Living with IBS

Acidity, indigestion, constipation, diarrhoea are conditions all of us are familiar with and have suffered from at some time of our life or the other. Sporadic bouts of these conditions can usually be written off as a food-related temporary abnormality that can be fixed with an antacid or minor diet corrections. However, if any or all of these problems become chronic, recurring without any apparent reason, and are accompanied by mild to severe pain in the abdomen, then the culprit may be IBS or Irritable Bowel Syndrome, a condition that affects the large intestine and is usually related to our lifestyle habits.

What is IBS?

IBS is a chronic condition that affects the large intestine, causing stomach cramping, gas, bloating, diarrhoea, constipation (or both), and sometimes severe pain. It is a condition that cannot be cured but can be effectively managed with lifestyle and dietary changes and medication as and when required.

Symptoms of IBS

Most of the people with the condition do not have any symptoms, and hence, are unaware of its existence. Triggers like spicy or untimely meals, excessive stress, smoking or consumption of alcohol can cause periodic aggravation leading to pain and discomfort. In some people, however, the symptoms are more obvious and they recur at frequent intervals. Following are the common symptoms:

• Abdominal pain – mild to severe
• Cramping, bloating that is typically relieved with passing a bowel movement
• Excess gas
• Frequent urge to pass stool, but unable to do so
• Alternating bouts of constipation and diarrhoea
• Mucus in stool

The symptoms may come and go, can at times be severe, and can completely disappear in good times.

When does it need a doctor’s attention?

If you observe a persistent change in your bowel habits or the severity of the symptoms does not subside over a while, you need to see a doctor. If your discomfort is accompanied by the following conditions, then an immediate visit to the doctor is warranted:

• Weight loss
• Diarrhoea at night
• Rectal bleeding
• Anaemia (iron deficiency)
• Unexplained vomiting
• Difficulty swallowing
• Persistent pain

Causes of IBS

Though the exact cause leading to the condition is not known, some factors appear to play a role in its occurrence.

• Disruption in muscular contractions in the intestine: Food movement in the intestine is largely dependent on the contractions of muscles lining the intestine walls. Stronger contractions that last longer can cause diarrhoea and gas, and weak contractions can slow food passage and are likely to cause constipation.
• Abnormalities in the nerves in the digestive system: This leads to poor coordination of signals between brain and intestine, which in turn can cause your body to overreact to normal changes that occur during the digestive process. This, in turn, leads to more than normal discomfort when your abdomen stretches due to gas or passing of stool.
• Increased number of immune cells in the intestine: Some people have this problem and it causes inflammation in the intestines, which in turn can lead to pain and diarrhoea.
• Severe infection: Infection caused by a bacteria or virus, like gastroenteritis, can trigger IBS. Bacterial overgrowth results in aggravated symptoms.
• Changes in the bacteria in the stomach: Our stomach contains some good bacteria (microflora). They play a key role in our good health. However, research has shown that some changes occur in the microflora in people with IBS which triggers the symptoms.

What are the triggers that aggravate the condition?

Food allergy and intolerance: Though the relation between food and aggravation of the symptoms of IBS is not known, it has been found that some foods cause more discomfort in some people. The kind of food may vary from person to person. Wheat, milk and dairy products, citrus fruits, beans, cabbage, carbonated drinks are some foods that may cause adverse reactions in people with IBS.

Increased stress: Though stress is not known to cause IBS, it is a factor that can make the symptoms worse.

Hormonal changes: Studies have shown that women are more susceptible to the condition. In some women, the condition aggravates during their menstrual cycle. This suggests hormonal changes may play a role in the aggravation of the symptoms.

What are the risk factors?

• Age: The condition is more common in people below 50 years of age. Though it would be wise to remember that if you have the condition, it is not likely to go away as you grow older. Lifelong management with lifestyle modification would be required
• Gender: It is known to be more common in women, particularly if you are on oestrogen therapy
• Genetic factors: If you have a family history of the condition, then you are more at risk. There could be a genetic trigger, or a shared family environment, or both, that may cause the problem
• Mental health issues: Factors like anxiety and depression are known to trigger IBS in many individuals. People who have gone through sexual, physical or emotional abuse are more prone to the condition

IBS can cause certain health complications that, though not fatal, can seriously affect one’s quality of life as people with the condition are more likely to miss workdays. They are also likely to suffer from depression and mood disorders. Chronic constipation or diarrhoea can cause haemorrhoids.

Is there a way to prevent IBS?

Since the reason for the onset of the condition is not known, it is difficult to prevent it. However, it can be managed and the symptoms kept in check with lifestyle modifications and taking certain precautions.

Diet correction: Low-fat diet works best for most people with IBS. Avoid fried food and animal fats, focus more on lean meats, fruits, vegetables, grains and low-fat dairy products. Certain carbohydrates which include whole wheat, milk, fruits (like pears, mangoes, watermelon), and sweeteners may be difficult to digest, so regulate the quantity. Since different people with IBS react differently to certain foods, it is recommended to talk to a dietician.

Mind training or meditation: Can be helpful in keeping stress at bay. Anxiety control is essential to keep the symptoms under check, so staying focused on the positives acts as a healer.

Counselling: Since depression and mood swings are common long-term effects of the disorder, a counsellor’s help may be required to deal with the mental health issues. In some cases, a psychiatrist consultation may be required as certain medications may need to be prescribed.

Exercise: Physical activity and regular exercise can help in not just keeping you fit, but also help in relaxing your mind. Obesity is a trigger for IBS, so keeping fit with optimum body weight is of utmost importance.

Diagnosis and Treatment: The condition is usually diagnosed by the doctor based on your symptoms and family history. You may have to undergo tests like sigmoidoscopy or endoscopy, X-ray or a CT scan. The doctor may also ask you to do certain blood and stool tests to check for lactose intolerance and other indicators.

Treatment for IBS usually comprises medications, lifestyle recommendations and therapy to manage the symptoms.

Medica’s IBS clinic offers comprehensive services, including dietary and counselling options, for long-term management of the condition. To know more click here.