Causes Of Ibs Symptoms
Studies show the exact causes of IBS are complex and different for every person, since many factors in someones life can affect digestion. Even when all other digestive disorders and food allergies are ruled out, and a physical blockage or structural problem of the digestion system cannot be found, IBS is still a big deal or something to take seriously. The more time you take to experiment with different factors in your life to see how they might cause your IBS symptoms, the more information you have to help you find relief.
Researchers believe that the underlying cause of IBS symptoms is abnormal functioning of the nerves, enzymes and muscles within the digestive tract. These help manage the absorption of nutrients after you eat, fluid levels, gas and the release of bowel movements.
One major factor that determines how the digestive system works is actually your stress levels and moods, since the gut is closely connected to the brain. The two actually communicate constantly via the vagus nerve so the gut can receive signals from your central nervous system that cause it to become irrigated and unpredictable. Stress and digestion are also directly related because the gut is capable of producing, or not producing, certain neurotransmitters, such as serotonin, which have important implications for how you feel.
While there is not one specific cause of IBS that applies to everyone, common factors contributing to IBS include:
Are There Different Types Of Ibs
Not everyone will experience the same IBS symptoms. There are three subtypes of IBS. While all types of IBS tend to cause abdominal pain, different subtypes of IBS will cause unique changes in your bowel habits:
IBS subtypes include:
- IBS-C : This is the most common subtype of IBS. If you have IBS-C, it probably means youâre probably experiencing infrequent bowel movements with hard and lumpy stools that are difficult to pass. â
- IBS-D : This is the second most common subtype of IBS. If you have IBS-D, it probably means youâre experiencing frequent bowel movements and loose and watery stoolsâ
- IBS-M : If you have IBS-M, it means youâre experiencing both constipation and diarrhea. If you have this subtype you may notice your bathroom habits alternate between one and the other.
How Can I Control Ibs
It may be frustrating trying to get a handle on IBS. Treatment can often be trial and error. But the good news is that nearly everyone with IBS can find a treatment that helps them.
Usually, diet and activity changes improve symptoms over time. You may need some patience as you figure out your triggers so you can take steps to avoid them. But after a few weeks or months, you should notice significant improvement in how you feel. A nutritionist can help you plan a healthy, filling diet that meets your needs.
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What Is Irritable Bowel Syndrome
IBS is a mix of belly discomfort or pain and trouble with bowel habits: either going more or less often than normal or having a different kind of stool . Doctors used to call IBS other names including:
There are four types of the condition:
- IBS with constipation
- Mixed IBS alternates between constipation and diarrhea
- Unsubtyped IBS for people who don’t fit into the above types
IBS isnât life-threatening, and it doesn’t make you more likely to get other colon conditions, such as ulcerative colitis, Crohn’s disease, or colon cancer. But it can be a long-lasting problem that changes how you live your life. People with IBS may miss work or school more often, and they may feel less able to take part in daily activities. Some people may need to change their work setting: shifting to working at home, changing hours, or even not working at all.
More Or Less Fiber May Help
The evidence for the best type and amount of fiber in the diet is conflicting.
Some people are certain that a high fiber diet helps their symptoms, whereas others find a low fiber diet is more effective.
The type of fiber supplement that has the most research completed on it is psyllium husk .
Psyllium husk is a soluble fiber, meaning that it dissolves in water.
It soaks up water like a sponge to add bulk to loose stools, but also softens hard stools to help them pass easier.
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Putting It All Together
- Brain imaging shows that people with IBS feel more pain than other people
- Sensations travel from the gut through the spinal column to the brain where they are felt as pain.
- The brain can modify the sensation of pain, either increasing or decreasing it
- Therapy and medications can help reduce or prevent the pain from IBS
- Strong painkillers like opioids should not be used for pain in IBS in fact, they might increase pain.
- Neurogastroenterologists or primary care doctors who know how to work with chronic pain are the best to help treat IBS pain
Adapted from IFFGD Publication #274 Understanding and Managing Pain in IBS by Douglas A. Drossman, M.D., Center for Education and Practice of Biopsychosocial Care, Center for Functional GI and Motility Disorders at UNC, and Drossman Gastroenterology, Chapel Hill, NC. Adapted by Abigale Miller
For healthcare providersHere is a video of a presentation by Douglas A. Drossman delivered at the UCLA GI Week 2016 on the topic, State of the Art Lecture: Understanding and Management of Patients with Chronic Abdominal Pain and Narcotic Bowel Syndrome.
AcknowledgmentWe are grateful to The Allergan Foundation for a health and human services educational grant in support of this publication.
How To Prevent An Attack
Understanding how to prevent an IBS attack can help you cope with this condition. Here are a few tips to reduce the frequency of an attack:
- Increase physical activity to regulate intestinal contractions and ease constipation. Exercise for at least 30 minutes 3 days per week.
- Eat at the same time every day to help regulate bowel function.
- Keep a food journal to identify trigger foods.
- Slowly increase your fiber intake to ease constipation. Too much fiber can cause diarrhea.
- You may also wish to try probiotics. Increasing the good bacteria in your digestive tract may relieve symptoms of IBS. Take probiotics as a supplement or eat yogurt containing probiotics.
- Drink peppermint tea or take peppermint supplements to ease intestinal spasms.
- Learn how to manage stress. Practice yoga, meditation, or mindfulness, or find enjoyable activities to minimize stress and anxiety.
- Try out acupuncture. This complementary therapy might relieve IBS symptoms.
- Consult a hypnotherapist and learn ways to relax your abdominal muscles. This may reduce symptoms of an IBS attack.
- Explore your thinking patterns through cognitive behavioral therapy. This technique teaches you how to replace negative thought patterns with positive ones.
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Psyllium Powder For Added Fiber
If your IBS symptoms persist even after you change your dietary patterns, consider taking psyllium powder, which is soluble fiber and the active ingredient in the fiber supplementMetamucil. The ACG strongly recommends soluble fiber to treat IBS in their latest guidelines.
There is a moderate quality of evidence for psyllium for overall symptoms relief, says Kara Gross Margolis, MD, a pediatric gastroenterologist at Columbia University Medical Center and NewYork-Presbyterian Morgan Stanley Children’s Hospital in New York City.
According to a review published in March 2021 in Current Opinion in Gastroenterology, psyllium supplementation is recommended to help treat IBS-C and IBS-D. Stir a teaspoon of psyllium powder into your morning oatmeal or into a glass of water, and down the hatch.
If youre constipated, psyllium powder helps move your bowels. If you have diarrhea, psyllium powder gives you something to form a bowel movement around, Dr. Powell says.
Understanding Pain In Ibs
Chronic abdominal pain in IBS is not associated with structural damage, like ulcers, but the pain is just as real. The sensation starts in the gut and then travels to the brain, which interprets the sensation as pain. The pain is not related to obvious damage in the body, like a broken bone.
Brain imaging shows that people with IBS feel more pain for a certain level of stress than other people. Those with IBS are hypersensitive they have an increased response that makes a stimulus feel more painful. They may experience pain from sensations that other people dont think are painful or have more severe pain than others .
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What Is The Outlook For Ibs
IBS usually causes symptoms long-term and often stays with you for the rest of your life. However, the symptoms tend to come and go. You may have long spells without any symptoms, or may have only mild symptoms. Treatment can often help to ease symptoms when they flare up. IBS often improves with time and, in some cases, symptoms clear up for good at some stage.
Try The Failsafe Diet
The FAILSAFE diet is an alternative diet therapy that can be considered when the low FODMAP diet doesnt provide good symptom relief.
Its another type of elimination diet that aims to identify a sensitivity to particular natural food chemicals and artificial food additives.
Similar to the low FODMAP diet, there are two main phases that involve an elimination phase to confirm a reaction, followed by a reintroduction process.
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When To See A Doctor
Still not feeling relief? It might be time to consult a healthcare professional. While at-home treatments can provide effective and long-term relief, a professional opinion can help you maintain better gut health.
If you experience any of the symptoms listed below, make sure you see a healthcare professional immediately. These symptoms may suggest you have a condition other than IBS that cannot be treated at home.
- Heart palpitations
How Long Does An Ibs Flare
IBS flare up duration is different for everyone. Most people’s IBS symptoms will flare-up for 2-4 days, after which your symptoms may lower in severity or disappear completely. Many people experience IBS in waves, in which symptoms may come and go over several days or weeks.IBS attacks can be managed to reduce symptoms or shorten duration using several management techniques .
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Mindfulness For Stress Relief
Reducing stress with breathing exercises and mindfulness may also help calm down the gut nerves that are misfiring. The ACGs guidelines recommend various mindfulness techniques that have the potential to improve IBS symptoms. A study published in September 2020 in the journal Neurogastroenterology and Motility found that after an eight-week mindfulness-based stress reduction practice, more than 70 percent of the participants in the study reported improved IBS symptoms. The reduction in severity also continued for three months after the eight weeks of the study.
I recommend 5-5-5 to my patients, Powell says. That is, smell the roses by inhaling through your nose for a count of five. Hold that breath for five counts, then exhale through your mouth for a count of five or longer, as if you are blowing out candles on your birthday cake. This breathing technique is very calming to the autonomic nervous system, which can help with IBS, she adds. Best of all, its portable. You can do it anywhere, such as when youre waiting in your car at a stoplight.
What Are Foods To Avoid With Ibs
Managing your diet when you have IBS may take a little extra time but is often worth the effort. Modifying amounts or eliminating certain foods such as dairy, fried foods, indigestible sugars, and beans may help to reduce different symptoms.
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Ibs Treatment And Home Care
Nearly all people with IBS can get help, but no single treatment works for everyone. You and your doctor will need to work together to find the right treatment plan to manage your symptoms.
Many things can trigger IBS symptoms, including certain foods, medicines, the presence of gas or stool, and emotional stress. Youâll need to learn what your triggers are. You may need to make some lifestyle changes and take medication.
Diet and lifestyle changes
Usually, with a few basic changes in diet and activities, IBS will improve over time. Here are some tips to help ease symptoms:
- Learn to relax, either by getting more exercise or by reducing stress in your life.
- Limit how much milk or cheese you eat.
- Eat smaller meals more often instead of big meals.
- Keep a record of the foods you eat so you can figure out which foods bring on bouts of IBS.
Common food “triggers” are red peppers, green onions, red wine, wheat, and cow’s milk. If you’re concerned about getting enough calcium, you can try to get it from other foods, like broccoli, spinach, turnip greens, tofu, yogurt, sardines, salmon with bones, calcium-fortified orange juice and breads, or calcium supplements.
Your doctor may suggest you try something called a low FODMAP diet that cuts down on hard-to-digest carbs such as wheat, beans, and certain fruits and vegetables.
The following types of drugs are used to treat IBS:
Other treatments can help with symptoms of IBS:
Belly pain and bloating
Common Medical Treatments For Ibs
Since the exact cause of IBS is not known, the goal of treatment is to reduce symptoms. If diet and lifestyle changes donât improve your symptoms, your healthcare provider may recommend IBS medications. Some common medications include:
- IBS medications: Some medications can help with IBS by either slowing the movement of material through the bowel to reduce diarrhea or by increasing fluid production in the small intestine to reduce constipation. Alosetron or Lubiprostone are two common IBS medications.
- Antispasmodics: These are designed to relax the smooth muscles of the colon to ease cramping and spasms. Two such medications are hyoscine and dicyclomine . They may cause side effects that include dry mouth, palpitations, and difficulty urinating.
- Antidiarrheals: These medications can be useful in treating severe diarrhea. But they should be taken with cautionâ antidiarrheals may have side effects such as nausea and vomiting and should be taken under close supervision. Loperamide is an example of an Antidiarrheal medication.
- Antidepressant medications: Certain antidepressants can help relieve diarrhea and constipation and may treat pain in IBS. They are often prescribed in lower doses for IBS than for depression. Antidepressants for IBS should be taken under supervision as side effects can include insomnia, nausea, and weight gain or loss. Some tricyclic antidepressants used for IBS include imipramine and selective serotonin reuptake inhibitors such as citalopram .
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Whether You’re Experiencing Diarrhea Constipation Or A Mix Of Both Get Relief From Irritable Bowel Syndrome With These Research
Irritable bowel syndrome, or IBS, is a collection of symptoms that can include cramping, abdominal pain, bloating, and changes in your bowel movements. Those changes could mean having diarrhea , constipation , or a mix of both . IBS is pretty common, with about 12% of people in the US believed to have it. And its a condition that women are up to two times more likely to develop than men. While IBS doesnt harm the intestines, it can cause a lot of discomfort. Thankfully, there are effective treatments available, including diet and lifestyle changes, that can help control symptoms.
Slowly Increase Your Fiber Intake
Many people with IBS are unnecessarily afraid of fiber. They fear that it will make their symptoms worse. Dietary fiber, which can be found in fruits, vegetables, and grains, is actually essential to keep your digestive system working at its best.
The ACG recommends increasing your intake of soluble but not insoluble fiber.Soluble fiber dissolves easily in water, while insoluble fiber does not. Common sources of soluble fiber include oats, peas, apples, beans, and citrus fruits.
For people with sensitive digestive systems, like those with IBS, it is important to increase fiber intake very slowly so that your colon has time to adjust.
When it comes to fiber, there are two more things to keep in mind. First, beware of bran. Many people with IBS say it irritates their systems. Second, when boosting your fiber intake, it may help to start with low-FODMAP fruits and vegetables, and those high in soluble fiber.
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Why Do Doctors Say Ibs Has No Cure
Conventional medicine does not know how to classify or discuss diseases that can start from completely separate causes. Because the exact same IBS symptoms can be triggered by a dozen different root causes, there is not one single treatment for IBS there are a dozen.
With a dozen IBS treatments that work in different IBS patients, conventional doctors say there is no cure.
Its the same with hypothyroidism, which can be triggered by several different underlying causes. Since there are multiple treatments for hypothoyroid patients with the same diagnosis, conventional doctors say there is no cure for hypothyroidism.
Physical And Behavioural Therapies
Pelvic floor dysfunction is underdiagnosed among patients with irritable bowel syndrome, especially those with the constipation subtype.32 These patients either fail to relax the pelvic floor or paradoxically contract the pelvic floor muscles causing obstructed defaecation.33 Through a technique referred to as biofeedback, physiotherapists with expertise can retrain patients to use their pelvic floor muscles appropriately. Patients are given visual or tactile awareness of involuntary bowel function in order to learn voluntary control.34 Behavioural aspects that contribute to symptoms such as incorrect toileting posture, prolonged time spent in the toilet and the use of inappropriate cues to trigger the need to defecate are also addressed with exercises and biofeedback.35 Selecting patients for this therapy is best determined by specialists with expertise in the diagnosis of irritable bowel syndrome.
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