Causes and Risk Factors | Forms of IBS | Dietary Adjustments | Medications and Therapy | Symptom Specific Diets | IBS Comorbidity | IBS in the Long Run

Irritable Bowel Syndrome (IBS) is a chronic disorder associated with reduced gastrointestinal function, abdominal discomfort, and changes in bowel habits.

This disorder has a shockingly high prevalence of 11% worldwide. More surprisingly, Canada is well above this average at a prevalence of 18%, making it the country with the highest rate of IBS. 

Given the similarity of IBS with various other conditions such as celiac disease, there is a need to spread awareness about IBS using valid, scientific resources.

In this article, we will explore the various forms of the disorder, their distinctive symptoms, potential risks, management strategies, as well as some common misconceptions. 

Causes and Risk Factors 

The exact cause of Irritable Bowel Syndrome remains unknown, however common risk factors have been associated with increased risk. These include: 

  1. Sex – women are twice as likely to suffer
  2. Age – most common in people under 50
  3. A family history
  4. Gastrointestinal tract infections 
  5. Food poisoning 
  6. Traveler’s diarrhea 
  7. Changes in diet or medications 
  8. Use of antibiotics 

Lifestyle, food sensitivities and mental health problems have also been shown to contribute to an increased susceptibility.

Forms of IBS 

Understanding the difference between the various forms of the disorder can aid in accurate diagnosis and effective treatment plans catered to reducing patient-specific symptoms.

4 types of IBS

There are a plethora of management techniques available for relieving and managing IBS symptoms.

Dietary Adjustments 

    Dietary adjustments are a common management strategy. These focus on increasing the intake of water-soluble fiber, balancing fat intake, maintaining proper hydration, limiting alcohol and caffeine consumption, and incorporating probiotics, peppermint, and digestive enzymes in the diet.

    These adjustments place heavy emphasis on avoiding foods which worsen symptoms of IBS. 

    Low Fodmap diet

           fodmap diet

          Specific Carbohydrate Diet (SCD)

                This diet centers around eliminating sugars and grain products from the diet. This includes avoiding bread, pasta, cereal, and high lactose products such as milk.

                Cedars-Sinai Diet

                    Also known as a low fermentation diet, this diet is restrictive in nature and avoids the consumption of foods which contain fermentable carbohydrates capable of feeding bacteria. This includes fibers, fructose, and lactose.

                    Conversely, easy to digest carbohydrates such as rice, potatoes, and proteins are permissible to eat on this diet. 

                    Medications

                    Over-the-counter and prescribed 

                          Common prescription medications include Alosetron which slows the movement of water through the lower bowel and is commonly prescribed to people with severe diarrhea-predominant IBS. Other medications include Eluxadoline, Rifaximin, and Lubiprostone.

                          Click here to learn more about each medication and when they are prescribed.

                          Individuals can also choose to consult dieticians who can recommend over-the-counter laxatives and fiber supplements associated with constipation. To help with depressive symptoms, tricyclic antidepressants can also be prescribed. 

                          It is important to consult your healthcare provider before consuming any medication for IBS. 

                          Therapy 

                            Cognitive-behavioral therapy (CBT) 

                                CBT focuses on the negative thoughts, beliefs, and avoidance behaviours that contribute to emotional distress and physical symptoms associated with IBS.

                                CBT is especially effective for IBS because of the link between psychological factors such as stress and physiological factors such as pain in the gut. 

                                Key components of CBT for IBS include: 

                                • Education through understanding the nature of IBS, the impact of psychological factors on physiological factors, and how symptoms can be controlled. 
                                • Stress management through relaxation and deep breathing techniques. 
                                • Behavioural strategies such as diet modifications and regular exercise. 
                                • Gut-directed hypnotherapy

                                    With irritable bowel syndrome there is often miscommunication between the brain and gut resulting in the misfiring of signals, interpreting normal gut sensations as pain.

                                    This can be resolved through gut-directed hypnotherapy which acts on the central nervous system to reduce the sensitivity of nerves in the gut.

                                    Symptom-Specific Diets

                                    IBS symptom specific diet

                                    IBS Comorbidity 

                                    Individuals with IBS can be more prone to chronic pain conditions such as fibromyalgia, chronic fatigue syndrome, and chronic pelvic pain.

                                    Additionally, while IBS does not always lead to these conditions, it can also be associated with high occurrences of digestive diseases such as dyspepsia and mental disorders such as anxiety, depression, and somatic symptom disorder. 

                                    IBS in the Long Run 

                                    Irritable bowel syndrome is a challenging disorder to live with, however the symptoms typically do not worsen over time. This suggests that an effective treatment plan can go a long way in drastically relieving symptoms.

                                    In fact, up to one-third of IBS patients may eventually become symptom free with an effective treatment plan. 

                                    Ambiguity around causes of the disorder has led to the development of many myths, a common one being that it causes permanent damage to the bowel and development of cancer.

                                    The Canadian Digestive Health Foundation has been quick in debunking these myths, stating that “while IBS can cause pain and stress, it does not cause any permanent damage to the bowel or lead to cancer or any other major illness.” 

                                    IBS is a complex condition with a relatively large prevalence worldwide and particularly in Canada. It is important to recognize and acknowledge the various resources available and the ongoing research in the field which allows for the production of effective treatments.

                                    From CBT to medications and diet changes, individuals can take charge of their own health and enhance their quality of life by researching these treatment plans and consulting nutritionists and doctors. 

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