What is IBS?
Irritable Bowel Syndrome, often shortened as IBS is a common yet painful condition of the gastrointestinal tract that severely impairs the quality of life of those affected. IBS is a group of symptoms that occur with varying duration, intensity, and severity and affect both genders with a predilection for the female gender.
Irritable bowel syndrome affects approximately 10 percent to 15 percent of the American population alone yet only 5 percent to 7 percent are actually clinically diagnosed with the syndrome. The varying presentation of the symptoms along with the heightened prevalence makes IBS a grave concern, both physically and financially. It is reported that the direct costs associated with the syndrome in the US are in the billions of dollars.
Here we talk more about IBS with Dr. Sony Sherpa, to get more insight into these diseases with the aim of understanding them further.
To understand it better, we are speaking to our Gilmore Health doctor Dr. Sony Sherpa about IBS and how it may be treated or cured, if at all.
Hello Doctor and thank you for talking to us today. Starting off, what exactly is Irritable Bowel Syndrome?
Dr. Sony Sherpa: Irritable Bowel Syndrome is a group of symptoms that are all believed to have a gastrointestinal, or gastrointestinal system-associated cause. Basically, it is a condition that affects the large intestine or the colon and may cause bloating, cramping, and pain. It is also important to mention that it is not a disease, although it is often mistaken as IBD.
Ok, so what is the difference between a syndrome and a disease or disorder?
That’s a great question. A syndrome is just the signs and symptoms associated with a similar cause, a disorder is the disturbance of normal physiological functioning of the body. A disease, on the other hand, is a pathophysiological response of the body to either external or internal stimuli.
If I understand correctly, IBS falls under both categories of disorder and syndrome?
In that case, what is the common cause of these gastrointestinal symptoms?
Well, there is no specific or exact cause for IBS. It has several causes like having an overly sensitive colon or the presence of certain genetic mutations or being under a lot of stress, which is actually one of the most common causes of IBS. In fact, childhood physical and psychosocial abuse and trauma are associated with an increased predisposition to IBS in adulthood.
That’s really interesting. Can it have a microbial etiology?
Yes, it can, actually, 10 percent of IBS cases occur after an acute gastritis infection. Such cases are aptly diagnosed as IBS-PI or postinfectious IBS.
It is a very variable disease then, isn’t it?
Yes, it is. IBS, apart from having various etiologies, also has varying symptoms and is classified accordingly. The major symptoms may be diarrhea, constipation, pain, or alternation bowel movements and habits. These types are classified as IBS-alternating bowel dominant or IBS-A, IBS-constipation dominant or IBS-C, and IBS-diarrhea dominant or IBS-D accordingly. It is important to note that it is possible for two or more of these symptoms to occur in the same case.
So it can cause both diarrhea and constipation in the same patient? How does that happen?
IBS symptoms appear as episodes and they will reappear a while after resolving. One episode may be with bouts of diarrhea and the other episode might just be constipation. However, some people experience continuous symptoms.
That can’t be pleasant. You mentioned pain with IBS, what kind of pain is associated with it?
The patient might feel abdominal cramping, bloating, gas, and abdominal pain with IBS that is often relieved by a bowel movement.
I understand. Given the vast phenotype of the condition, how does one get diagnosed with IBS?
So the initial suspicion of IBS is associated with the symptoms, especially when associated with certain triggers. After that, the physician might do certain tests like a complete blood test, stool analysis, and even a colonoscopy to rule out other potential causes of the abdominal symptoms. Then and only then can the diagnosis be made.
Interesting fact though, recently researchers found that MRI can help with the diagnosis of IBS as it can measure the changes that occur in the colon due to IBS. This is a great step forward in the understanding of IBS
Wow, that’s amazing. What do you mean by triggers?
Triggers are the causes for the episodes of IBS. The most commonly seen triggers are stress, anxiety, and certain foods. For this reason, the physician might ask the patient to keep a food diary and exclude certain foods to evaluate if it really is IBS or some other reason might be causing the symptoms.
Ok and then what happens, after the diagnosis has been made?
So it is important to know that there is currently no cure for IBS but certain therapeutic interventions can help manage the condition significantly. Dietary changes can remarkably improve the quality of life and decrease the frequency and intensity of the episodes.
Looking at the food journal and avoiding the foods that act as a trigger is one of the most important steps in the management of IBS.
If dietary changes do not work, then medications may be considered. The prescribed medications may target all the symptoms or one symptom specifically depending on the specific case of IBS. For example, laxatives may be prescribed for constipation that won’t be relieved even with the addition of high fiber foods in the diet.
Is there anything else that can be done? Any herbal remedies of the sort?
There really isn’t much that can be done for IBS apart from lifestyles and dietary changes like regular exercising decreased consumption of caffeine, spicy foods, and the addition of probiotics in the diet. Like I mentioned before, if these fail, medications must be considered.
However, peppermint oil has been found to work in the short term but more studies need to be performed before we start considering it a therapeutic option.
Similarly, IBS fasting is an option that might relieve certain symptoms of IBS while worsening other symptoms. Basically, choosing a treatment modality heavily depends on the patient and the symptoms of IBS present. It’s a long, trial and error kind of process.
That’s really interesting. Are there any researches being performed with the aim of finding a cure?
Yes, actually. Recently, researchers tried to cure IBS with fecal microbiota transplant or stool transplant, since patients with IBS have been found to have unbalanced microbial flora in the gut.
Did the research show any promising results?
Yes actually, in the study the cure rate using a stool transplant was between 36 percent to 60 percent. Further research and follow up is being performed to analyze any long term side effects. Maybe soon we might have a cure.
Hopefully so, thank you for taking the time to speak to us about IBS, I learned quite a few things today.
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