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:
Exhibiting pain and discomfort with defecation
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.
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