If you have irritable bowel syndrome, better known as IBS, you’re in good company. According to the International Foundation for Functional Digestive Disorders, it affects between 15 and 20% percent of people worldwide, most of them women. But what is it exactly, what treatments are available, and what should you do if you think you might have it? Read on to find out more…
What is it, exactly?
The main symptoms are constipation, diarrhea, bloating, abdominal cramps, gas, and mucus, but you might not experience all of them. Some people have only constipation or only diarrhea, while for others it alternates. Symptoms can be continuous or come and go, but are likely to vary in intensity on different days and at different times. You may find it’s worse after certain meals, around your period, or when you’re stressed.
IBS is caused by bowel spasms, which are needed to push food through your body. If this happens too quickly, you get diarrhea, too slowly, you’ll be constipated.
How is it diagnosed?
IBS isn’t diagnosed until you’ve experienced symptoms for at least three months, but see your doctor sooner if daily life feels overwhelming. If you have blood in the toilet pan, rapid weight loss, a fever, nausea, or continuous diarrhea, seek medical help immediately.
A doctor will want to rule out an infection or parasite, celiac disease, inflammatory bowel disease, and cancer. (Try not to panic—IBS is much more common.) This will likely involve a blood test and stool sample, and possibly an endoscopy, which takes a biopsy of your gut, a sigmoidoscopy, which looks at the lower colon, or a colonoscopy, which examines the whole thing.
What causes it?
Scientists aren’t 100% sure. It’s not clear if there’s one cause for everyone, or multiple possible causes. It does seem to be linked to diet, and many sufferers say that stress makes symptoms worse.
It could be triggered by inflammation in the gut, or gut dysbiosis—an imbalance of bacteria, often exacerbated by taking antibiotics for extended periods of time. It might just be that the nerves in your digestive system are particularly sensitive.
What treatments are available?
You could try over-the-counter medications or supplements, like laxatives or psyllium husk for constipation and loperamide (Imodium) for diarrhea, but start with a low dose, don’t take them long-term, and let your doctor know.
Some doctors prescribe tricyclic antidepressants for provide pain relief and to soothe the nerves to your gut, which can improve symptoms.
There are stronger prescription medications but they often have side-effects (typically the opposite problem to the one you’re having) so it’s often worth trying other interventions first.
Can dietary changes help?
Keeping a food diary can help you keep track of what you eat and how it affects you. Symptoms might take a few hours or longer to show up, so this should allow you to spot any patterns.
In general, a bland diet is best. Soda, candy, caffeine, chips, cookies, spices, and fried food have all been linked to IBS. Raw food like salad can also be hard to digest, and artificial sweeteners in gum, diet drinks and diet foods may exacerbate diarrhea.
Some people with IBS say that cutting out gluten helps, and others have found relief by sticking to a diet that avoids FODMAPS, which stands for fermentable, oligo-, di-, mono-saccharides and polyols—types of carbs that the small intestine finds difficult to absorb.
Remember to check with a doctor before you cut out entire food groups, or make any other major changes.
What else can help?
Meditation, yoga, biofeedback, counseling… Anything that helps you reduce stress should calm your gut as well. Make sure you drink water regularly throughout the day and that you get enough sleep. Exercise can be good for constipation, but don’t overdo it, especially if you have diarrhea, as it can make it worse.
You might also want to try probiotics, which rebalance the good bacteria in your gut, or prebiotics, which provide the environment for them to grow. A nutritionist or dietitian can give advice on what’s right for you.
Whatever your symptoms, chances are there’s something out there that can help your bowel (and your mood) be a little less irritable.