Understanding Irritable Bowel Syndrome (IBS): Symptoms, Causes, and Effective Management

They say to always follow your gut, but what do you do when your gut is not feeling especially confident? How often do you feel like your gut is under the weather? Most of us are constantly battling some digestive issue or another. One day it’s acidity, and the other day it’s bloating. These seemingly insignificant events may very likely signal the development of IBS, or Irritable Bowel Syndrome. IBS is so common in both adults and children that many individuals choose to ignore it by using short-term home remedies. However, IBS is a serious disorder that requires attention as soon as possible.

This post will help you understand what IBS is, what its symptoms are, how you can keep your gut safe, and a lot more. We’re discussing all things IBS and gut health, stay with us till the end.

What is IBS and What It’s Not

Unlike other diseases that come and go, only to never show their face again, IBS stays with you lifelong. At times it gets worse, and at times you feel like you’ve gotten rid of it, but it’s always there. This is probably why most people don’t think of it as a serious issue. Don’t be too disheartened, you can manage IBS effectively with the right methods. We’ll come to that eventually, but for now, let’s understand more about this gut-wrenching disorder.

The moment you begin to chew food, your body begins to digest it. Food passes through the food pipe (esophagus), stomach, and intestines before the waste is eliminated from the body. This whole digestive passage from the mouth to your anus is your gastrointestinal tract or gut.

In order to gradually advance the food through the GI tract, the muscles contract and relax periodically. This rhythmic contraction and relaxation of muscles is called peristaltic movement. The large and small intestines' peristaltic movements are occasionally interrupted, which results in Irritable Bowel Syndrome over time. Constipation results from sluggish bowel muscle contractions, while dysentery results from rapid bowel muscle contractions.

Alright, that’s IBS for you. Now there are 3 types of IBS

• IBS-C ( Irritable Bowel Syndrome with Constipation)

As stated above if the peristaltic movement becomes too slow, it leads to discomfort in the abdominal area and is accompanied by constipation.

• IBS-D ( Irritable Bowel Syndrome with Diarrhea )

Faster contraction and relaxation of bowel muscles can lead to loose bowel movements or very frequent bowel movements.

• IBS-M (Irritable Bowel Syndrome with Mixed Bowel Movement )

You guessed it right! When you are hanging somewhere between IBS-C and IBS-D, you have mixed-type IBS. You experience all the symptoms of IBS, but your bowel movements can vary.

Prevalence of IBS

IBS can happen to anybody, from children to seniors, at any point in their lives. Studies have proven that IBS is more prevalent in individuals under the age of 50. In a study, almost half of the sample size reported having symptoms of IBS before the age of 35.

If you are wondering why IBS is so prevalent, there could be a number of potential reasons, but stress, an unhealthy lifestyle, and the quality of food take the cake.

IBS is usually a result of certain bacterial infections or stress. Considering how stressful everybody’s life has become, it is no surprise that a huge number of the population is either diagnosed with IBS or is suffering from its symptoms.

Is it more common in women than men?

Women tend to experience more severe symptoms than men due to several factors, but largely hormones since they control the peristaltic movement.

It is observed that the prevalence of IBS-C is higher in women than in men. So is the prevalence of IBS-D in men. Hormones play a vital role here.

Women have higher levels of estrogen and progesterone than men. These hormones are known to restrict smooth muscle contraction. Smooth muscles are present in the intestine and stomach lining; they help move food forward. Inhibiting their contraction slows down bowel movements, thus causing constipation. Hence, IBS-C is more common among females.

Women with IBS are also more likely to report severe abdominal pain than men. This is because of the difference in testosterone levels between the sexes. Men have higher levels of testosterone, which is known to work as a painkiller, thus reducing any pain-related IBS symptoms.

It is also reported that regardless of the menstrual phase, the symptoms of IBS are more frequently observed in women.

What causes IBS?

Although most of the symptoms of IBS are observed in the GI tract, it is a disease that is caused by psychological & physiological changes. It could be caused by stress, food, infections, or a variety of other reasons. These symptoms also include an imbalance in the gut microbiota. Let’s understand some of the main causes of IBS in detail.

• Stress and Depression

Did you know that your gut is called the second brain? It is because of the ENS system that is spread out on the lining of your GI tract. Enteric Nervous System consists of more than 100 million nerve cells that carry messages to trigger actions related to digestion.

ENS is a partially independent component of the nervous system that regulates immunological and endocrine activity as well as gut mobility and local blood flow. Since it can work independently without any cues from the brain, it is called the second brain.

Your brain and gut communicate in a two-way mode using chemical messengers. Not only does the brain send signals to the gut, but it goes the other way around too. Your second brain (ENS) also sends signals to your brain when things aren’t going too well in the GI tract.

Have you ever felt empty in your stomach when you're under too much stress? It's the simplest way to describe how activities in your brain can affect how your digestive system functions. Additionally, a problematic gut might cause the brain to transmit signals that cause you to feel particular emotions without any practical justification.

Long story short, your emotions can most certainly affect your gut health. Studies on humans, as well as animals, have shown that persistent or chronic stress is linked to the emergence and worsening of IBS symptoms. It is also reported that patients with IBS, in particular, have altered gastrointestinal processes brought on by stress. Being under stress for too long can also disrupt (dysbiosis) the balance of your gut microbiome composition.

• Dysbiosis

To maintain gut health, you need to maintain balance in the composition of the gut microbiota. Gut microbiota refers to the colony of bacteria, viruses, and fungi that reside in your GI tract. These bacterial colonies carry out important functions like digestion and immune response. It is estimated that your gut contains 10 times more bacterial cells than the number of cells in your body.

A healthy microbiota is a clear sign of a healthy gut. To keep these friendly bacteria happy, you need to maintain their composition. Disruption in this balanced composition leads to what we call dysbiosis.

For example, stressful signals from the brain can lead to the shedding of lactobacilli and bifidobacteria, which ruins the balance and thus causes digestive issues.

Smaller imbalances are readily controlled, but when the balance is drastically shaken, it can result in major complications and gut health problems like IBS. Studies have shown that imbalances in the intestinal microbiota are commonly observed in IBS patients.

• Post-infectious IBS

A previous episode of infection in the gut also increases your chance of developing IBS by six times. Gastroenteritis, or food poisoning, is a common infection that is caused by the consumption of contaminated food. Gastroenteritis can also be caused by viruses such as norovirus, bacteria like the Campylobacter bacterium, parasites like cryptosporidium, chemicals like lead, and certain antibiotic medications.

• Genetics

Has a doctor ever asked you if this problem of digestion runs in your family? Well, a lot of health diseases have a genetic component to blame, and so does IBS. Your inherited genes may not directly cause IBS but may lead to other major causes like stress, anxiety, food intolerance, and imbalanced gut microbiota.

• Food Intolerance or Food Hypersensitivity

Ever wondered how food allergies are developed? When your body comes in contact with an allergen, the immune system is triggered to form an antibody called immunoglobulin E, a.k.a. IgE. The first few instances of indulging in the food item you are allergic to may not lead to any allergic reactions, but your immune system remembers this allergen. After continuous exposure to the allergen, the immune system might trigger an allergic reaction as part of its immune response. This is how your allergies are formed. Some common allergies that you might have come across are lactose intolerance, gluten intolerance, and fructose intolerance. Besides these common food intolerances, people are allergic to a variety of food items. It has been observed that food hypersensitivity is an underlying cause of IBS in a considerable number of patients. IgE-mediated food allergic reactions release histamines, leukotrienes, and other hormones that are known to affect the GI tract.

• Certain Medications

Your gut has a huge colony of friendly bacteria that help you digest food and fight bad bacteria. The gut immune system is smart enough to differentiate between the bad and the good bacteria entering the gut. This is what allows good gut bacteria to stay in your gut. But certain antibiotics can disrupt this balance. While wiping off the bad bacteria, the medications might also shed the good ones, thus causing an imbalance in the gut microbiota, a.k.a. dysbiosis. And now we already know that dysbiosis can most certainly cause IBS.

• Nutrient Deficiencies in IBS

Certain nutrient deficiencies can also contribute significantly to IBS. Studies have shown that IBS patients are more deficient in micronutrients like vitamin B1, B2, calcium, iron, and zinc compared to healthy individuals.

Other Bowel Conditions that Overlap with IBS

There are some other bowel conditions that share common symptoms with IBS. Hence, there is a chance that someone who has IBS might also have heartburn. Such diseases that happen at the same time are called overlapping diseases.

• Dyspepsia

This is a condition in which the patient experiences pain right below the rib cage. Some symptoms include pain in the upper abdomen, bloating, and a burning sensation.

• Celiac Disease

Celiac disease is an autoimmune disorder. It happens when you indulge in food containing gluten and your body identifies it as a foreign particle. The immune system immediately takes action to keep your body safe, but while doing so, it ends up damaging your intestinal lining, causing diarrhea, constipation, bloating, and abdominal pain.

• Heart Burn

When the fluids in your stomach travel back into the esophagus it causes discomfort, which we usually call "heartburn". It is a symptom of GERD (gastroesophageal reflux disease). Occasional occurrences of stomach fluid flowing backward are normal. A burp once in a while is fine, but when these burps become too frequent and also happen at night, the discomfort increases, and the condition is referred to as heartburn.

• IBD - Crohn’s Disease & Ulcerative Colitis

At times, patients with IBS also have IBD (Inflammatory Bowel Disease). IBD is characterized by inflammation in the bowels. There are two common examples of IBD - Crohn’s disease ( causes damage anywhere on the GI tract) and Ulcerative Colitis ( causes damage to the lining of the colon).

How to Tackle IBS?

So how do we cure IBS? Sadly, there’s no cure, but we can always keep the symptoms under control and coexist with IBS peacefully. It’s not that difficult. Let’s see how you can effectively manage IBS symptoms to prevent discomfort.

• Manage Your Stress

Irritable bowel syndrome starts with an irritable brain. We already saw how stress can lead to an unhealthy gut and eventually cause serious conditions like IBS. So let’s first start with managing stress. Given the competitive world we live in, it is understandable that you are awfully stressed, but you can work on yourself and live a stress-free lifestyle.

Stress management techniques can be different for different individuals but here are some effective stress management tips to try.

• Take a break from the world. Just stop scrolling through your social media accounts and stop reading and watching all the disturbing news. Use this time to travel somewhere you like or do anything that makes you happy. Social detox for a couple of days is great.
• Exercise every day! It might sound like too much work, but it's a great way to help your brain and body stay healthy.
• Eat what you love but mindfully. Try to include an array of veggies and fruits every day to ensure your body gets all the nutrients it needs.
• Speak up! If there’s something that is disturbing you, try sharing it with a friend, or family or the best option is a therapist.
• Avoid drugs, alcohol, and cigarettes. Indulging in these substances might sound like a straightforward way to cope with stress, but it is actually not. It can create additional health issues to add to your stress.

• Find What’s Not Working

Food allergies contribute considerably to your gut issues. If your body is not ready to accept certain food items, the ideal thing to do would be to avoid it. You can use a planner to track your gut health. Analyze what makes your gut happy and upset. Once you know what you’re allergic to try avoiding those things concisely.

• Avoid FODMAPs

A study found that a low FODMAP diet helped over 76% of IBS patients improve their symptoms and get relief from discomfort. But what are FODMAPs?

FODMAP- Fermentable Oligosaccharides, Disaccharides, Monosaccharides & Polyols

It is found that our small intestine finds it difficult to digest and absorb these carbohydrates; hence, it is used as an alternative therapy for most IBS patients. FODMAPs increase the amount of fluid in the bowel, thus resulting in gas, bloating, pain, and diarrhea.

Avoiding these food items can help you considerably improve your IBS symptoms.

• Increase Probiotic and Prebiotic Consumption

Now that we have seen what food items we should avoid, let’s take a look at some food items that you should consume to improve gut health. As stated above, an imbalance in the gut microbiota can cause a lot of trouble for you. There are two things you can do to maintain a healthy gut microbiota composition: a) ensure enough diversity of bacteria, and b) nourish the existing bacteria.

Probiotics are present in food items like curd, ACV, etc. that contain good gut bacteria. This ensures there’s enough diversity and balance in the bacterial colony. Prebiotics are fibers that help you nourish the existing gut bacteria, thus ensuring a healthy gut microbiota. You get prebiotics from food items like bananas, apples, oats, chicory roots, and flaxseeds.

Probiotics, prebiotics, and a good portion of veggies are the ultimate happy gut combo you need.

• Invest in Gut Health Supplements

If you want to ensure that you have a good dose of probiotics and prebiotics every day without fail, you can rely on supplements. Supplements are fairly easy to have and provide you with an appropriate amount of probiotics and prebiotics that you need for a healthy gut.

We also saw some nutrient deficiencies that were common among the IBS patients: vitamin B, calcium, zinc, and iron. Figure out if you lack any of these nutrients and use supplements to get the right dosage of them.

Wrapping Up

IBS might look like a harmless disease, but it is actually quite scary. It makes daily life fairly difficult. In this post, we covered everything there is to know about IBS, including the ways to tackle it. IBS will stay with you for a long time, but you can certainly enjoy your life by mindfully managing its symptoms.

References

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/gastroenteritis#causes-of-gastroenteritis

https://www.health.harvard.edu/diseases-and-conditions/a-new-diet-to-manage-irritable-bowel-syndrome

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175559/#:~:text=Women%20with%20IBS%20experience%20constipation,slower%20GI%20transit%20than%20men.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039952/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4202343/#:~:text=Stress%2Dinduced%20alterations%20in%20neuro,stress%20and%20stress%2Dinduced%20responses.

https://www.health.harvard.edu/diseases-and-conditions/a-new-diet-to-manage-irritable-bowel-syndrome

https://www.asge.org/home/for-patients/patient-information/understanding-irritable-bowel-syndrome-with-diarrhea-also-known-as-ibs-d

https://www.asge.org/home/for-patients/patient-information/understanding-irritable-bowel-syndrome-with-constipation-ibs-c