IBS is a group of intestinal symptoms that can include abdominal cramping, diarrhea, constipation, bloating, and gas. The cause of IBS is not clear but may be related to an overly sensitive colon or immune system.
The condition affects more women and young people. Some people with IBS have minor symptoms. However, for others, the symptoms are significant and disrupt daily life.
Possible Causes of IBS
While we do not know for sure what causes IBS, it is a multifactorial disorder that likely involves an interaction between the GI tract, bacteria in the gut, the nervous system, and external factors, such as stress.
Although not proven, theories exist as to factors that influence IBS symptoms, including:
- neurological hyper-sensitivity within the GI (enteric) nerves
- physical and/or emotional stress
- dietary issues such as food allergies or sensitivities, or poor eating patterns
- use of systemic antibiotics for GI infection
- bile acid malabsorption
- the amount or pattern of physical exercise
- chronic alcohol abuse
- abnormalities in GI secretions and/or digestive muscle contractions (peristalsis)
- acute infection or inflammation of the intestine (enteritis), such as traveller’s diarrhea, which may precede onset of IBS symptoms
The GI system is very sensitive to adrenalin – the hormone released when one is excited, fearful, or anxious – and to other hormones as well. Changes in female hormone levels also affect the GI tract, so IBS symptoms may worsen at specific times throughout the menstrual cycle. Since these hormones can affect the transit time of food through the digestive tract, this might account for the predominance of IBS in women, although direct evidence is still lacking.
Management of IBS
The GI tract is an extremely complex system, influenced by many nerves and hormones. The types of food eaten, the frequency and environment of eating, as well as various medications affect both the secretions and motility of the intestine.
Dietary and Lifestyle Modifications
The bowel responds to how and when a person eats, so it is important to eat regular, well-balanced, moderately sized meals rather than erratic, variable meals. Occasionally, IBS symptoms improve by allowing sufficient time for regular eating and bathroom routines. In addition, maintaining a healthy sleep schedule and getting a moderate amount of exercise can help reduce symptoms.
Some individuals report that dietary fats and the food additive monosodium glutamate (MSG) trigger symptoms. Some find symptoms worsen when consuming a large volume of liquids with meals. Others find that cooking vegetables and fruits lessens IBS symptoms, compared to when eating them raw. Those with IBS might need to avoid or decrease consumption of GI stimulants such as caffeine, nicotine, and alcohol, particularly if the predominant symptom is diarrhea.
Having IBS does not necessarily mean you produce more gas, but your intestines might be highly sensitive to the passage of gas. Reducing the ingestion of air, which is the major source of intestinal gas, and avoiding large quantities of gas-producing foods can help. To decrease swallowed air, avoid chewing gum, gulping food, drinking carbonated beverages, washing food down with liquids, and sipping hot drinks. Poor-fitting dentures, a chronic postnasal discharge, chronic pain, anxiety, or tension may also contribute to increased air swallowing. It is important to note that IBS is highly variable, and each person can experience different triggers. By keeping a food intake diary and noting any adverse reactions, you can quickly identify and remove problematic food from your diet and determine an approach that works best for you. Be sure to consult a registered Dietitian – Nutritionist before eliminating any food group long-term. Traditionally, dietary advice for IBS patients had included avoidance of caffeine, alcohol, fatty foods, and spicy foods. However, the growing evidence supporting dietary modification to treat IBS has led to new knowledge regarding additional therapies.
The influence of diet is unique to each person. There is no generalized dietary advice that will work for everyone. During your appointment with your healthcare provider, they may take a brief dietary history to help identify dietary and/or other factors that may impact symptoms.
It is important to note that often, people with IBS report that some foods can be bothersome at certain times but not at other times. There is a sense of inconsistency and unpredictability.