IBS Awareness Month: How to keep symptoms at bay

S. Bashar Almadani, MD, MPH ProMedica Physicians Digestive Healthcare

        April is Irritable Bowel Syndrome Awareness Month. While irritable bowel syndrome (IBS) is not talked about often, it is one of the most common disorders seen by doctors. According to the American College of Gastroenterology, it is thought that nearly 10-15% of the population has IBS, but only about 5% of people in the United States have received a clinical diagnosis.
        What is it?
        IBS is a common disorder that affects the stomach and intestines. It is characterized by persistent and recurring gastrointestinal (GI) symptoms. Most people who have IBS will have no significant abnormalities noted on imaging tests, endoscopy, blood work or stool testing. IBS is the result of abnormal functioning of the GI tract and neurologic communication between the GI tract and the brain. In other words, it is a disorder of gut-brain interaction.
        For those with IBS, there is a problem with the wiring between the gut and the brain, also known as the gut-brain axis, resulting in overactive nerves sending inappropriate signals of pain and discomfort, sometimes leading to abnormal movement of the bowels. This can lead to abdominal pain, bloating, gas, cramping and diarrhea or constipation or a mix of both. It is important to know that IBS does not cause changes in the lining of the bowel or increase the risk of GI-related cancers.
        What causes it
        The exact cause of IBS is not clear. One theory is that infection may trigger hypersensitivity. Another is that nerve signaling is more sensitized due to underlying anxiety and stress. There is no strong evidence that food intolerances lead to IBS, though symptoms of food intolerance can mimic IBS.
        Keep symptoms at bay
        IBS is often a chronic condition that may wax or wane in intensity over time, but typically does not completely resolve. Learning to cope with the symptoms is a vital part of managing the disorder.
        Medications often used for anxiety and depression can be used in low doses to help with the nerve pain. Examples of these include tricyclic antidepressants or serotonin reuptake inhibitors. They can also help to decrease pain perception, improve mood and help with disturbed sleep patterns.
        Given the role that stress and environmental factors have in IBS, psychological treatment can be very helpful in managing symptoms.
        Dietary modification is another key tool in keeping symptoms in check. A food elimination diet can help to identify whether certain foods exacerbate symptoms. An elimination diet should only be done under the guidance of a doctor or nutritionist so important nutrients are not missed from the diet.
        Achieving symptom-free relief is often not possible, and one should have a more realistic goal of improving quality of life and function to a manageable level.
        Seeking a diagnosis
        There are many misconceptions regarding IBS in society and on the internet. Misleading information can be more harmful than good. If one suspects he or she may have IBS, a primary care provider is a great place to start. They can provide a referral to a gastroenterologist for further evaluation if needed.


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