Irritable Bowel Syndrome (IBS)
What is Irritable Bowel Syndrome?
Irritable Bowel Syndrome (IBS) affects up to 15% of the adult population in the United States and occurs twice as often in women than men according to the National Institute of Digestive Diseases. IBS is a chronic functional gastrointestinal disorder with symptoms that can be painful and sometimes debilitating. Functional GI disorders happen when your GI tract behaves in an abnormal way without evidence of damage due to a disease.
There are four types of IBS classifications: IBS with constipation (IBS-C), IBS with diarrhea (IBS-D), Mixed IBS (IBS-M) and Unsubtyped IBS (IBS-U). Stool consistency dictates the classification and the various types of IBS have different treatment recommendations.
What causes IBS?
The specific causes of IBS are unknown, and there are many things that can create IBS symptoms. Those with IBS often develop heightened sensitivity in their intestines and altered motility. Then when they produce gas this causes a distention of the intestine, which can produce bloating pain. The altered motility can cause constipation or diarrhea.
Small intestinal bacterial overgrowth (SIBO) can be a disruptive contributor in causing your GI tract to behave in an abnormal manner. SIBO is an overgrowth of bacteria in the small intestine, which is an area that should be relatively sterile. SIBO can be triggered by an event, like stress, certain foods, antibiotics or different medications. Once the excess bacteria build up in the small intestine they feed off the foods we eat and use the carbohydrates as fuel. The bacteria in the small bowel then create excess gas that leads to painful bloating and possibly a change in bowel habits as well.
New medications and other treatments are being developed and tested, so doctors are hopeful that better remedies will be available for their IBS patients in the near future.
The symptoms of IBS can occur frequently or on an occasional basis. The most common symptoms of those that suffer from IBS are:
How is IBS Diagnosed?
Diagnosis depends on a detailed medical history and physical exam. Other more serious conditions such as Crohn’s disease, Ulcerative colitis, colon cancer, peptic ulcer disease, celiac disease, etc. have to be excluded. Your Dallas gastroenterologist might want to do additional testing and procedures in order to ensure the correct diagnosis.
These may include:
- Imaging studies such as ultrasound or Computerized Tomography (CT) Scans
- Blood Tests
Once a diagnosis is made, your Gastroenterologist will be able to treat accordingly with the correct medication or treatment regimen in order for you to live an active, healthy lifestyle.
Treatment Options for IBS
If you suffer from IBS, I encourage you to work with your doctor on a treatment regimen that is best suited for your symptoms. While IBS symptoms can be frustrating, the good news is that IBS does not cause permanent harm to the intestines and does not lead to intestinal bleeding or to a life-threatening disease such as cancer.
IBS Dietary and Lifestyle Recommendations
Since those with IBS tend to have different reactions to certain types of foods, it is often recommended to try various dietary & lifestyle regiments to counteract IBS symptoms. I’ll provide an overview of the most common food and beverage triggers that should be considered when developing dietary changes along with lifestyle choices to consider changing and you should consult with your doctor on the best choices given your specific symptoms. Also, keeping a diary is a good way to track how your body reacts to different foods & beverages, and allows your doctor to have more information to help you make the best choices.
Foods and beverages that commonly trigger IBS symptoms:
- Milk products
- High fat foods
- Gas producing foods (e.g. beans)
- Spicy foods
Going gluten-free is a popular choice now, but if you are not gluten intolerant it may not be beneficial to eliminate gluten from your diet. I encourage you to have a discussion with your doctor, before deciding that a gluten-free diet is a good option for you.
Lifestyle changes to help manage IBS symptoms:
- Reduce stress
- Relaxation techniques (e.g. deep breathing exercises, yoga)
- Keep hydrated
- Stay active
- Get enough sleep
Medications for IBS
In the past prescription medication options for IBS have been limited, but this is rapidly changing with new medications getting FDA approval and several more drugs in various stages of development. The most common drugs that I use for my IBS patients are Amitiza, Linzess, Xifaxan, Hyocyamine, Dicyclomine, Donnatol, Glycolax, Viberzi, Atrantil, IBGard, Align. Some of these drug options treat specific types of IBS (e.g. IBS-C), so they are not typically a universal solution for all IBS patients. Your physician will discuss the drug options that are best suited for your specific IBS symptoms.
Natural IBS Treatment Options
Alternative treatments for IBS usually are not the first choices from gastroenterologists, but some patients prefer them so I thought it would be important to mention some of the popular remedies. Common natural choices for IBS relief are various oils, probiotics, herbs and digestive enzymes. The thought is that these natural options may improve the overall digestive health by calming the intestines and potentially reducing abdominal pain.
A new natural treatment option for those suffering from IBS symptoms is Atrantil. This is an over the counter supplement that was developed by my partner Dr. Kenneth Brown. Atrantil is different than other treatment options, since it focuses on removing bacteria from the small bowel where it does not belong. If you have an overgrowth of bacteria in your small bowel (SIBO), this can cause symptoms like bloating, stomach pain and a change in bowel habits. While Atrantil still needs more data to prove its efficacy, the initial results are very promising.
It is important to remember that just because natural treatment options are available over the counter, this does not mean that they are always safe. It is essential that you speak with your doctor before trying any herbal supplement to make sure that the herb in question will not negatively affect any medication you are taking or any other health problem that you may have.