Irritable bowel syndrome (IBS) affects around 11% of adults worldwide, making it a relatively common chronic gastrointestinal disorder. While research is ongoing, there is still much to be learned about the condition. To help dispel some prevalent myths about IBS, we spoke with Dr. Ashkan Farhadi, a gastroenterologist at MemorialCare Orange Coast Medical Center, and Dr. Mollie J. Jackson, a gastroenterologist at the University of Kansas Health System.
According to Dr. Farhadi, certain foods may trigger symptoms, but they do not cause the condition. However, post-infectious IBS can be caused by bacteria such as Campylobacter jejuni.
Recent research suggests that levels of mental stress influence gut bacteria composition and play a key role in IBS via the gut-brain axis. Dr. Farhadi notes that people with and without IBS generally face similar amounts of stress, meaning that it may be how people manage stress that influences whether or not they experience IBS symptoms. They can manage stress through an active lifestyle, which can help prevent mental decline.
Dr. Farhadi explains that when a person is stressed, the numbers of mast cells in their gut increase, changing the anatomy of the gut and making it more sensitive to stress. This means that even if the stressful period is over, the gut is not the same, and IBS symptoms triggered by stress can linger.
A study conducted by Dr. Farhadi found that subjective perception of well-being is linked to fewer symptoms of IBS. Previous research also suggests that psychological, social, and genetic factors may play a role in the development of IBS symptoms.
Diagnosing IBS
Dr. Farhadi says that IBS can be diagnosed without fancy tests, and with the right clinical criteria, doctors can diagnose IBS with 97% accuracy in 5 years. The diagnosis is based on the Rome IV criteria, which includes symptoms of abdominal pain at least once weekly, associated with a change in stool frequency, stool form, and/or relief or worsening of abdominal pain related to defecation.
There are different subtypes of IBS, including predominantly diarrhea, constipation, or a mixed pattern. Patients often experience bloating, but this symptom is not needed for diagnosis. To ease bloating and discomfort, patients can try natural remedies.
Treating IBS
Treatment for IBS includes a mixture of prescription medication and lifestyle changes tailored to each person’s individual situation. Dr. Farhadi recommends fiber, probiotics, reassurance, and exercise as simple and effective management strategies.
When it comes to medication, Dr. Farhadi notes that it can be a “trial and error” experience, but it can help relieve symptoms caused by IBS. However, there is no cure for IBS, and medication may only provide temporary relief.
Dr. Jackson emphasizes that IBS is a chronic, debilitating, and common disorder that can significantly affect patients’ quality of life. One study highlighted the negative impact of IBS, with patients reporting that they would give up 10-15 years of their life expectancy for an instant cure.
While some kinds of exercise, such as competitive exercise or weight-lifting, may not relieve stress and can even produce stress, other types of exercise can help alleviate IBS symptoms. They can explore our content hubs for more information on managing IBS.
Diet and IBS
A recent review found that there is no conclusive link between IBS and lactose intolerance, although many patients with IBS report milk intolerance. Cutting out dairy products may help relieve gastrointestinal symptoms, especially for those who are lactose intolerant.
Dr. Jackson explains that an elimination diet can help identify trigger foods, and the low FODMAP diet is the most studied diet for IBS. FODMAP foods can lead to increased gas and distension, triggering meal-related symptoms in patients with IBS.
Natural remedies such as peppermint oil and cardamom have shown some promise in relieving symptoms of IBS and gastric ulcers. However, research into natural remedies is limited, and they may not be universally helpful.
Ultimately, managing IBS requires a tailored approach, and what works for one person may not work for another. Dr. Farhadi notes that the key to managing IBS is to find the right combination of treatments that work for each individual, much like finding the right balance for a complex engine.
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