What is Irritable Bowel Syndrome?

Managing IBS: Types, Triggers, and Lifestyle Support

Irritable Bowel Syndrome (IBS) is a gastrointestinal disease that affects the digestive system. IBS may not be life-threatening, but it can significantly deteriorate a person's life. You may often have stomach cramps, bloating, and alternating outbreaks of diarrhoea and constipation.

About 5 to 10% of the world's population suffers from IBS, which can significantly impact a person's daily life. Keep reading to understand irritable bowel syndrome (IBS), its categories, causes, and symptoms, and how it can affect your life.

What are the different categories of irritable bowel syndrome (IBS)?

Researchers have categorised IBS into 4 types. Knowing the difference among the types, certain treatments are effective only for specific types of IBS.

The disease is classified based on how your stools look on the days you have a flare-up (temporary worsening of symptoms, abdominal pain, or bowel movements triggered by stress). Here are its types discussed below:

• IBS-C (Irritable Bowel Syndrome with Constipation): In this condition, you would find your stool to be lumpy and hard. It is IBS accompanied by constipation.
• IBS-D (Irritable Bowel Syndrome with Diarrhoea): In this condition, your poop would be loose and watery. It is IBS accompanied by diarrhoea.
• IBS-M (Irritable Bowel Syndrome with Mixed Bowel Habits): This condition is mixed-IBS. This means you can make both lumpy and loose movements.
• IBS-U (Irritable Bowel Syndrome - Unsubtyped): People who don't fit into the other subcategories are classified under unsubtyped IBS.

What are the symptoms of irritable bowel syndrome?

IBS can affect you physically and mentally. The physical signs of IBS include:

• Frequent and sometimes intense diarrhoea.
• Chronic constipation.
• Bowel movement alternating between diarrhoea and constipation.
• Extreme gas and abdominal bloating with pain.
• A distended abdomen.
• Presence of white mucus in stool.
• A feeling of incomplete bowel movement.

These physical signs tend to take a toll on mental health, leading to

• Anxiety
• Depression
• Emotional withdrawal
• Persistent stress

What are the causes of irritable bowel syndrome?

Doctors are not sure what causes Irritable Bowel Syndrome (IBS). But it falls under the umbrella of neuro-gastrointestinal disorders. That means the disease involves how the brain and the gut (intestine) work together. A malfunction in their communication network causes the following IBS symptoms.

They may include:

• Dysmotility: In IBS patients, the large intestine, or colon, tends to contract too much or too little, causing bloating, abdominal cramps, and irregular bowel movements.
• Visceral Hypersensitivity: During IBS, your digestive tract can become extra sensitive to pain. Research shows that people with IBS tend to have a lower pain tolerance than other people.

Over the years, doctors have highlighted other factors that increase the chance of irritable bowel syndrome. These include:

• Gut Bacteria Imbalance: Research has shown that individuals with IBS have distinct types and amounts of gut bacteria compared to those without it. This imbalance can affect digestion and cause the typical symptoms.
• Infections: Severe infections in the stomach and GI tract infections can cause IBS symptoms. These infections can be bacterial or parasitic (Giardia).
• Food Sensitivity: Certain foods, such as insoluble fibre, dairy, gluten, processed foods, and caffeine, can exacerbate IBS symptoms.
• Childhood Trauma: People who have suffered tremendous stress, abuse (physical or mental), or trauma during their early days are more likely to develop IBS when they hit puberty.
• Genetics: Research indicates that people with an IBS-affected family member are at a higher risk of developing the syndrome. However, researchers are yet to find the specific genes involved in this medical condition.

Besides the above causes, certain triggers cause an IBS flare-up in patients. Find them listed below:

• Periods or menstrual cycle.
• Stress and anxiety. IBS is sometimes called the "nervous stomach" disease for this reason.

Furthermore, there are certain risk factors associated with IBS. They are:

• Being a Woman: Women are two times more likely to develop IBS than men.
• Age: IBS typically begins before age 40, but new symptoms occurs after 45.
• Stress and Emotional Issues: Doctors cannot figure out what comes first-- the stress or the IBS. However, the two are connected somehow.
• Medications: Medications for depression (antidepressants), infection (antibiotics), and drugs containing sorbitol (cough syrups) can trigger typical IBS symptoms.
• Other Conditions: Other conditions that can be linked to IBS are fibromyalgia, chronic pelvic pain, interstitial cystitis, migraine, and chronic fatigue syndrome.

What is the diagnosis for Irritable Bowel Syndrome (IBS)?

Doctors ask for your medical history and eliminate symptoms of other diseases. The diagnosis process usually includes determining:

1 . The Rome Criteria: It includes experiencing belly aches once a week for at least three months. This ache is accompanied by at least two of the following signs:

• Bowel movements
• Change in stool frequency
• Change in stool consistency

2 . Type of IBS: There are four types of IBS:

1. IBS-C (constipation)
2. IBS-D (diarrhoea)
3. IBS-M (mixed)
4. IBS-U (unclassified)

Medicines are prescribed based on the kind of IBS the person has.

If you are over 40 years old, have rectal bleeding, have lost a lot of weight suddenly, are experiencing nausea and vomiting, have pain after passing stool, or have iron deficiency, the doctor will prescribe additional tests, such as:

• Colonoscopy
• CT scan of the full abdomen
• Upper endoscopy to look at the upper digestive tract and collect samples for testing

Here are a few lab tests that the doctor may suggest:

• Lactose intolerance test
• Breath test for bacterial overgrowth in the intestine
• Stool test to look for infections

What are the treatments for IBS?

There is no one-size-fits-all treatment for IBS. The treatments and medical advice are particular to the type of IBS you have. The general advice includes:

1. Monitoring Symptoms: 

• This will help you identify patterns and triggers related to food intolerances or stress.

2. Dietary Changes:

• Fibre-rich diet for people with constipation, such as fruits, grains, nuts, etc.
• Take fibre supplements such as Metamucil or Citrucel
• Limiting dairy products
• Avoiding cruciferous vegetables like cabbage and Brussels sprouts, since they cause excessive gas and bloating
• Avoid gluten
• Following a low-FODMAP diet. That means reducing the intake of fermentable carbohydrates that are difficult to digest.
• Avoid triggers such as caffeine, alcohol, spicy foods, and fatty meals.
• Drinking plenty (at least 2 litres) of water every day.

3. Activity Changes:

• Regular exercise
• Trying relaxation therapies such as yoga and meditation
• Seven to nine hours of restful sleep is mandatory.

4. Psychological Therapies:

• Cognitive behavioural therapy
• Gut-directed hypnotherapy (for people with severe IBS)
• Biofeedback therapy

5. Medications:

Doctors may prescribe antidepressants, laxatives (for constipation), anti-diarrheals, or medicines to reduce spasms in the intestine.

The medicines prescribed for IBS are

• Hyoscyamine
• Lubiprostone
• Linaclotide
• Plecanatide
• Rifaximin

There is no guaranteed way to cure or prevent IBS. However, with regular monitoring and following medical advice, along with a clean diet, it is possible to manage this medical condition. Understanding the underlying causes of the disease will help you take control of the symptoms. Overall, a good life with IBS is possible.

Now, when managing IBS, regular doctor's visits and medical tests can hurt your pocket. Therefore, having health insurance can lower costs while ensuring that you get timely access to quality medical care.

What are the effects of irritable bowel syndrome (IBS)?

IBS can affect more than your gut; it can affect your quality of life. The physical and emotional effects of IBS on a person can include the following:

• Physical Discomfort and Bloating: Chronic stomach pain, abdominal cramps, bloating, and irregular bowel movements can drain your energy, leading to exhaustion and disturbed sleep.
• Reduced Concentration: IBS symptoms can distract you from tasks and reduce mental clarity (brain fog).
• Nutritional Deficiencies: People with IBS start avoiding food that causes irritation and aggravates their symptoms. Some of these foods are healthy, but they miss out on key nutrients. Over time, they develop poor nutrient absorption and iron, vitamin B, and magnesium deficiencies.
• Limitations on Physical Activity: Exercising and regular household chores can be challenging for IBS patients. They avoid these tasks due to discomfort or fatigue resulting from IBS.
• Reduced Quality of Life: IBS can affect social interactions as people avoid activities that trigger symptoms. Social activities are often compromised due to the unavailability of nearby toilets, especially during travel.
• Impact on Mental Health: IBS can be linked with anxiety and depression. The fear of sudden triggers causes a sense of embarrassment and helplessness.
• Work and Academic Challenges: People with IBS experience difficulties in job performance or academic responsibilities, which result from decreased productivity and increased absenteeism.

IBS is a chronic but manageable condition. There is no cure, but the right amount of dietary awareness, stress management, and medical guidance will help keep your symptoms in check. Awareness and understanding of the disease and its symptoms will help you confidently lead life.

It is also advisable to have health insurance to secure your health and finances during critical times. At Star Health, we offer extensive coverage for various health conditions under our tailored insurance plans. We also provide hassle-free claim settlements with reduced turnaround time across over 14,000 network hospitals in India.