IBS is a condition of the gastrointestinal tract that consists of a cluster of symptoms that have not been attributed to any other cause. There is no one specific study to identify IBS, however the diagnosis is typically made based on exclusion of other diseases. Symptoms often include abdominal pain, altered bowel habits, bloating and gas, and feelings of poor digestion.

IBS one of the most commonly diagnosed conditions in gastroenterology, but unfortunately continues to be undermanaged for many patients. This is likely due to the fact that an exact cause for IBS remains unclear. However there is evidence that a variety of factors can contribute. These factors may include diet and food intolerances, stress, G.I. motility, intestinal inflammation, the condition of the microbiome, prior infections, and genetics.

A person’s quality of life can be greatly affected by symptoms of IBS. They can find it challenging to enjoy a meal at a restaurant, find themselves in pain when under increased stress, or have uncontrolled diarrhea resulting in missed work. Many patients have come to the conclusion that there is no treatment for IBS and they will be at the mercy of their G.I. symptoms for the rest of their lives.
This post is to help shed some light on IBS management and what we have to offer at VNPS.

DIET: 

Dietary management of IBS can play a big role in a symptom control. Eliminating many foods that can be irritating to the bowels are typically recommended. Low FODMAP (fermentable oligosaccharides disaccharides monosaccharides and polyols) diet is one dietary approach that is often implemented. This aims to reduce the fermentable short chain carbohydrates that can be irritating to the gut and contribute to pain and inflammation.

John Hopkins Medicine has a simple outline of a low FODMAP diet here: https://www.hopkinsmedicine.org/health/wellness-and-prevention/fodmap-diet-what-you-need-to-know

STRESS:

One of the most common complaints I get for IBS patients is that their symptoms are significantly worse when under stress. Uncontrolled stress can contribute to depression, anxiety, and chronic disease. Often times psychiatric illness is accompanied by IBS. Stress management is paramount for IBS management. Implementing effective coping skills can have a big impact on IBS control.

ALTERED BOWEL HABITS:

IBS typically will be accompanied by abnormal bowel habits. This can include constipation, diarrhea, or mixed constipation and diarrhea. In my professional experience I have found that constipation is the predominant bowel condition accompanied with IBS. People may report loose stools, but fail to understand that this too can be a component of the constipation process. When the colon is full of stool it becomes distended and that can contribute to pain and bloating. Loose stools can be due to an overflow phenomenon in which the stool burden within the colon is large but the person is only able to pass the looser stools that seep around the hard retained stool. Working on accurately identifying the bowel habits and addressing those habits appropriately can really improve IBS symptoms. We have a variety of medications that can help to improve bowel frequency.

MICROBIOME:

This refers to the collection of microorganisms that live in the gut. There is a growing body of evidence identifying the importance of the microbiome and its impact on our overall health. Alterations in the gut microorganisms can positively or negatively affect IBS. The gut microbes are sensitive to diet, antimicrobial use, and stress. Finding ways to improve the health status of the gut microbiome can help IBS. Pre-biotics (such as fiber), probiotics, in the form of probiotic rich foods or supplements, and careful use of antibiotics can help to rebalance the gut microbiome.

VISCERAL HYPERSENSITIVITY:

Here is the pain component of IBS. The perception of pain within the G.I. tract can be affected by all the factors previously mentioned. Removing irritating foods from the diet, addressing stress, and improving bowel habits can be very helpful in reducing gut pain. In addition, there are a variety of non-narcotic medications that can assist in improving pain. Antispasmodics and antidepressants that can help to target gut pain are available.

IBS management will often require trial and error to find what will be most helpful for you. This isn’t a one size fits all approach. You will need patience and an open mind but it will be worth it in the end. If you would like more assistance in managing IBS, feel free to make an appointment with an experienced GI NP at VNPS.