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  • Alexandra Inman, RD

All About Irritable Bowel Syndrome (IBS)

Updated: Nov 21, 2022

Irritable Bowel Syndrome, or IBS, is a common functional gastrointestinal disorder that affects up to 20% of Canadians. IBS is considered a chronic condition, as treatment is focused on management of symptoms.

The key symptoms of IBS are:

  1. abdominal pain

  2. altered bowel habits (e.g. constipation, diarrhea, or a mixture of both)

Other symptoms can include:

  • bloating

  • abdominal distension

  • gas

  • urgency to defecate

  • fatigue

IBS symptoms vary greatly from person to person!

Symptoms of IBS can improve or worsen over time, sometimes they can disappear altogether only to reappear later or new symptoms develop! This can be incredibly frustrating for people with IBS, as they may feel that there is nothing they can do to improve their symptoms... or even what helped them before, is making things worse now. That's why working with a dietitian who focuses on digestive disorders, such as IBS, is so important.

Irritable Bowel Syndrome should not be self-diagnosed.

People should work with their primary care provider to rule out other possible causes of their unpleasant digestive symptoms, such as celiac disease, inflammatory bowel diseases, or endometriosis. Diagnosing IBS will include a review of your medical history, physical exam, and/or investigative tests such as blood tests, stool samples, or a scope (e.g. colonoscopy or gastroscopy).

Unreliable tests for IBS that should be avoided (they are not helpful in diagnosis - save your time and money!), include:

  • Breath tests

  • IgG food intolerance tests

  • Fecal microbiota testing

There are certain 'red flag' symptoms that are very important to share with your primary care provider, if you have them:

  • Blood in the stool

  • Anemia

  • Unintended weight loss

  • Fever

  • Vomiting

  • Symptoms that are severe or getting progressively worse

  • Daily diarrhea

  • Nocturnal bowel movements

  • Family history of other bowel diseases or bowel cancers

These 'red flag' symptoms can also be present in more serious bowel conditions, such as celiac disease or inflammatory bowel diseases. That is why it is important to share with your primary care provider if you are experiencing them.

So what causes IBS?

The short answer is: we don't really know. There are many theories about what causes IBS, but the most likely explanation is that it is probably multifactorial. Some of these factors may include (in no particular order):

  • Gut hypersensitivity

  • Altered gut motility and/or gut secretions

  • Bacterial dysbiosis (an imbalance of "good" vs. "bad" bacteria in the gut)

  • Physical or emotional stress

  • Food allergies or sensitivities

  • Poor dietary habits

  • Use of systemic antibiotics for infection

  • Bile acid malabsorption

  • Acute infection or inflammation of the gut or 'leaky gut' (e.g. after traveller's diarrhea)

  • Physical exercise

  • Chronic alcohol use

  • Pelvic floor disorders

Many menstruating people may notice that their IBS symptoms change throughout their menstrual cycle. This is likely due to changing hormones throughout the menstrual cycle that affect gut transit time, or how long it takes food to move through the gut.

IBS treatment focuses on symptom management, and can include:

  • Pelvic floor physiotherapy

  • Medications

  • Supplements

  • Psychological therapies (such as cognitive behavioural therapy [CBT] and hypnotherapy)

  • Lifestyle & diet changes (such as the low FODMAP diet)

There is a lot of information out there about IBS that can unfortunately be overwhelming and confusing. If you want an evidence-based treatment approach to your health and nutrition, book an appointment with Alex today.

Questions? Comment below!


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