What is IBS?
Irritable Bowel Syndrome, also known as IBS, is a chronic functional gastrointestinal disorder that has made an influence on 10-20% of people worldwide. This disorder presents itself with abdominal pain that comes from bowel movement, followed by irregular stool form and/or frequency. This disease often gets confused with IBD because it is subjected to many of the same, or similar, symptoms. IBD stands for inflammatory bowel disease which causes inflammation to the gastrointestinal tract. There are two types of IBD: Crohn’s Disease and Ulcerative Colitis. Crohn’s Disease can cause inflammation in any part of the GI tract ranging from the mouth all the way to the anus, while Ulcerative Colitis only affects the colon and/or rectum.
Irritable Bowel Syndrome is diagnosed by the process of elimination of other diseases that contain many of the same key symptoms such as unexplained abdominal discomfort, changes in bowel defecation, as well as gas, bloating, diarrhea, and constipation. Another symptom that is common for IBS patients is psychological stress. This can be due to the high healthcare costs and the extensive testing that takes place for many IBS patients. The high healthcare cost goes hand in hand with the extensive testing because physicians want to make sure that it is IBS and not some other underlying illness or disease. It is also common for people diagnosed with IBS to have increased levels of stress, anxiety, and depression due to not knowing how to manage their IBS.
What are the types of IBS?
This disorder has subcategories related to the type of stool form you present with:
This type of IBS is predominant with diarrhea and its symptoms include at least three or more bowel movements/day, urgency, and loose watery stools.
This type of IBS is predominant with constipation and its symptoms include less than three bowel movements per week, hard, lumpy stools, and a sense of tension during bowel movements.
This type of IBS is a mix of constipation and diarrhea, and its symptoms include a mix of hard and soft stools over a period of hours to days.
This type of IBS is unclassified, and its symptoms include insufficient abnormality to meet other known types of IBS.
How are you tested/diagnosed with IBS?
IBS has traditionally been diagnosed by the process of eliminating other illnesses. Initial testing should start by examining full blood counts, urea and electrolytes, C-reactive protein, and liver function, which are all minor screenings or exams. When seeking diagnosis for IBS it is important to check for certain red flags as they may require you get further testing or see a specialist. These red flags consist of being 50 years or older and having no previous colon cancer and a recent change in bowel habits, gastrointestinal bleeding or pain in stools, unintentional weight loss, family history of colon cancer or IBS, evidence of iron deficiency anemia, or positive test for fecal occult blood. The price for these tests can really add up as you might have to go through all of them to eliminate other possible conditions. Thankfully, a recent study just came out proposing a promising new tool for diagnosing IBS patients. This new tool is a nutrient drink test (NDT) that provokes GI symptoms that allows for a clear differentiation from someone who has a normal GI tract. To this day, IBS proves to be difficult to identify and diagnose.
What Causes IBS?
Is IBS Genetic?
Many doctors believe that there is a genetic link for IBS, but not enough formal research has been conducted on the subject. A study in 2018 found that new variants in DNA are associated with the diagnosis of IBS in women, but do not have the same correlation in men. This specific chromosome also influences first menstruation cycles among women. It was also found that Women with IBS are much more likely to show symptoms of harder stool and constipation. However, further research needs to be done to advance the investigation in these findings.
Increase Likelihood of Stress and Anxiety?
When being diagnosed with IBS, the likelihood of stress and anxiety can increase. On the other hand, if you present with anxiety and depression, you are more likely to be screened for GI issues. This is often the case because many people do not know how to manage their IBS symptoms. Your stress and anxiety levels are also dependent on the severity of your IBS symptoms. These symptoms can be decreased if you continue to educate yourself on this disorder by referring to a dietitian to identify possible trigger foods.
Increase Eating Disorder/Disordered Eating?
It has been found that disordered eating behaviors are increased in IBS patients compared to non-IBS patients. When patients are diagnosed with IBS, they often respond by giving themselves their own dietary restrictions. Patients may skip meals to avoid and prevent stomach pains, bloating, diarrhea, and other discomforts that patients may experience with untreated IBS.
How is IBS Treated?
Can an IBS nutritionist help?
IBS can be treated in a variety of different ways, ranging from dieting to medication. However, the main source of treatment that is recommended for IBS patients is the low FODMAP diet, as administered by an IBS nutritionist. Another eating style that has been found to be helpful is a gluten-free diet. This has been proven to be beneficial for IBS patients because it cuts out the fructan intake that is found in gluten products (7).
What types of medication can help?
There are various medications that seem to relieve the pain that occurs with the diagnosis of IBS. The five main medications that have be found to be helpful in treating IBS patients are Alosetron (Lotronex), Eluxadoline (Viberzi), Rifaximin (Xifaxan), Rifaximin (Xifaxan), and Linaclotide (Linzess). All of these prescriptions are designed to either help to increase or decrease the movement of byproducts. It has been stated that many of these medications should only be prescribed if all other options have failed and should only be used for women with IBS.
If you are concerned that you might have irritable bowel syndrome, call your primary care doctor to determine the next individualized steps for you today. Since IBS and nutrition go hand in hand, an IBS nutritionist can help you plan out a low FODMAP or gluten-free diet as a means of treatment.
If you have any more questions or concerns regarding IBS, talk to a Health Loft IBS nutritionist in Chicago, IL (virtually via our telehealth platform or in person) by calling us at (312) 374-5399 or by scheduling an appointment online. For more tips and fun facts to also check out our Facebook, Instagram, and Twitter pages for more articles on nutrition, physical therapy, and exercise!
Written By Frankie Severyns Edited By Alexander Franz Reviewed by Morgan Murdock, RD.
- Banerjee, A., Sarkhel, S., Sarkar, R., & Dhali, G. K. (2017). Anxiety and Depression in Irritable Bowel Syndrome. Indian Journal of Psychological Medicine, 39(6), 741-745. doi:10.4103/ijpsym.ijpsym_46_17
- Basnayake, C. (2018, October). Treatment of irritable bowel syndrome. Retrieved September 01, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6202292/
- Bonfiglio, F., Zheng, T., Garcia-Etxebarria, K., Hadizadeh, F., Bujanda, L., Bresso, F., . . . D’Amato, M. (2018). Female-Specific Association Between Variants on Chromosome 9 and Self-Reported Diagnosis of Irritable Bowel Syndrome. Gastroenterology, 155(1), 168-179. doi:10.1053/j.gastro.2018.03.064
- Drossman, D. A. (2016). Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features, and Rome IV. Gastroenterology, 150(6). doi:10.1053/j.gastro.2016.02.032
- Estremera-Arevalo, F., Barcelo, M., Serrano, B., & Rey, E. (2019). Nutrient drink test: A promising new tool for irritable bowel syndrome diagnosis. World Journal of Gastroenterology, 25(7), 837-847. doi:10.3748/wjg.v25.i7.837
- Harer, K. (2019, May). Irritable Bowel Syndrome, Disordered Eating, and Eating Disorders. Retrieved September 10, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6589841/
- Irritable bowel syndrome. (2018, March 17). Retrieved September 10, 2020, from https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/diagnosis-treatment/drc-20360064
- Judge, E. (2020, May 27). The Difference Between IBS and IBD. Retrieved September 01, 2020, from https://www.judgenutrition.com/blog/ibs-and-ibd
- Patcharatrakul, T., Juntrapirat, A., Lakananurak, N., & Gonlachanvit, S. (2019). Effect of Structural Individual Low-FODMAP Dietary Advice vs. Brief Advice on a Commonly Recommended Diet on IBS Symptoms and Intestinal Gas Production. Nutrients, 11(12), 2856. doi:10.3390/nu11122856