Irritable Bowel Syndrome or IBS is one of the most common bowel disorders worldwide. In South Africa, a study conducted by Cipla in 2016 showed that 38% of the participants reported suffering from IBS.
Because the symptoms of IBS are often seen as non-life-threatening, people often just “ride it out” and don’t consult their physicians, resulting in undiagnosed IBS.
If you’re reading this, you or someone you know are most likely experiencing some symptoms associated with IBS.
In this article, we’ll clear up the causes and symptoms of IBS, as well as the options for diagnosis and treatments for patients of IBS.
Possible Causes of IBS?
The exact cause of IBS is not known yet. Several factors and triggers seem to play a part, including the following:
- Food: A lot of people attribute IBS to recent food intake, food intolerance, or allergy. The connection between IBS and food intolerance or allergy is not fully understood in the medical field. The latter rarely causes IBS. But many patients have reported that they experienced worse IBS symptoms whenever they eat or drink certain foods or beverages.
- Hormones: Women are more likely to have IBS than men, indicating that hormonal changes might be a factor. Many women experienced worse signs and symptoms of IBS during their menstrual periods.
- Muscle Spasm in the Gut: As food moves through the digestive tract, muscles that line the intestinal walls contract naturally. When these contractions last longer and become stronger than normal, it can cause bloating and diarrhea. On the contrary, when these contractions are weak, it can cause a slow food passage that leads to hard and dry stool.
- Intestinal Inflammation: The human body has a way of healing itself. Humans are built with immune system cells that defend the body against diseases, attack bacteria and toxins, and repair damaged cells. Some people experiencing IBS have an increased number of these cells in the intestines. This is the body’s natural response when something is wrong within.
- Severe Infection: IBS can be associated with bacterial overgrowth or a surplus of bacteria in the intestines. It can develop after severe gastroenteritis. Gastroenteritis is an infection and inflammation of the digestive system caused by a virus, bacteria, parasite, or particular chemicals and drugs.
- Human Gut Microbiome: The microbiome is comprised of bacteria, fungi, and virus that live inside the human body. The gut microbiome plays a key role in digestion and a person’s overall health. Several studies connected changes or dysfunction in the gut microbiome to IBS.
- Nervous System: The human body is partially composed of nerves that transmit signals to its parts. Poor transmission and coordination of signals between the brain and the intestines can cause the body to react wrongly such as sending signals to have stronger contractions or weaker contractions. These lead to abdominal pain, diarrhea, or constipation.
In addition to these factors and triggers, IBS is associated with:
- Stress: Most people experience worse signs and symptoms of IBS in moments of heightened stress.
- Mood Disorder: IBS induces feelings of frustration and may sometimes cause anxiety to those who experience it. And like a cycle, anxiety, and depression aggravate IBS symptoms.
Although not common, IBS can cause intestinal damage. However, IBS does not increase the chances of being diagnosed with gastrointestinal cancer.
Symptoms of IBS
IBS symptoms may be experienced at the same time or alternately. The following are the common symptoms of IBS:
- Pain and cramping: It usually rests in the lower abdomen. The pain and cramping usually ease after defecating.
- Diarrhea: This is one of the most commonly experienced symptoms. An average person defecates once or twice a day. If one has diarrhea, trips to the toilet become as frequent as three or more times per day. Diarrhea is also indicated by loose, watery stool.
- Constipation: Aside from diarrhea, constipation is also one of the most experienced symptoms of IBS. If a person is constipated, bowel movement is less frequent, with as few as less than three times per week. It also causes a feeling of incomplete bowel movement because stools become difficult to pass. This leads to unnecessary straining and pain.
- Abdominal Bloating. Bloating is the discomfort, and sometimes pain, of a “stuffed” feeling. Changes in the digestive process due to IBS lead to more gas accumulated in the gut.
The symptoms of IBS experienced vary from person to person. Blood in the stool may also be experienced.
This indicates a range of harmless to a potentially serious medical condition. If you are experiencing these symptoms, it’s best to consult a gastroenterologist in Cape Town for a timely and proper diagnosis.
Home Remedies for IBS
Lifestyle and diet changes can reduce the signs and symptoms of IBS. These include:
- getting more exercise
- drinking more water
- eating a more fiber-rich diet
- taking probiotics
- limiting the intake of laxatives
Other home remedies include bowel relaxants like peppermint oil and chamomile.
Although home remedies can alleviate IBS symptoms, they can only do so much.
When experiencing signs and symptoms of IBS, it is still best to find a gastroenterologist in Cape Town and schedule an appointment to diagnose your condition.
There are currently no tests that can directly diagnose IBS. Rather, IBS is diagnosed when all other possible causes of symptoms are eliminated.
Your doctor is likely to start with getting a complete medical history and physical tests to rule out other conditions.
These tests can be done by a gastroenterologist, a specialist trained in diagnosing treating disorders of the stomach and intestines.
To rule out other conditions, gastroenterologists conduct a series of tests including the following imaging tests:
- Flexible Sigmoidoscopy to examine the lower part of the colon.
- Colonoscopy for the whole length of the colon.
- X-Ray or CT Scan for the abdomen and pelvis.
Laboratory tests may include:
- Lactose Intolerance Tests to know if your body cannot digest the sugar contained in dairy products.
- Breath Test for bacterial overgrowth in the gut.
- Upper Endoscopy to inspect the upper digestive tract (mouth, oesophagus, stomach, and duodenum).
- Stool Test to examine for the presence of bacteria, parasites, or bile acid (produced in the liver).
Once all other conditions are ruled out, your doctor is likely to use one of these criteria for IBS diagnosis:
- Manning Criteria. It is the first global IBS diagnostic criteria to be introduced in 1978. The manning criteria looked at abdominal pain, bowel-movement related pain, and its frequencies.
- Rome Criteria. There have been iterations in the Rome criteria for years. Its latest version is the Rome IV criteria which look into all symptoms and the organs related to the digestive system. This is the widely used criterion in IBS diagnosis.
- Type of IBS. For IBS treatment purposes, the three types of IBS based on symptoms are constipation-predominant, diarrhea-predominant, or mixed.
The most difficult part of having IBS is the fact that there is no known cure for it. Treatments can only be done to relieve the pain and symptoms.
The U.S. Food and Drug Administration (FDA) approved several medications to treat IBS. The drugs used for specific IBS symptoms are Alosetron hydrochloride, Eluxadoline, Lubiprostone, or Rifaximin.
Symptom-specific medications are also prescribed. These include:
- Bile acid sequestrants
- Fiber supplements
Many of the medications mentioned above are intended to be taken when IBS symptoms worsen and should not be taken frequently or daily unless prescribed.
Consult your doctor especially if you are taking other medications or treatment for another disease.
Some medications should not be taken simultaneously because it will have negative effects on the body.
Because IBS symptoms are different to each person, individualized treatment is preferred over general recommendations or self-medication.
Diagnosing and treating IBS considers the nature and the severity of the symptoms before prescribing medications.
IBS is a condition that causes great discomfort and, when left unchecked, may disrupt your daily routine.
It can also cause anxiety because the bowel movement may become incontrollable and the pain may attack anytime.
And because of the stress, hormonal imbalance, and mood disorders, IBS symptoms worsen. There is no cure for IBS, but it can be managed and treated.
At the onset, only you can gauge the mildness or severity of your IBS symptoms. You may prefer to do home remedies at first to alleviate the pain and discomfort.
But whichever you prefer, you can always talk to a gastroenterologist who is an expert in this field.
DISCLAIMER: PLEASE READ CAREFULLY
The information on this website is to provide general guidance. In no way does any of the information provided reflect definitive medical advice and self-diagnoses should not be made based on information obtained online. It is important to consult a Gastroenterologist or medical doctor regarding ANY and ALL symptoms or signs including, but not limited to: abdominal pain, haemorrhoids or anal / rectal bleeding as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today and schedule a consultation.
© Dr. Eduan Deetlefs, Registered Gastroenterologist, GI Doc Cape Town
Our website information is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a doctor about your specific condition. Only a trained physician can determine an accurate diagnosis and proper treatment.