Understanding Irritable Bowel Syndrome (IBS): Causes, Symptoms, and Treatment Options
Irritable Bowel Syndrome (IBS) is a chronic functional digestive disorder that affects the gastrointestinal system. It is characterised by a combination of symptoms that can vary widely, often making diagnosis challenging. IBS is commonly diagnosed using the Rome IV criteria, which outlines specific symptoms and durations to confirm the condition.
Many people with IBS experience visceral hypersensitivity, meaning their gut-brain connection is heightened, causing them to feel digestive discomfort more intensely than individuals without the condition.
Types of IBS
IBS is categorised based on the predominant bowel symptoms:
IBS-D: Diarrhoea-predominant IBS
IBS-C: Constipation-predominant IBS
IBS-Mixed: Alternating between diarrhoea and constipation
IBS-U: Unsubtyped IBS with varying gastrointestinal symptoms
Who is Affected by IBS?
IBS affects people of all ages, but it is more commonly diagnosed in individuals between the ages of 20 and 30. It’s also 50% more prevalent in women than men in Western countries. Many people trace their symptoms back to childhood or adolescence, suggesting that IBS can develop early and persist into adulthood.
Signs and Symptoms of IBS
The symptoms of IBS can vary greatly from person to person, but common signs include:
Abdominal discomfort or cramps
Bloating and intestinal gas
Urgency to move bowels
Frequent, loose bowel movements
Constipation or diarrhoea
A feeling of incomplete evacuation
Changes in stool consistency and appearance
Additionally, IBS is often associated with other conditions, such as:
Fatigue
Mood changes, including anxiety and depression
Fibromyalgia
Urinary frequency
Migraines
Chronic pelvic pain
Causes and Triggers of IBS
Several factors can trigger or exacerbate IBS symptoms:
Post-infectious IBS: Damage to the intestinal lining following gastroenteritis.
Visceral hypersensitivity: Increased sensitivity of the gut’s nerves, leading to heightened pain perception.
Small Intestinal Bacterial Overgrowth (SIBO): A major cause of IBS symptoms due to excessive bacteria in the small intestine.
Stress: The gut-brain axis plays a significant role in IBS, and stress can trigger symptoms.
Gut Dysbiosis: An imbalance of gut bacteria, with lower levels of beneficial bacteria (Bifidobacteria* and Lactobacilli) and higher concentrations of harmful bacteria.
Recurrent antibiotic use: Can lead to dysbiosis and IBS symptoms.
Diet: Low-fibre, high-protein, or high-fat diets, along with food intolerances (e.g., lactose, fructose), can trigger IBS.
Food Intolerances: Certain foods like gluten, dairy, and chemicals found in foods (amines, glutamate, and salicylates) can worsen symptoms.
Diagnosing IBS
Diagnosing IBS typically involves ruling out other gastrointestinal conditions. Tests may include:
Blood tests (urea, creatinine, iron, vitamin B12, serum folate, zinc)
Coeliac genotyping and serology
Abdominal ultrasound
Lactose and FODMAP sensitivity breath tests
Small Intestinal Bacterial Overgrowth (SIBO) breath test
Endoscopy and colonoscopy
Gut Microbiome mapping
A comprehensive stool analysis using polymerase chain reaction (PCR) and microscopy is also valuable in identifying gut function markers and microbial imbalances.
Treatment Solutions for IBS
Conventional Treatments
Allopathic treatments often focus on symptom relief and include:
Laxatives (for IBS-C): e.g., Movicol
Anti-diarrheal medication (for IBS-D): e.g., Imodium
Anticholinergic drugs: e.g., dicyclomine
Tricyclic antidepressants or SSRIs: e.g., Endep or Fluoxetine
Pain medications: e.g., pregabalin or gabapentin
Complementary Treatments
Complementary approaches focus on addressing the root causes of IBS and supporting gut health through the following goals:
Correcting nutritional imbalances and digestive enzyme insufficiency
Identifying and addressing food intolerances
Restoring healthy hydrochloric acid production
Addressing visceral hypersensitivity and gut inflammation
Eradicating bacterial overgrowth and pathogenic infections
Reintroducing previously eliminated foods once gut health improves
Natural Treatment Options for IBS
Prebiotics: Prebiotics are fibre-rich foods that fuel beneficial gut bacteria. *Galactooligosaccharides (GOS)* have been shown to improve stool consistency, reduce bloating, and alleviate abdominal pain in IBS sufferers.
Probiotics: Research shows that specific probiotic strains help manage IBS symptoms, including:
- Lactobacillus plantarum (299V)
- Lactobacillus rhamnosus (LGG)
- Bifidobacterium breve (Bb99)
- Lactobacillus acidophilus (CUL-60) and Bifidobacterium lactis (CUL-34)
- VSL#3 probiotic blend
Nutritional Medicine: L-glutamine is particularly beneficial for repairing gut lining, while fish oil, zinc carnosine, and quercetin support gut healing and reduce inflammation.
Herbal Medicine: Several herbs are helpful for managing IBS symptoms:
- Anti-diarrheal herbs: Cinnamon, Agrimony, and Green tea help reduce stool volume.
- Gentle laxatives: Flaxseeds, Licorice root, and Yellow Dock for IBS-C.
- Mucoprotective herbs: Slippery Elm, Aloe vera, and Marshmallow root for healing the gut lining.
- Anti-inflammatory herbs: Turmeric, Boswellia, and Nettle help soothe inflamed intestines.
- Carminative herbs: Peppermint, Fennel, and Chamomile help relieve bloating and gas.
Iberogast: A German herbal formula shown to improve gut motility and reduce symptoms of IBS by acting on serotonin receptors in the gut.
Managing IBS and Moving Forward
IBS is a complex condition that requires a multifaceted approach to manage. Whether you choose conventional medicine, complementary therapies, or a combination of both, it’s essential to work with a healthcare professional to tailor a treatment plan that meets your unique needs.
If you’re ready to take control of your IBS symptoms and improve your digestive health, book a clarity call and learn more about how to address this condition.
