Irritable bowel syndrome, or IBS, is a common gastrointestinal disorder of the large intestine. People with IBS experience a range of symptoms connected to the movement of food through the digestive tract and how the brain interprets the signals it receives from intestinal nerves during this process. IBS typically causes the colon muscles that move food to contract more frequently, resulting in painful cramps. Although the chronic condition can be uncomfortable — or even embarrassing — it does not lead to changes in bowel tissue or raise the risk of colorectal cancer. It does, however, require long-term management to minimize the impact it has on quality of life.
Symptoms of IBS
People with IBS typically experience abdominal pain or cramping in relation to bowel movements. They may also observe changes in the frequency or appearance of bowel movements, including the presence of blood or stools that are harder or looser than usual. Other symptoms can include diarrhea, constipation or both. Some people also experience excessive gas or bloating during an IBS flare-up.
There are three subtypes of IBS that can affect the type of medication doctors prescribe to treat the condition: IBS-C (with constipation) involves stools that are hard and lumpy; IBS-D (with diarrhea) relates to stools that are loose and watery; and IBS-M, deals with the presence of both types of stools in the same day.
How is IBS diagnosed?
As there is no known cause for IBS, the condition is impossible to prevent or avoid. Risk factors are believed to include stress, anxiety, depression and a family history. While there is no definitive test for IBS, doctors will usually compile a medical history and conduct a physical exam to rule out other conditions. Depending on the results of this exam — and the symptoms experienced — other tests, including stool samples, X-rays and even a colonoscopy may be required to get a diagnosis.
Health-care providers will typically devise an individualized treatment plan that involves a mix of dietary and lifestyle changes that can alleviate symptoms and minimize the ability of IBS to interfere with daily life. Dietary changes can involve an increase in fibre, including more fruits, vegetables, grains and nuts, drinking eight-ounces of water per day and avoiding caffeine. Lactose intolerance can be more common in people with IBS, so doctors may recommend avoiding milk, cheese and other dairy products. Other items that may contribute to IBS include green onions, red peppers, wheat and red wine. Recent study, however, has found diet may play less of a role in the course of the condition than originally thought.
Activity changes may include more exercise, engaging in relaxation techniques and eating smaller portions of food throughout the day as opposed to larger meals less often. It is also recommended that people with IBS quit smoking if they haven’t already.
If these changes don’t yield results, doctors may also rely on medication to treat any underlying anxiety or depression that may be a contributing factor. Some probiotics have been known to improve symptoms of the syndrome.
Interestingly, a recent study found the pandemic had an unexpected effect on people with IBS living in Argentina. Researchers expected the lockdowns and increased stress caused by the virus to amplify the symptoms of condition but these factors had the opposite effect and the number of participants suffering from severe IBS decreased over the course of the study. The team attributed these encouraging results to a decline in the amount of outside stress subjects were exposed to and an increased ability to avoid IBS-triggering foods provided by spending more time at home.
Prevalence in Canada
Canada has one of the highest rates of IBS in the world, according to the Canadian Digestive Health Foundation, with studies showing it affects around 18 per cent of the population (compared to a global rate of 11 per cent). It is believed the true prevalence of IBS may be even higher because symptoms can vary to the point of under-diagnosis. The condition, which often starts early in adulthood, occurs more frequently in women than men and is the second-most common reason people are forced to miss work, according to the Canadian Psychological Association. IBS has been known to resolve itself at various points in a patient’s life before returning again, years later. In addition to the heavy toll IBS can take on quality of life, it also comes at a heavy financial expense to Canada, with the total indirect economic burden on the economy exceeding $1-billion annually.
Find support for IBS
If you or someone you know suffers from irritable bowel syndrome, there are resources available online to help you better understand the condition and connect with other people who share your experience. In Canada, these include the Canadian Society of Intestinal Research, IBS Support Canada, and the Canadian Digestive Health Foundation.
Dave Yasvinski is a writer with Healthing.ca