Irritable Bowel Syndrome Treatment
Irritable bowel syndrome (IBS) is a group of symptoms that can affect quality of life. It is a very common disorder; The American College of Gastroenterology (ACG) estimates that 10 to 15 percent of Americans have IBS. The ACG has also estimated that women are twice more likely than men to develop the condition.
IBS is often confused with inflammatory bowel disease (IBD). Even though the two share some similar symptoms, they are quite different. IBS is a functional GI disorder, while IBD is a gastrointestinal disease. IBD is more serious and carries a higher risk of developing colon cancer. While IBS can cause discomfort and pain, it does not increase your risk of colon cancer, nor is it a serious disease. It can often be controlled with diet and lifestyle changes. However, those with IBS should seek irritable bowel syndrome treatment to manage symptoms.
What Is Irritable Bowel Syndrome?
Irritable bowel syndrome is a functional GI disorder, rather than a gastrointestinal disease. IBS itself refers to a group of symptoms that affect the digestive tract, often resulting in abdominal pain, bloating, or cramping. However, some people with IBS have no symptoms at all.
A functional GI disorder is also known as a disorder of the gut-brain interaction. If your gut and your brain aren’t sending signals to one another correctly, it can result in sensitivity of the GI tract. This also affects how your bowel muscles contract. IBS affects everyone differently, and three types of IBS may require irritable bowel syndrome treatment.
The different types of irritable bowel syndrome are:
- IBS with diarrhea (IBS-D). If you have this type of IBS, your bowel movements will be loose and watery the majority of the time.
- IBS with constipation (IBS-C). Stools can be difficult to pass, and they are hard and lumpy.
- IBS with mixed bowel habits (IBS-M). This type of IBS is a combination of constipation and diarrhea. One day you may have loose, watery stools, and the same or following day you may have constipation.
What Are the Symptoms of IBS?
While some patients have no symptoms of IBS, others can be very noticeable and can be present for a long time. The most common signs and symptoms of IBS include:
- Abdominal pain and bloating
- Abdominal cramping related to a bowel movement
- Increased amount of gas (flatulence)
- Mucus in the stool
- Diarrhea, constipation, or both at the same time
- Changes in bowel habits, such as:
- Change in appearance of stool
- Changes in frequency of bowel movements
Women may notice an IBS flare-up immediately before or during menstruation. It can occur during every menstrual cycle, which can cause discomfort and stress. However, with diet and lifestyle changes, you can treat IBS successfully.
What Are the Causes of Irritable Bowel Syndrome?
Doctors and researchers do not know the exact cause of irritable bowel syndrome. However, there are some factors associated with the development of IBS. These include:
- Signals between the gut and brain. There can be abnormalities in the nerves of the digestive tract that can cause poor signaling. This can result in constipation, diarrhea, and abdominal pain.
- Intestinal muscle contractions. The muscles in the intestines always contract as food moves through the digestive tract. However, in a patient with IBS, strong, sharp contractions can cause bloating, gas, and diarrhea. Weak signals result in hard, dry stool and constipation.
- Changes in the gut microbiome. Changes in gut microbes, such as viruses, fungi, and bacteria, can lead to IBS symptoms.
- Infection. IBS can develop after gastroenteritis (stomach flu) or by bacterial or viral infections. IBS is also associated with bacterial overgrowth.
- Childhood stress or trauma. Those with traumatic events early in life seem to be more predisposed to IBS.
The symptoms of IBS can also be triggered by certain things, particularly food. The connection between certain foods and IBS isn’t known, but certain foods or beverages can cause symptoms. For example, those with lactose intolerance may experience irritable bowel syndrome and need irritable bowel syndrome treatment. Even those without lactose intolerance can experience a flare-up from milk or dairy products. Other foods and beverages that can trigger IBS include:
- Carbonated beverages
- Citrus fruits and their juices
- Products containing wheat
Stress can also aggravate symptoms. Stress doesn’t directly cause symptoms of IBS, however, those with high stress in their lives may have more severe symptoms.
When Should I Call a Doctor for IBS?
While irritable bowel syndrome is more of a quality of life issue for patients, you should still consult a doctor if you are having gastrointestinal symptoms. Sometimes irritable bowel syndrome treatment needs more intervention than just diet and lifestyle changes. Another reason to consult a gastroenterologist is the fact that IBS shares symptoms with more serious gastrointestinal diseases, and your physician may want to rule those out. More serious signs and symptoms of IBS that warrant an emergency or doctor visit include:
- Dysphagia (difficulty swallowing)
- Rectal bleeding or blood in the stool
- Iron-deficiency anemia
- Nocturnal diarrhea
- Unintended weight loss
- Unexplained vomiting
- Pain that isn’t relieved by a bowel movement or passing gas
Many of these symptoms also present in inflammatory bowel disease, so it’s wise to get a workup just to be sure of your diagnosis.
Your gastroenterologist may diagnose IBS in one or more ways so you can receive proper irritable bowel syndrome treatment. First, your physician will perform a physical exam and ask about your medical history. They will ask many questions about your bowel habits, such as when a change in bowel habits began and how often you have symptoms.
IBS is typically diagnosed via blood or stool tests. Also, X-rays can help rule out other gastrointestinal diseases. In more severe cases, or if your gastroenterologist suspects a different condition, they may perform a colonoscopy or sigmoidoscopy.
For colonoscopy, you will prep the night before to empty your intestines. The next day, you are put under light sedation, and a long, flexible tube is inserted through the anus and rectum to examine the intestines. A tiny camera is attached to the end that offers photos of the colon. Your physician may also take a biopsy (tissue sample) during the procedure.
Flexible sigmoidoscopy is very similar—the prep is the same, and you will also be under light anesthesia. However, a sigmoidoscopy only looks at the sigmoid colon (lower part), rectum, and anus. Flexible sigmoidoscopy is a common recommendation for looking for polyps, causes of rectal bleeding, and diagnosing bowel disorders.
Treatment Options for Irritable Bowel Syndrome
Treatment options differ for each patient, because IBS presents differently. However, it is a long term, lifetime disease, so irritable bowel syndrome treatment is needed to keep symptoms at bay and improve quality of life. The most common treatment options include making diet and lifestyle changes. These can include:
- Adding more fiber to your diet or adding a fiber supplement
- Adapting to a low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet; foods high in these substances can trigger IBS
- Limit dairy and look for calcium in other food choices, such as salmon, broccoli, or spinach
- Drink plenty of water; at the very least, aim for 64 ounces per day
- Avoid caffeine (this includes coffee, tea, soda, and chocolate)
Other ways to avoid IBS flare-ups include:
- Getting more exercise
- Quitting smoking
- Eating smaller meals
- Make a food diary to see which foods trigger IBS
- Try alternative therapies, such as meditation or relaxation techniques
In some IBS cases, symptoms are not helped with diet and lifestyle changes, and medication is required for irritable bowel syndrome treatment. Also, according to the National Institute of Diabetes and Digestive and Kidney Diseases, IBS is often comorbid with other diseases, and these must be treated concurrently. Conditions such as fibromyalgia, digestive diseases such as gastroesophageal reflux disease (GERD), and mental health disorders such as anxiety and depression can contribute to IBS, so your physician will treat these disorders as well to help ease symptoms. However, unwanted side effects of medication may lead to alternative therapies.
Concerning medication and supplements, your doctor may prescribe or suggest probiotics, antidepressant medications such as selective serotonin uptake inhibitors (SSRIs), antidiarrheals, and medications that relieve constipation. If none of these treatments are helping, you may want to try alternative therapies. These include:
- Cognitive behavioral therapy (CBT)
These are second-line irritable bowel syndrome treatments but can help with the improvement of symptoms.