Irritable Bowel Syndrome, referred to as IBS, predominantly affects the large intestine (colon) in up to 1 in 4 people. IBS is a long-term (chronic) condition and those who suffer need to manage its effects for a life-time.
IBS is one of the most common disorders seen by physicians and many patients are both surprised and relieved that they are not alone in suffering from IBS, it is a very common digestive disorder.
It’s symptoms are brought on by changes in how our GI tract or intestines work. The term functional is used because these changes in our GI tract do not show up in typical diagnostic tests – there is “nothing to see” if tests are run to look for infection or if an endoscope is used to examine the colon (colonoscopy). It can be frustrating for patients as – given their symptoms – they are concerned something serious is being missed.
Symptoms Associated with IBS:
- Abdominal pain
- Bloating, gas
- Diarrhea and/or constipation – often varying back and forth between the two extremes.
Nevertheless, while IBS can bring on feelings of extreme discomfort and pain for sufferers, let me reassure the reader it is unlikely to lead to other health problems or damage your intestines.
According to research organizations there are between 2.4 million and 3.5 million physician visits a year for IBS and the disorder accounts for up to 12% of total visits to primary care providers in the U.S. Clearly, it is a major affliction with real societal costs. The economic impact of IBS is considerable, with direct medical expenses and losses of productivity and work absenteeism accounting for an estimated $21 billion a year.
- IBS is not gender specific, however it is a major issue in women’s health with approximately 60% to 65% who report IBS in the community being female. In addition, the data on IBS suggests that those suffering are at higher risk of being given inappropriate surgeries such as an appendectomy or hysterectomy.
- IBS is not age-specific, it can affect people of all ages, but it is more likely to affect people from their teens to the early 40’s. Perhaps this is because after many years of symptoms, trial end error has led the IBS sufferer to avoid “triggers” that they’ve been able to identify as worsening the problem. We now have a much better understanding of the science behind these “triggers”.
Common IBS triggers can include:
- Foods and drinks that dehydrate the body
- Fatty foods can trigger diarrhea; specific food triggers of diarrhea and other IBS symptoms may vary between individuals
- Stress and anxiety
- Drugs like antibiotics, antidepressants and /or medicines that contain sorbitol
- Lack of exercise
- Eating while under stress
- Very hot or cold foods
Despite being a common disorder, the direct cause of IBS is not yet known. In about 10% of cases, IBS appears to arise after a gastrointestinal infection – even after it clears the person is left with IBS symptoms that may be life-long.
GI researchers, however, believe there are possibly multiple causes of IBS, including but not limited to:
- Food sensitivity
- Brain-gut signals such as anxiety or stress, body chemicals – neurotransmitters and reproductive hormones
- Genetic (family) history
- Medications being taken and bacterial overgrowth in the intestine.
Often patients with IBS report that foods they consume that are rich in carbohydrates, fatty foods, high-fiber foods, dairy products, coffee and/or carbonated beverages will “trigger” their symptoms. All of these are very common in the Western diet so it can be hard to pull out the cause. Recent research informs us that certain sugars (carbohydrates) in our food are poorly absorbed by the small intestines.
These carbohydrates pass through the small intestine, unabsorbed, both holding and drawing fluid into the bowel. However the bacteria living in the colon can use these sugars. In doing so, they lead to fermentation, converting the sugars to acids and gas as a by-product. This coupled with additional sensitivity in the colon of those with IBS leads to real symptoms. This conversion to acids and gas in the colon results in the gassiness, bloating, cramping and variable bowel habit that we experience if we have IBS.
This blog will focus on why some of us have this sensitivity to certain foods, both naturally occurring and processed, and what we can do to remedy the symptoms of our IBS through a better understanding of how to better manage our nutrition, putting our digestive systems on the path of health and wellness.
Remember, you are what you eat.
Warmly, Dr. Viv