Irritable Bowel Syndrome

 

Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine. According to some estimates, up to 20% Americans have IBS. This disorder affects women more than men.

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Symptoms:

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The symptoms of IBS include: 

• cramping

• abdominal pain

• bloating and gas

• constipation

• diarrhea

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People with IBS can have episodes of both constipation and diarrhea for several months or years and can be lifelong. Symptoms such as bloating and gas typically go away after you have a bowel movement.

Symptoms of IBS aren’t always persistent. They can resolve, only to come back. However, some people do have continuous symptoms.

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Triggers:

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Several foods and psycho-emotional, social and stress related factors can trigger symptoms of IBS. This reflects the fact that gut and brain are strongly connected and imbalance or derangement in the function of one can lead to dysfunction in the other and vice a versa. 

In addition, anything which disrupts gut microbiome can trigger symptoms of IBS.

 

Treatment and Management:

 

1. Diet:

A healthy mostly plant based diet containing a lot of fiber

and devoid of processed foods is the hallmark of IBS management. 

Even if not following a whole plant based or vegan diet,

make sure to eat at least 3-6 servings  of vegetables and fruits every day. 

Some people find better symptom control when they eat smaller quantiities

at intervals as opposed to eating large meals.

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2. Identification and Management of Individualized Triggers:

IBS management is based upon modification of diet and lifestyle. It is very important to identify individualized triggers and remove or mitigate these. One person's triggers may be very different from another person but most common triggers are listed below. 

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1. Certain foods

   • Food sensitivity and allergy tests can identify individual triggers. Most common foods which affect a vast majority of population are dairy, eggs and wheat. ​

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   • Low FODMAP diet has successfully been used in some studies to alleviate symptoms of IBS. But it does not improve everyone's symptoms.

   • Elimination diet is a very useful tool to identify food triggers and adjust diet accordingly.

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2. Stress

   • Stress reduction strategies such as yoga, meditation and mindfulness have shown to improve IBS symptoms.​

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3. Lack of sleep

   • Sleep improvement and circadian rhythm management can alleviate IBS symptoms. ​

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4. Certain medications 

   • Any medication which alters gut motility (causes constipation

   • or diarrhea) can trigger IBS. ​Most common culprits are opioids,

   • antidepressants and antibiotics.

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5. Microbiome/gut flora disrupters

   • A balanced microbiome is needed for healthy gut. Several factors can cause disruption in the gut microbiome. Most common of these are ​antibiotics, intestinal infections, lack of fiber, processed foods.

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6. Menstrual periods in women

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3. Exercise:

Regular exercise has been shown to improve IBS symptoms

by regulating gut motility and alleviating overall stress. 

 

4. Fluids:

Fluid and electrolyte balance is very important not just for gut

motility and microbiome function but also for tansport of nutrients

across intestinal wall which is necessary to avoid IBS related

symptoms.

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5. Probiotics:

Though a well balanced plant based diet may not require supplemental

probiotics, these may become necessary if there is significant disruption

in the gut microbiome. A balanced gut flora or microbiome  can help alleviate symptoms of IBS.

 

6. Medications:

Certain medications can be used to manage symptoms of

pain and constipation or diarrhea. However, these medicines

do not treat the root cause and should always be combined with the other methods such as lifestyle modification and treatment of root cause. 

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