By Vishal Mehta, BPharm, RPh
IBS or irritable bowel syndrome is a disorder of the intestine that affects nearly 18% of Canadians. There is a problem with the movement of digested food through the intestine and how the brain interprets signals from the intestinal nerves, which leads to changes in bowel patterns and other symptoms. Although not life-threatening, IBS can be quite debilitating, disruptive and embarrassing. More than 70% of those affected with IBS have symptoms that interfere with everyday life.
There are three main types of IBS: IBS-C (with predominant constipation), IBS-D (with predominant diarrhea) and IBS-M (with both constipation and diarrhea). Signs and symptoms include abdominal pain, abnormal stool frequency, urgency, cramps and bloating. The characteristic sign of IBS is abdominal pain, along with associated predominant symptoms of either constipation or diarrhea, or both. The pain can be severe and at times go away completely.
The exact cause of IBS remains unknown. It is possible to develop symptoms following a gastrointestinal infection, food poisoning, traveller’s diarrhea or after surgery. Sometimes, a change in the balance of intestinal bacteria, or antibiotic use or starting a new medication can cause symptoms. Risk factors include age, gender and family history of IBS.
Treatment options depend on the type and severity of the symptoms. In most cases, simple diet or lifestyle changes can provide relief. Medications (either over-the-counter or prescription) target the dominant symptom. For constipation, osmotic laxatives or bulk-forming laxatives can be used. Stool softeners, either alone or in combination with a laxative are also a good choice.
For diarrhea-dominant cases, probiotics, fibre or diet enzymes such as Beano can be used.
Stress is one factor that can trigger symptoms or make them harder to manage. Diet, sleep, exercise and social connections are important, too. Studies show that mindfulness can increase both attention and emotional regulation, which in turn can have a positive impact on IBS and physical health.
Changing what’s on the menu is another key tool for people to manage IBS. The FODMAP diet developed by researchers at Monash University has gained the most attention from scientists. According to the National Library of Medicine, studies show anywhere between 52% to 86% of participants report significant improvement in their symptoms after following the diet, including reduced gas and bloating.