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Irritable Bowel Syndrome: Symptoms and Treatment

Irritable Bowel Syndrome (also coined as IBS) is one of the most common causes of digestive pain and discomfort. It affects nearly 1 in 5 Canadians, meaning that if you have IBS, you’re not alone! Here we’ve outlined the most common symptoms of IBS, and techniques to manage it.

 

What are the symptoms of IBS?

Due to its high incidence, IBS has become normalized in our culture. But it can be a very disabling condition for patients and significantly lower their quality of life. Although symptoms of IBS can be difficult to diagnose and present differently in different people.

One reason for this is because IBS is typically a diagnosis of exclusion. Meaning it is diagnosed after all other likely conditions are ruled out, such as parasites, food allergies, celiac disease, cancer, inflammatory bowel disease, etc.  

Another reason for wide-ranging symptoms is because of the different types of IBS.

Three types of IBS: 
  1. IBS with constipation (IBS c): During flares, individuals suffer from non-frequent hard or lumpy, difficult to pass bowel movements
  2. IBS with diarrhea (IBS d): During flares, individuals suffer from frequent loose or watery, urgent bowel movements
  3. IBS with mixed bowel habits (IBS m): During flares, individuals suffer from mixed bowel movements. They may have loose or watery stools, followed by hard and lumpy stools. Or vice versa.
Common symptoms of IBS:
  • Pain and cramping in the lower abdomen/pelvis. 
  • Gas and bloating
  • Digestive discomfort after eating a meal
  • Fatigue
  • Anxiety and depression
  • Abnormal bowel movements – read about healthy bowels and poop here!

 

IBS treatments & remedies

One of the key steps in treating your IBS is to first establish a good healthcare team. Your doctor can work with you to figure out the best ways to manage your IBS symptoms, and get you back to living a carefree life. Sounds nice, right?

The best treatment plans often include a few different elements and are a result of trial and error.

Symptom-based treatments:

Antispasmodic medications: these are essentially painkillers. They are often prescribed to IBS patients to decrease chronic pain and cramping symptoms.

Anti-diarrhea agents: commonly prescribed to IBS d patients and used to prevent or relieve episodes of diarrhea. 

Anti-depressants: many tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) can reduce IBS symptoms. Many of the benefits are the result of decreased stress. While others may be due to the effects of the medications on serotonin and pain receptors in the gut. Read more on gut-mind connection.

Alternative therapies:

Exercise: can promote digestive health and decrease stress, which may reduce IBS. Exercises such as walking, cycling and yoga can reduce symptoms. 

Peppermint oil: known to be a natural antispasmodic agent, peppermint oil can help to reduce pain and relax muscles. It is effective in decreasing pain and bloating in IBS patients. 

Relaxation techniques: cognitive behavioural therapy (CBT), psychotherapy and hypnotherapy can reduce IBS pain. Meditation, acupuncture, and deep breathing can also relieve stress and prevent IBS flares.

 

IBS diet changes

Low FODMAP diet

The low FODMAP diet, pioneered by Monash University, is an effective, short-term treatment that can help decrease IBS symptoms. 

“FODMAP” is a term to describe sugars that are highly fermentable. They are found in many common foods and are notorious for causing symptoms in IBS sufferers. Hence, the low FODMAP diet! It is not a life-long or long-term diet, but rather a way for IBS sufferers to regain comfort and control.

Exclusion diet

A natural next step from the low FODMAP diet is to reintroduce foods into your diet. It is crucial to introduce foods one-by-one to note which foods trigger your IBS. 

People who don’t follow the low FODMAP diet can instead keep a food journal, where they keep track of what foods they eat. From there, they can attempt to pinpoint the foods that trigger their IBS.

Common foods to avoid with IBS are gluten, dairy, fried foods, beans, caffeine, processed foods, alcohol, garlic and onions, and cruciferous vegetables.

Fiber

Fiber is notorious for promoting regularity and good gut health. But, for those with IBS, fiber is a more complicated story.

Certain fibers are high in FODMAPS and can intensify IBS symptoms, and they should be avoided at all costs. Whereas other types of fiber can be extremely beneficial. 

Soluble fiber can be favourable in those with IBS c. It is known to “bulk” up the stool, adding volume, and making it easier to pass. Pro-tip: be sure to drink lots of water with soluble fiber. 

Holy Crap Cereals are a great source of soluble fibers and are low FODMAP at the suggested serving size. We take pride in helping people have better poops. Healthy gut, happy mind. That’s the motto!

 

How to encourage patience and self-care

IBS can be a very debilitating condition, and it is important to recognize that. Honestly, say it out loud! IBS is a DEBILITATING condition. While it is not as harsh as some diseases, IBS is a chronic condition that often lasts for many years, and it can affect many aspects of your life. Acknowledging that IBS is a major source of pain in your life can take some of the stress off of you. It can also motivate you to take action. 

Proper diagnosis can take a long time. Discovering the best set of techniques to prevent your IBS takes time too. It is a frustrating process, no question. But with IBS, and all chronic conditions, patience is key! Stress and frustration can trigger IBS flares. So, promoting acceptance and relaxation is crucial during these stages. 

While IBS may be debilitating, YOU are strong and resilient. With the right medical team, support system and habits, you can decrease your symptoms of IBS. And more importantly, you will get past it.

 




References:

Algera, J., Colomier, E., & Simrén, M. (2019). The Dietary Management of Patients with Irritable Bowel Syndrome: A Narrative Review of the Existing and Emerging Evidence. Nutrients, 11(9), 2162. https://doi.org/10.3390/nu11092162

Bellini, M., Tonarelli, S., Nagy, A. G., Pancetti, A., Costa, F., Ricchiuti, A., de Bortoli, N., Mosca, M., Marchi, S., & Rossi, A. (2020). Low FODMAP Diet: Evidence, Doubts, and Hopes. Nutrients, 12(1), 148. https://doi.org/10.3390/nu12010148

Canadian Digestive Health Foundation. Irritable Bowel Syndrome (IBS) Statistics. Retrieved from: https://cdhf.ca/digestive-disorders/irritable-bowel-syndrome-ibs/statistics/

Muir J. (2019). An Overview of Fiber and Fiber Supplements for Irritable Bowel Syndrome. Gastroenterology & hepatology, 15(7), 387–389.

Patel N, Shackelford K. Irritable Bowel Syndrome. (2020). StatPearls Publishing. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK534810/