocadoes, and bananas.

Probiotics and fibers

Dietary fiber is shown to have strong evidence in improving symptoms of IBS. Soluble fiber (psyllium, ispaghula) specifically improves abdominal pain.¹⁰ Foods high in soluble fiber include carrots, green beans, blueberries, and bananas.

Probiotics are live microorganisms that contribute to health benefits to the body. Some probiotic-rich foods include yogurt, fermented food (kombuchas, kefir).

Medications

Currently, medication such as laxatives for IBS-C and anti-diarrheal medication for IBS-D does not have strong evidence of their effectiveness.⁶ However, depending on the individual, it could work. It is best to consult your doctor to plan for the best course of action.

Takeaway

Everybody is different and everybody has different ways of managing pain and stress. Treating IBS is an individualized process that might work for one but not the other. It is helpful to understand what food might be a potential trigger for the symptoms, the current level of stress, and be mindful of the journey. Oftentimes, IBS goes undiagnosed so it is important to address the signs and symptoms with a Registered Dietitian or your doctor.