Gut Health Part 2

Welcome back to part 2 of Gut Health. Since we spoke about GUT HEALTH & LEAKY GUT let’s take it one step further and talk about Irritable Bowel Syndrome. This is a very common topic and is also known as, IBS. We talk about risk factors, symptoms, diagnosis, prevention and treatment of IBS. IBS impacts many people and many don’t even know they have this! If you want to listen to the episode now you can do so by CLICKING HERE!

♡ What is IBS?

IBS is a disorder that affects the large intestine. It typically presents with symptoms of cramping, abdominal pain, bloating, gas and diarrhea or constipation or both. These subtypes will sometimes be known as, IBS-D (D for diarrhea) and IBS-C (C for constipation). It is a chronic condition and many people may have it without being diagnosed with it or even realizing that this is what they have.


The overall approach in treating these patients is typically with diet, lifestyle and stress management. More severe cases may need both medication and counseling. This goes right into its strong association with psychological factors. You can easily notice this with yourself when your gut reacts to changes in your mood or when you are under particular stress.


♡ Symptoms

Typical IBS symptoms you may experience include:


  • Abdominal pain

  • Gas

  • Alternating bouts of stool changes

  • Mucus in the stool


And these symptoms range from being continuously present to not present at all


♡ Contributing Factors in IBS?

  • You get muscle contractions in your intestines

Your intestines are a crucial part of the digestive system which helps move food along and the process starts from the moment you put food in your mouth. Incredible right?


What happens in IBS is that the contractions are stronger and longer or if the contractions are weaker it can slow the passage of food leading to constipation and other symptoms

  • Nervous system or your CNS is also important

For example, if you have poor signals between the brain and the intestines it can cause your body to overreact to changes that normally occur in the digestive process

  • Inflammation in the intestines

Pretty self-explanatory, we would say

  • If you have a severe infection

I.e.: after an episode of gastroenteritis or due to bacterial overgrowth

  • Changes in bacteria in the gut (also known as, microflora)

These changes are common in healthy people but may be different in those suffering from IBS


♡ Key Triggers and Risk Factors


Key Triggers are: food, stress and your hormones!


Risk factors:

  • Young (typically less than age 50)

  • Female sex

  • Family history of IBS

  • Mental health issues (i.e.: anxiety, depression, abuse)

♡ Complications

Complications include: hemorrhoids, mood disorders and a poor quality of life


♡ Prevention

Prevention is focused around:

  • Counseling

  • Biofeedback

  • Progressive relaxation exercises

  • Mindfulness training (one of our faves!)

♡ Diagnosis

So in order to diagnose a physician will typically figure out the subtype of IBS first (i.e.: constipation predominant, diarrhea predominant, mixed or unspecified).


The criteria for diagnosis involves:

  1. Exhibiting pain and discomfort with defecation

  2. Frequency and stool consistency altered with at least one day a week of symptoms for 3 months

Along with two of the following three additional criteria:

  • Pain relieved by defecation

  • Change in stool frequency or change in bowel consistency

In these cases, physicians may also want to rule out something more severe as well as underlying infection, lactose intolerance, bacterial overgrowth, cancer, etc.


♡ Treatment

Treatment is aimed at eliminating the causal factors as much as possible and dietary as well as, lifestyle changes.


Let’s talk about the infamous low-FODMAP diet which stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyols diet.


They consist of short-chain carbohydrates that are poorly absorbed and rapidly fermented by gut bacteria, resulting in the production of gas and an increased osmotic fluid load (aka water) within the gut lumen.


The effects of dietary FODMAPs may contribute to the symptoms of IBS-D.


A trial involving 84 adults with IBS-D compared a low-FODMAP diet to a diet based on modified National Institute for Health and Care Excellence (mNICE) guidelines. In this study, patients on the low-FODMAP diet reported relief of their symptoms (52% versus 41%) and decrease in abdominal pain (51% versus 23%) than those on the mNICE diet.


There are also pharmacological therapies that have been approved. These include: alosetron, linaclotide, lubiprostone.


Alosetron:

a peripherally acting serotonin type 3–receptor antagonist approved for the treatment of IBS-D in women aged 18 years or older if they fail of conventional therapy.


Adverse effects: severe constipation and ischemic colitis.

Note: You have to take a risk evaluation and mitigation strategy training program before taking this drug. INTENSE.
It’s also not approved for men with IBS-D because they included only a small amount of men in the clinical trials.

Linaclotide:

is a peripherally acting guanylate cyclase-C activator approved for the treatment of IBS-C


Lubiprostone:

is a peripherally acting chloride channel activator also approved for IBS-C in women aged 18 years or older


These are just some of the options and of course counseling is another important aspect of treatment as we alluded to earlier.


In summary, the best bet is to change your lifestyle around, keep stress at a minimum and seek help through social support to get through this condition or at least keep it at bay.


That's all for this week, don't forget to leave us feedback, rate, review, subscribe and send in your questions so we can continue to improve as well as, provide you high quality content.


Disclaimer: The Content on our podcast/website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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