Irritable bowel syndrome: Causes, symptoms, treatment or tips to cure IBS
A very common health condition in India that affects the digestive system, irritable bowel syndrome or IBS is a mix of belly discomfort or pain and trouble with bowel habits: either going more or less often than normal (diarrhoea or constipation) or having a different kind of stool (thin, hard, or soft and liquid). It's not the same as inflammatory bowel disease (IBD) and it has nothing to do with other bowel problems but has been noticed that women suffer through this condition more than men and some have only minor discomfort while for others it may end up disrupting daily routine.
Types of IBS
The type of IBS you have depends on the abnormal bowel movements you experience:
• IBS with constipation (IBS-C): Most of your poop is hard and lumpy. IBS with constipation is a condition where people experience belly pain or discomfort due to constipation.
• IBS with diarrhea (IBS-D): Most of your poop is loose and watery. IBS with diarrhoea is usually characterised by chronic and recurrent episodes of diarrhoea.
• IBS with mixed bowel habits (IBS-M): You have both hard and lumpy bowel movements and loose and watery movements on the same day. Mixed IBS where the person experiences alternating episodes of constipation and diarrhoea.
Causes of IBS
In an interview with HT Lifestyle, Madhavi Karmokar Sharma who is a Functional Nutritionist, Certified Diabetes Educator and Founder of Informed Health, said that IBS is generally concluded by exclusion, after ruling out other health issues that cause similar symptoms like lactose intolerance, thyroid problems, celiac disease and parasitic infection. Though it is tough to know the precise causes of IBS, she listed the factors that trigger it:
1. Muscle contractions in the intestine - (i) Changes in the Nervous System - The nerves of digestive system lead to symptoms ranging from bloating to stools. Poorly coordinated signals between the brain and the intestines can cause the body to overreact to changes that normally occur in the digestive process, resulting in pain, diarrhea or constipation.
(ii) Severe infection: IBS can develop after gastroenteritis caused by bacteria or a virus. IBS might also be associated with a surplus of bacteria in the intestines (bacterial overgrowth).
2. Early life stress: People exposed to stressful events, especially in childhood, tend to have more symptoms of IBS.
3. Changes in gut microbes: Research indicates that the microbes in people with IBS might differ from those in healthy people.
4. Food triggers: Food related sensitivities to wheat, milk, citrus fruits, beans, cabbage, milk, aerated drinks may trigger IBS. Sugary/oily/spicy food aggravate IBS.
5. Stress: IBS symptoms get aggravated in the presence of stress.
As per Aman Puri, Founder of Steadfast Nutrition, “IBS or Irritable bowel syndrome is a group of uncomfortable symptoms of the digestive system. IBS is a form of functional gastrointestinal (GI) disorder that may occur due to an impaired gut-brain interaction, severe infection, or stress in early life.”
Symptoms of IBS
According to Nutritionist Madhavi Karmokar Sharma, “Irritable Bowel Syndrome (IBS) is classified as a functional gastrointestinal disorder. It is a chronic condition of the lower gastrointestinal tract that is a growing cause of concern among Indians today. Its hallmark symptoms include abdominal pain or discomfort along with change in consistency and /or frequency of bowel movements. Many also complain about a constant feeling of incomplete evacuation. It is often referred to as spastic, nervous or irritable colon.”
Aman Puri revealed, “People with IBS may experience symptoms such as diarrhoea, constipation, abdominal pain/cramps, excessive gas, bloating, harder or looser stools than normal, the appearance of mucus in their stool, certain food intolerances, tiredness, loss of appetite, anxiety, heartburn and indigestion.”
Treatment or tips to cure IBS
Asserting that when it comes to treating IBS, no specific diet or therapy works for everyone, Aman Puri highlighted that since people with IBS can have different symptoms, one needs to see what works best for them. However, adhering to general dietary and lifestyle changes may help improve IBS symptoms. He advised, “Gradually increase the fibre content in your diet by including fruits, vegetables, whole grains, and nuts. Stay hydrated by consuming at least 7-8 glasses of water daily. Have small and frequent meals rather than consuming large portions at once. Make probiotics a part of your daily diet as they increase the growth of good gut bacteria, thereby improving digestion and relieving the symptoms of bloating.”
He added, “Restrict the consumption of tea, coffee, aerated beverages, and sodas. Consume dairy products only in moderation or eliminate them from the diet as lactose intolerance is common in people with IBS. Ensure that you get enough calcium from alternate food sources such as sesame seeds, soybean, almonds, and spinach. Exercise regularly as a sedentary lifestyle can worsen the problem of IBS. Quit smoking and drinking, and manage stress by practicing mindfulness and breathing techniques to help resolve IBS effectively.”
Nutritionist Madhavi Karmokar Sharma pointed out that treatment of IBS focuses on relieving symptoms so that you can live as normally as possible. A basic understanding of triggers helps in preventing and reducing the intensity of experienced symptoms. She suggested:
1. Avoid foods that trigger symptoms. These include physical, thermal and chemical irritants like spicy, oily, hot foods.
2. Based on the type of IBS eat low FODMAP foods or include high fiber foods.
3. Stay Hydrated. Dehydration is known to cause cramps and increase abdominal pain. It is also the leading cause of constipation.
4. Engage in Stress Management activities like deep breathing, pranayama. This helps to calm the nervous system and, in turn, the gut through the Gut Brain Axis.
5. Build a regular exercise routine. Exercise has both positive physiological and psychological affects that prove beneficial in management of IBS.
6. Follow circadian Rhythm eating. Eating in sync with the sun clock assists the body in improving digestion.
7. Adopting a healthy lifestyle, where sleeping and waking up times, meal timings are well structured helps in orienting the body better to rest, digest and recovery.
8. Regulating intake of alcohol and smoking also goes a long way towards managing symptoms of IBS.
9. Avoiding off the counter medication. Unprescribed and frequent medication is known to disrupt the gut microbiome. Frequent courses of antibiotics eliminate not just the bad bacteria but also the good bacteria in the body, thereby causing dysbiosi.