Irritable Bowel Syndrome (IBS): It may be the cause of your discomfort

Jan 14, 2024 Dr Zulfikar Bux, Features / Columnists, News, Waterfalls Magazine, Your Health Matters

---

By Dr. Zulfikar Bux, Emergency Medicine Specialist

Waterfalls Magazine – I am back! It’s been a little over a year since I did my last health column. Unfortunately, life threw me some curveballs which made it challenging for me to continue to share weekly health developments with you. However, I could not continue to ignore the many requests, so here I am today, resuming my weekly health column with the hope of sharing information that will impact your health and life in a positive way.

Today, I wish to discuss Irritable Bowel Syndrome (IBS); a condition which is often undiagnosed and causes discomfort for many. IBS affects approximately 11% of the World’s population but only about 30% of persons having symptoms, will consult with a physician for their symptoms.

Often, those affected will go years with pains and discomfort which cannot be diagnosed by testing. Patients sometimes go from physician to physician but cannot find the help they need. Data has shown that persons diagnosed with IBS are highly likely to have other functional diseases and have more surgery than the general population. However, with dietary and lifestyle changes, life with IBS can be more fruitful and comfortable.

What causes IBS?

Science has not been able to determine exactly what causes IBS. It may have something to do with over activity of part or parts of the gut within the digestive system. The cause of overactivity in parts of the gut is not clear. One or more of the following may play a part:

• Overactivity of the nerves or muscles of the gut. It is not known why this may occur. It may have something to do with overactivity of messages sent from the nervous system to the gut. Stress or emotional upset may play a role. About half of people with IBS can relate the start of symptoms to a stressful event in their lives. Symptoms tend to become worse during times of stress, depression and anxiety.
• Intolerance to certain foods may play a part in some cases. Foods such as dairy, wheat and those termed High FODMAP play a great role in this.
• Infection and germs in the gut. IBS is not caused by an ongoing gut infection. However, in some cases, the onset of symptoms seems to follow a bout of a gut infection with diarrhea and vomiting called gastroenteritis. So, perhaps a germ may sensitize or trigger the gut in some way to cause persisting symptoms of IBS.
• Oversensitivity to pain. Persons with IBS feel more pain when their gut is expanded than those without IBS. They may have a lower threshold for experiencing pain from the gut.
• Gut Microbiome. In recent years there has been increasing interest in the links between the gut microbiome, the brain and IBS. The microbiome is the combination of bacteria and viruses that are found in the gut. Patients with IBS have a different microbiome pattern to those without IBS.

 What are symptoms of IBS?

The main symptoms of IBS are abdominal pain with constipation or diarrhea along with any of the following associated symptoms:

• Changes in bowel movement patterns.
• Bloating and excess gas.
• Lower abdominal pains.
• Mucus in stools.
• Body pains and fatigue.

You are more likely to have IBS if you have these symptoms and they have lasted at least 6 months, you have had belly pain at least 3 days each month for at least 3 months, and at least two of the following are true:

• The pain is relieved by having a bowel movement.
• The pain is linked to a change in how often you have a bowel movement.
• The pain is linked to a change in the look or texture of your stool.

Because there are no structural problems in the intestines of people who have IBS, some people may think this means that the symptoms “are all in their head.” This isn’t true. The pain, discomfort, and bloating are real.

 How can IBS be managed?

 IBS can be successfully managed with treatments which are tailored to the individual; since the IBS trigger varies according to the individual. Your doctor will often recommend identifying and avoiding triggers. Treatment options may include:

• An increase in dietary fiber, together with clear fluids
• Moderating common gas-producing foods, or undertaking a diet with a trained dietician, such as a low “FODMAP” diet and avoiding dairy and wheat as much as possible.
• Anti- Diarrhea medication, such as loperamide – for those with diarrhea-predominant IBS
• Laxatives for constipation for those with constipation-predominant IBS
• Antispasmodic drugs, which may ease cramping – examples include mebeverine, hyoscine and peppermint oil or tea.
• Tricyclic antidepressants – These are effective in treating pain, bloating and bowel frequency in IBS. Use of these medications does not mean that IBS is caused by depression or anxiety.
• Psychological therapies, including cognitive behavioral therapy administered by psychologists.
• Behavioral and pelvic floor therapies. Often symptoms of IBS can be caused by inability to effectively defecate, trained pelvic floor physiotherapists can treat this effectively.
• Probiotics- There are some advocates that recommend the use of probiotic rich foods or supplements to help balance the gut microbiome in some IBS patients.

If you are one of the many that experience these unexplained symptoms, ask your doctor about IBS. Life with IBS is confusing and discomforting, but with careful planning and lifestyle adjustments, a normal and healthy life is very achievable.

---

• Dr. Zulfikar Bux, Emergency Medicine Specialist, Health, information, Irritable Bowel Syndrome (IBS)

---