Learning to Live with IBS

    Symptoms, Risks, and solutions for Irritable Bowel Syndrome

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    The holiday season – from Halloween through New Year’s – can serve up a bellyful of digestive distress for people with irritable bowel syndrome (IBS). Holiday stress combined with high-fat and high-carb seasonal treats can worsen IBS symptoms. Most people with IBS have strong colon contractions, leading to uncomfortable symptoms when fatty foods hit the small intestine. Luckily, a few simple steps can help those with IBS quiet digestive uproars while savoring the season.

    What is IBS?

    A common disorder that affects the large intestine, IBS is a chronic condition, which can fluctuate from producing mild to severe symptoms — and sometimes symptoms disappear completely. Symptoms include cramping, abdominal pain, bloating, gas, diarrhea, and constipation. While as many as one in five American adults has symptoms of IBS, fewer than 20 percent of those who suffer seek medical help. Often, people feel embarrassed discussing the symptoms.

    Fortunately, IBS does not cause changes in bowel tissue or increase your risk of colorectal cancer. In most cases, you can successfully control mild symptoms of IBS by learning to manage stress and making healthy changes to your diet and lifestyle. This includes exercising regularly, drinking plenty of fluids, and getting enough sleep. Your healthcare provider may prescribe other specific dietary changes, medications, and supplementary treatments.

    When to See a Doctor

    See your doctor if you have a persistent change in bowel habits or other symptoms that may indicate a more serious condition, such as colon cancer. More serious signs and symptoms include the following: weight loss, diarrhea at night, rectal bleeding, iron deficiency anemia, and persistent pain that is not relieved by passing gas or having a bowel movement.

    What are the Causes?

    IBS is a functional problem and the precise cause is not known. There are five factors that may play a role:

    1. Muscle contractions in the intestine. When contractions are stronger and last longer than normal, the result can be gas, pain, bloating, and diarrhea. Conversely, weak intestinal contractions can slow food passage and lead to hard, dry stools.

    2. Nervous system. Abnormalities in the nerves in your digestive system may cause you to experience greater than normal discomfort when your abdomen stretches from gas or stool. This is called visceral hypersensitivity.

    3. Inflammation in the intestines. Some people with IBS have an increased number of immune-system cells in their intestines.

    4. Severe infection. IBS can develop after a severe bout of diarrhea caused by bacteria or a virus.

    5. Changes in bacteria in the gut (microflora). Microflora are the good bacteria that reside in the intestines and play a key role in health. Research indicates that microflora in people with IBS might differ from microflora in healthy people.

    What Triggers IBS?

    Symptoms of IBS can be triggered by food, stress, and hormones. A true food allergy rarely causes IBS, but many people have worse IBS symptoms when they eat or drink certain foods or beverages, including wheat, dairy products, citrus fruits, beans, cabbage, milk, and carbonated drinks. Most people with IBS experience worse or more frequent signs and symptoms during times of increased stress. While stress may aggravate symptoms, it doesn’t cause them. Lastly, hormones are a major factor for women, who are twice as likely as men to have IBS. Consequently, many women find that signs and symptoms of IBS are worse during or around their periods.

    How About Risk Factors?

    You are more likely to have IBS if you are young, as IBS occurs more frequently in people under age fifty; if you are female, as estrogen therapy before or after menopause also is a risk factor for IBS; if you have a family history of IBS; or if you have a mental health problem, such as anxiety, depression, history of sexual, physical, or emotional abuse, and other mental health issues.

    Stress Prevention and Diet May Improve Quality of Life 

    Finding ways to deal with stress may help prevent or ease symptoms of IBS. Regarding diet, you may need to change what you eat for several weeks to see if your symptoms improve. Here are three recommendations:

    1. Eat more fiber.  The 2015-2020 Dietary Guidelines for Americans (health.gov) recommend that adults get twenty-two to thirty-four grams of fiber a day. Two types of fiber are soluble fiber, which is found in beans, fruit, and oat products, and insoluble fiber, which is found in whole-grain products and vegetables. Research suggests that soluble fiber is more helpful in relieving IBS symptoms. Adding fiber to your diet slowly, by two to three grams a day, may help prevent gas and bloating.

    2. Avoid gluten. You may try avoiding foods that contain gluten – a protein found in wheat, barley, and rye – to see if your IBS symptoms improve. Foods that contain gluten include most cereals, grains, and pastas, as well as many processed foods.

    3. Try a low FODMAP diet. Your doctor may recommend that you try a low FODMAP diet to reduce or avoid certain foods that contain carbohydrates that are hard to digest. These carbohydrates are called FODMAPs (an acronym, derived from fermentable oligo-, di-, mono-saccharides and polyols) and they are poorly absorbed in the small intestine. For diet suggestions, visit ibsdiets.org.

    The good news about IBS is while it can impact your quality of life, in most cases, it is within your power to control symptoms by making changes to your diet and learning to manage stress.