How to Manage Irritable Bowel Syndrome

If you are feeling constantly gassy, or your stomach is bloated and you can’t lose your gut no matter how hard you’re exercising, if you have problems with excretion, such as suffering from constipation, diarrhea or both- you’re not alone.
Gastrointestinal diseases which can cause the symptoms are very common, and one of the most prevalent in the developed world, with about 10-15% of people suffering from it, is irritable bowel syndrome (or IBS). 

Because it is poorly understood and shares a lot of symptoms with other, more serious gastrointestinal diseases, such as Crohn’s disease, celiac, parasitic infections and even colon cancer, it would be best to rule out all other options before assuming you have IBS.

 

What do we know about IBS?

The mechanism and causes of IBS are not fully understood, though it has been posited that infectious intestinal inflammation, genetics and psychological stress could all trigger IBS. It is twice as common in women, and onset is typically before the age of 45. Common symptoms include abdominal pain, diarrhea and/or constipation, a feeling of fullness, a protruding gut, not feeling relieved after going to the bathroom, depression and anxiety.

One thing to understand is that a distended gut in a person with IBS does not reflect fat. Typically, your abdomen will not feel flabby if a GI condition is a culprit- on the contrary, it will feel hard to the touch, and is often accompanied by a feeling of fullness which some describe as having an inflated balloon lodged in their abdomen. The most common explanation for this symptom is too much gas in the intestines. 

While stress might trigger or exacerbate your intestinal troubles, the inverse is also true, and many people who have IBS also suffer from depression and anxiety. This correlation joins in a long list of riddles the medical world has yet to solve, but it could be due to constant pressure on the nervous system associated with the condition, the emotional hardship of dealing with this condition, or shame with regards to physical appearance, irregular excretions and gas.

IBS is not a life-threatening condition by any stretch of the imagination, but it does affect life quality for the worse, and there is no known cure for it. That being said, there are several ways to manage it:

1. Medication

Some medicine and supplements have been shown to be effective in mitigating some of the symptoms of IBS. Laxatives work well for people whose IBS manifests in constipation, while anti-diarrheals might relieve those who suffer from loose stool and diarrhea. 

Some antidepressants of the selective serotonin re-uptake inhibitor family seem to have a positive effect on abdominal pain and other symptoms, independent of their effect on depression.

Antispasmodic medicine may relieve cramps and diarrhea in people with IBS, as well as relax the muscles in the colon.

Soluble fiber supplements, such as that of the psyllium plant, have been effective in both bulking up the stool of those who suffer from diarrhea and help with excretion in case of constipation.

Several probiotics can also alleviate some symptoms of IBS. B. breve, B. longum and L. acidophilus are effective at reducing abdominal pain. B. breve, B. infantis, L. casei, and L. plantarum may help with abdominal distention.
B. breve, B. infantis, L. casei, L. plantarum, B. longum, L. acidophilus, L. bulgaricus, and Streptococcus thermophilus all improve flatulence.

2. Physical activity and stress relief

Exercise, and in particular, aerobic activities, are effective in reducing the symptoms of IBS. Recommended activities include swimming, jogging, walking and cycling. Additionally, yoga (and especially yoga that focuses on the lower abdomen) has been shown to help reduce stress and also help with IBS symptoms.

Meditation is another way to relieve stress, alleviate IBS symptoms and improve quality of life for people with IBS. 

3. Therapy

Healthy mind, healthy body. In this case, it’s at least partially true, as psychotherapy and other forms of talk therapy (even without prescribed antidepressants) appear to improve quality of life among people with IBS and reduce symptoms.

The effect therapy has on one’s gastrointestinal health can be explained by the existence of the gut-brain axis, a two-way communication corridor between the nervous and gastrointestinal systems which informs both feelings of hunger and being sated, but can also affect gut flora in response to stress and trauma. Likewise, physical circumstances that affect gut flora (such as diet or disease) can have an adverse effect on your mental state. 

4. Changes in diet

In many cases, IBS flares up in reaction to a “trigger food”. Such trigger foods contain carbohydrates known as FODMAPs, which are poorly absorbed in the small intestine, undergoing fermentation in the bowels. This causes a buildup of gas in the intestines which may cause bloating and flatulence.

People with IBS may want to attempt to eliminate FODMAPs from their diet, and then slowly reintroduce them in order to find out which ones cause a flare-up. Giving up FODMAPs altogether is not advisable, as many of the foods that contain them, such as onions and legumes, provide valuable nutrients.

For the FODMAP diet kindly see my next post, thanks.

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