Solving the mystery of Irritable Bowel Syndrome

Have you noticed that more and more people are complaining about irritable bowel syndrome (IBS)? This may be because 1 in 10 people have abdominal pain, bloating and a change in bowel habit, leading to them being diagnosed with IBS.

The cause of this staggering increase in IBS is unknown but new research shows that there may be a miscommunication between the brain and gut.

How is IBS diagnosed?

There are 3 categories in IBS:

  • IBS-C: Where there is constipation on most days of the week,
  • IBS- D: Where there is diarrhoea on most days of the week, and
  • IBS-M: Where there is intermittent diarrhoea and constipation.

There is a need for a detailed history to be taken as well as a physical examination, which usually shows normal. A gastroenterologist or surgeon usually does investigations including Endo- and colonoscopies to eliminate other disorders/ intolerance.

Then, diagnosis using the ROME IV criteria involves recurrent abdominal discomfort, on average at least 1 day per week in the last 3 months associated with 2 or more of the following:
– Related to defecation (passage of stool)
-Associated with a change in frequency of stool
-Associated with a change in form/ appearance of stool
These criteria should be fulfilled for the last 3 months with symptoms appearing at least 6 months before diagnosis.
The Rome IV criteria takes into account early life influences eg. Genetics, environment and culture and psychosocial factors eg. stress, social support, psychological state and personality. As well as physiology eg. Motility, sensation, immune function, gut microflora, food and diet.

Symptoms:

Often, we take gastro-intestinal symptoms as normal such as:

  • Abdominal pain
  • Constipation
  • Diarrhoea
  • Bloating and visible distension.

These are not normal and should not be ignored. Further more, symptoms that are not obviously related include:

  • Headache
  • Backache
  • Sleep disturbances
  • Chronic fatigue
  • Pelvic pain and general body aches
  • Depression and anxiety.

From the above, it is quite evident that Irritable Bowel Syndrome is a complicated condition and need careful treatment.

Treatment and more:

Medications may include treatment for pain, diarrhea, constipation, infection as well as psychological disorders. Sometimes there is even a change in the quality and quantity in the bacteria in the gut. Therefore, probiotics are prescribed in an attempt to harmonize the gut micro-biome. Education and support is essential. IBS is a lifelong disorder and medical professionals including a doctor, dietician and psychologist can all assist with its management.

Lifestyle plays an integral part in the management of IBS. Stress, depression and anxiety can affect symptoms of IBS due to the close relation between the gut and brain. Therefore, planning, managing anxiety and regular exercise help control stress which in turn, controls symptoms of IBS. See Shannon’s article on Turning New Year’s Resolutions into Healthy Habits for more information on how to live a healthier lifestyle.

Diet plays a huge role in gut health and IBS. A healthy diet is the first step to feeling well again. See Leah’s article for diet tips on managing IBS.  However, if these tips do not help as a first line treatment, new research shows that a Low Fermentable, Oligosaccharides, Disaccharides, Monosaccharides and Polyols (FODMAP) diet improves bloating, pain and stool patterns.

Low FODMAP foods include:

  • rice
  • oats
  • melon
  • strawberry
  • grapes
  • green beans
  • spinach
  • sweet potato
  • tomato
  • lactose free foods

High FODMAP foods include:

  • wheat productswheat products
  • apple
  • fruit juices
  • broccoli
  • cabbage
  • onion
  • beetroots
  • milk and dairy products
  • artificial sweeteners
  • all beans and lentils

Following a Low FODMAP diet can be daunting, which is why it is best to consult a dietician to help guide you through the process. For a full assessment and specialized meal plan, consult your nearest Newtricion Wellness Dietician for more information.

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