Irritable bowel syndrome: Stress to infection, common causes of IBS and effective ways to treat the condition

Irritable bowel syndrome, more commonly referred to as IBS, is a chronic condition that affects stomach and intestines and causes symptoms like cramping, bloating, abdominal pain.

The exact cause of IBS can be tricky to determine, and the gastrointestinal problem may have roots in lifestyle issues, food intolerances, changes in composition of gut bacteria, abnormalities in digestive system’s nerves among others. If you have unexplained bloating and stomach pain for an extended period of time, you must get yourself checked for irritable bowel syndrome.

Also referred to as neuro-gastrointestinal (GI) disorder, IBS occurs when there is a problem in gut-brain communication. While there is no specific treatment for irritable bowel syndrome, making appropriate changes in the lifestyle, taking measures for improving mental health, and dietary changes often do the trick, and help relieve symptoms.

“Irritable bowel syndrome (IBS) is a common condition that affects the digestive system and is characterised by abdominal pain, bloating, cramps and associated with changes in bowel movements (either diarrhoea or constipation or both). Prevalence of IBS varies from 4-7% among general population in India,” says Dr Surakshith TK, Consultant, Gastroenterology and Hepatobiliary Sciences, Fortis Escorts, Okhla Road, New Delhi.

IBS can cause either constipation or diarrhoea, and in some cases both. More common in women than men, people with IBS often report phases where the symptoms are minimal or absent and get aggravated due to triggers like stress, food or during depressive episodes.

“While the exact cause of IBS is unknown, various factors can contribute to its development. However, there are several remedies that can help alleviate symptoms and provide relief for individuals with IBS, including dietary modifications, stress management, medications, probiotics, and alternative therapies. It is important to consult with a healthcare professional to determine the most appropriate treatment plan for each individual,” says Dr Meghraj Ingle Director and Senior Consultant Gastroenterology Global Hospitals Parel Mumbai.

Symptoms of IBS
IBS symptoms are varied and depends on the cause of the disorder. At times symptoms of IBS are related to hypersensitivity of the nerves in the gastrointestinal tract or changes in imbalance between good and bad bacteria in the intestine. It is due to altered communication between the gut nerves and the brain or altered processing of signals from these nerves by the brain.

Dr Surakshith lists signs and symptoms of IBS:

• Abdominal pain or cramps, usually related to defecation.

• Excessive gas, flatulence, and bloating

• Diarrhoea or constipation or alternating between the two.

• Mucus in stools.

• Sense of incomplete evacuation even after defecation.

Types of IBS
Dr Surakshith TK says IBS can be categorised based on stools consistency.

• IBS with constipation (IBS-C): when stools are hard and lumpy.

• IBS with diarrhoea (IBS-D): when stools are loose and watery.

• IBS with mixed bowel habits (IBS-M): when both hard and lumpy bowel movements and loose and watery movements on different occasions.

Diagnosis of IBS
Dr Surakshith TK says IBS may be triggered after an intestinal infection or symptoms may also flare up during stress, certain foods or drinks, anxiety or depression.

“Diagnosis of IBS is usually made based of the history and examination. Lab investigations are usually within normal limits. However certain investigations may be needed to exclude any pathological disorders of the gastrointestinal tract like celiac disease or inflammatory bowel disorder. These tests may include colonoscopy and an endoscopy apart from basic blood investigations. IBS can also overlap with other gastrointestinal disorders,” says Dr Surakshith.

Experts say most people with IBS can find a treatment plan that works for them. Many of the treatments take time to work. They can help in decreasing the symptoms, but they can flare episodically.

Treatment or management of IBS
Dr Ingle shares that there are several remedies that can help provide relief for people with IBS, however, these remedies can vary depending on the specific symptoms experienced.

The expert shares some common remedies:

1. Dietary modifications: Identifying and avoiding trigger foods such as certain types of carbohydrates (FODMAPs), caffeine, alcohol, and spicy foods can help alleviate symptoms. Maintaining a healthy, balanced diet that includes fibre-rich foods can also help regulate bowel movements.

2. Stress management: Stress can exacerbate symptoms of IBS, so it is important to find strategies to manage stress levels. Techniques such as deep breathing exercises, yoga, meditation, and regular exercise can help reduce stress and promote overall well-being.

3. Medications: Over-the-counter medications such as antispasmodics and laxatives can provide temporary relief from symptoms. Prescription medications such as low-dose antidepressants, which can help regulate bowel movements and suppress pain signals, may also be prescribed in more severe cases.

4. Probiotics: These beneficial bacteria can help restore the natural balance of the gut microbiota, potentially improving digestion and reducing symptoms.

5. Alternative therapies: Some individuals find relief from treatments such as acupuncture, hypnotherapy, and herbal remedies. However, the effectiveness of these treatments can vary and should be discussed with a healthcare professional.

Dr Surakshith recommends the following changes in lifestyle for managing IBS well.

• Change in diet: Increasing fibre and limit dairy products like cheese and milk. Follow low FODMAP diet. Increase water intake and limit the foods that tend to cause bloating.

• Exercising regularly: Make sure to include some aerobic exercises or strength training workouts. The duration for such workouts should be 30 minutes a day, at least 5 days a week.

• Avoid stress: Yoga or meditation can help manage stress levels and thus the symptoms of the disorder.

• Medications: These may include antispasmodics, laxatives and anti-diarrhoea medications. If symptoms persist, then antidepressants and drugs that modulate pain perception may be added.