What is Irritable Bowel Syndrome (IBS)?
Irritable bowel syndrome (IBS) is a condition that affects the digestive system causing abdominal pain, bloating and changes in bowel movements. It can also lead to diarrhea and constipation which can both be short lived or prolonged.
Some people have severe IBS which can impact adversely on their everyday lives, whereas others learn to manage the condition by recognising what triggers it.
The cause of IBS is unknown and even though it affects up to 21 percent of the population there is still no cure. (1,2)
Irritable bowel syndrome (IBS) is a chronic disease that lasts for years, albeit the symptoms may come and go and could appear mild or chronic. Whatever the traits it can severely affect people’s quality of life and ability to function.
The main symptoms of IBS are:
The pain associated with this condition can vary greatly from chronic to manageable. It can come and go and last from a few hours to more than a few days. People are unable to predict when they will get bouts of pain, yet when they do it can be debilitating.
Some people find passing stools help relieve the pain to some degree, whilst emotional stress and eating can make the pain worse.
Stomach cramps are another symptom often reported accompanying this pain.(3)
Bloating affects up to 30 percent of the general population and it’s also very common in IBS. In fact it’s rated as the most troublesome symptom by 60 percent of sufferers.
It could be the result of excess gas formed by bacteria in the intestines when undigested foods are broken down. It also might be because gas cannot pass efficiently through the digestive system.
Another contributing factor of bloating points to the abdomen muscles being stretched. This can cause loss of tone and pressure on the walls of the intestines, this leads to an inability to function properly when stools move along the colon.
Bloating can also make you feel like your tummy is full and swollen. (4)
Altered Bowel Habits
Diarrhea and constipation are both associated with IBS. They can occur separately or may happen one after the other. However, there could be bouts of normal bowel movements in between.
Diarrhea is the passage of loose watery stools which happens more than 3 times a day. On the other hand, where constipation is concerned stools become hard and dry. Bowel movements are generally less than three per week and can be painful. (5,6)
There are a number of less common symptoms associated with irritable bowel syndrome (IBS) including:
One of the by products of digesting food is gas. This happens when there is an excess of or change to bacteria in the small intestine. Gas can be excessive and is expelled from our bodies through the anus. (7,8)
Passing mucus in your stool, or on its own is another symptom of IBS. (9)
Tiredness and Lethargy
Fatigue is often reported with other symptoms of IBS. This can leave people feeling tired and lacking energy to carry out everyday tasks. (10)
Fecal incontinence is a distressing symptom of IBS which leaves sufferers unable to control their bowel movements. It can have a knock on effect causing anxiety, embarrassment and depression.
The impact on daily life can be extreme, causing people to take time off work and avoid social situations. (11)
IBS can cause problems with your urinary system. You may feel the need to urinate more often and even when you do go it can still feel like you haven’t emptied your bladder. (12)
Many individuals with IBS report intolerance to certain foods. However, it appears foods that trigger symptoms vary from person to person.
Unlike food allergies, there is no clear reason for these intolerances. Some of the foods reported are gluten, lactose and gas producing foods. (13,14)
IBS is a condition that comes and goes and doesn’t have defined stages as such. However, there is a set of guidelines laid out around diagnosis and treatment.
These are based upon assessment of frequency and types of stools produced by IBS sufferers. They are classed depending on whether episodes predominantly involve constipation, diarrhea or both. There should also be at least four days a month in which they occur.
They can be staged as the following types: (15)
IBS C Predominant Constipation
People who have more than 25 percent constipation and less than 25 percent diarrhea.
IBS D Predominant Diarrhea
People who have less than 25 percent constipation and more than 25 percent diarrhea.
IBS M Mixed Bowel Habits
People who have more than 25 percent constipation and more than 25 percent diarrhea.
In addition, the criteria also assesses recurrent abdominal pain and bloating.
On average they should have episodes at least one day per week in the preceding three months. This should also be accompanied by a change in the appearance and frequency of stools.
The onset of symptoms should have been at least six months previous and present for the last three months. (16,17)
Opinions on the treatment of IBS can differ greatly. What might work for one person may exacerbate it for another. Some of the more agreed recommendations include eating or avoiding particular foods and exercise.
Keeping a diary of what you eat and how it affects you may help you identify trigger foods. It is also worth recording how exercise and stress affects you. By doing this a pattern may emerge which will give you some insight into managing your condition.
There are also types of medication and treatments which can ease the symptoms of IBS. These include:
Fiber is found in foods like beans, fruit, whole grains, oats and vegetables. You can also get dietary supplements containing fiber.
Fiber can soften stools which in turn can help them pass through the colon more efficiently. This may help relieve constipation. (18)
Peppermint oil capsules help alleviate the symptoms of abdominal pain. They are a safe and effective treatment to use in the short term.
One side effect of taking peppermint oil is heartburn, but this can be mild and pass quite quickly. (19)
This dietary supplement provides the digestive system with good bacteria. It helps with bowel function and aids digestion. (20)
Probiotics can help relieve abdominal pain and reduce the severity of linked symptoms like bloating, diarrhea and constipation. (21)
Anti Cramping Medications
Cramps in the abdomen are one of the common and more painful symptoms of irritable bowel syndrome (IBS). Anti cramping drugs aim to relax muscles of the intestine which can in turn relieve cramps.
Some, but not all, of these medications have shown to help IBS sufferers. There are four in particular where research has proved favorable: butylscopolamine, cimetropium, otilonium and pinaverium. (22)
Medication for Constipation and Diarrhea
Over the counter medication for constipation and diarrhea are available from your pharmacist. However, evidence for their effectiveness in treating diarrhea is limited and they may actually be counterproductive.
Medications like laxatives for constipation can cause diarrhea and likewise, medications to stop diarrhea can cause constipation. This could exacerbate existing symptoms, especially if you have alternating constipation and diarrhea. (23)
Treatment of diarrhea and flatulence in IBS with antibiotics is sometimes considered. In certain cases, antibiotics have shown alleviation of constipation and gas. (24)
Whilst antibiotics may help symptoms it is worth noting they can also have side effects like allergic reactions, fungal infections and nausea. Also too many antibiotics can result in the body becoming resistant to them making them less effective. (25)
When it comes to managing the symptoms of IBS, some antidepressants can be effective. They can work in different ways, some have a pain-relieving effect whilst others influence muscles in the digestive system.
However there are various side effects associated with these drugs, including: nausea, loss of appetite, a reduced sex drive and some can even cause constipation or diarrhea.
This is why your doctor will weigh up the pros and cons of use before prescribing them for irritable bowel syndrome (IBS). (26)
Some psychological therapies which help improve the mind and body have emerged as being effective tools in treating IBS. These include cognitive behaviour therapy and hypnotherapy.
These types of therapies help stress management, self-empowerment and teach you positive coping mechanisms. They focus on changing your awareness and increasing acceptance of your condition to help you cope with it better.
What is irritable bowel syndrome (IBS)? IBS is a condition that affects the digestive system characterized by abdominal pain, bloating and changes in bowel movements.
What are the signs of irritable bowel syndrome (IBS)? The main signs of IBS are abdominal pain, bloating, diarrhea and/or constipation. These factors can also vary in severity.
How do you develop irritable bowel syndrome (IBS)? The actual cause of IBS is unknown. It’s thought to be linked to points like poor digestion with foods passing too quickly or slowly through the system. Other contributing factors can be over sensitive nerves in your gut or stress. A family history of IBS may also predispose you to the condition. (27)
How are you diagnosed for irritable bowel syndrome (IBS)? We have learnt the main symptoms of IBS are abdominal pain, bloating and diarrhea and/or constipation. Your doctor will initially assess and try to find the cause of these symptoms. If they are unexplained by any other condition or disease then a diagnosis of IBS will be considered. This is based upon the criteria: frequency and type of stools.
What is the best treatment for irritable bowel syndrome (IBS)? Treatments for IBS aim to relieve the symptoms. They include self help tools like monitoring diet and keeping a food diary. There are also over the counter and prescription medications that may help. Psychotherapy may assist you in coping better with the condition.
What are the long term complications of irritable bowel syndrome (IBS)? IBS can impact hugely on everyday life and learning to cope is key to your well being. People may feel the condition rules their lives making them feel embarrassed and withdrawing from social life. After all it’s never easy talking about bowel movements and the associated symptoms of IBS. (28)
Is irritable bowel syndrome (IBS) considered a disability? Whilst IBS can have a major impact on your life and ability to function it is not a disability. The factors, if extreme may allow you to claim social security benefits. (29)
Is there a cure for irritable bowel syndrome (IBS)? There is currently no known cure for IBS and symptoms can only be managed.
Is irritable bowel syndrome (IBS) life threatening? Quality of life can be greatly impacted by IBS, but it is not a condition considered to be life threatening. (30)
We have learnt irritable bowel syndrome (IBS) affects the digestive system through abdominal pain, bloating and changes in bowel movements. It also causes diarrhea or constipation which can be mild or chronic.
IBS can have a major impact on your lifestyle. You may find you need to plan your daily activities around your symptoms. For example, it may be as simple as locating the nearest toilet wherever you may be or requesting the aisle seat on an aeroplane.
Whilst there is no cure for IBS there are treatments available that can help when the symptoms flare. What’s more, no matter the type you have, learning about your own personal triggers can help improve your quality of life.