IBS: awful, embarrassing, painful. It’s not fun and I’m sure many of you reading this post know all about what it’s like to be plagued by IBS symptoms.
For those that aren’t familiar with IBS, let’s take a little moment to crack the basics. IBS stands for Irritable Bowel Syndrome and is a common condition of the digestive system. IBS is a functional disorder which means there is a problem with the function of the gut, yet on medical inspection all parts of the gut look normal. IBS causes a number of symptoms and can affect anyone, at any age, but most commonly first announces itself in young adults and teenagers.
Your gut has the job of processing food from the stomach. Your small intestine has the task of absorbing nutrients from food and passing undigested food onto the large intestine. Your large intestine then turns the waste products into faeces and well … you know the rest.
When the bowel is working normally, food is moved along the intestines through muscular contractions (known as peristalsis). But when someone has IBS, it usually means his or her body has lost control over the coordination of these muscular contractions.
Many people with IBS have increased sensitivity to external factors such as stress, affecting the gut, which indicates that IBS is often the complex product of both psychological and physical factors. Digestive disorders often have a diverse range of symptoms, because a digestive disorder can affect the gut anywhere from the mouth right down to, well, the bottom! You can see why I have no qualms talking about stool quality and other such topics considered unbecoming — ha!
Causes and Symptoms
Like endometriosis and PCOS, the exact cause of IBS is unknown (isn’t that great, the cause of the three big disorders I’ve lived with for the past 10+ years is still not known — medical mystery!). However, most experts agree it is related to an increased sensitivity of the entire gut. Occasionally this can be linked to a prior food-related issue, however, it also may be caused by a change in your body’s ability to move food through your digestive system or from an increased sensitivity to pain that stems from your gut. Another common theory is that sufferers of IBS have abnormalities in their gut flora resulting in inflammation and altered bowel function. I guess the jury is still out on the causes.
Several other conditions may present themselves as IBS, such as coeliac disease, fructose malabsorption, infections including parasitic infections (such as giardia), inflammatory bowel diseases, bile acid malabsorption, chronic functional abdominal pain, small intestinal bacterial overgrowth and functional chronic constipation.
There is no specific lab or imaging test that will diagnose IBS. It simply involves excluding conditions that produce IBS-like symptoms, and then following a procedure to categorize the patient’s symptoms. I remember this well, going through all those painful camera tests to rule out one thing or another. I was lucky my doctors were on to it though, as IBS patients are at risk of being given unnecessary and inappropriate surgeries such as appendectomy, cholecystectomy and hysterectomy (!!) due to misdiagnosis of their IBS.
The symptoms of IBS come and go and are usually worse after eating. When symptoms flare up, they tend to stick around for two to four days, at which point the symptoms will improve but not disappear completely. The most common symptoms are:
- abdominal pain and cramping
- constipation, diarrhoea or sometimes both
- bloating and swelling of your abdomen
- an urgent need for the toilet (as in, I need a toilet now now NOW!)
- feeling that you need to go again — even though you’ve just been
- feeling like you haven’t fully emptied your bowels
- passing mucus
- depression and anxiety, due to the embarrassment, pain, and discomfort this condition brings
There are three main patterns of bowel symptoms associated with IBS:
- IBS with diarrhoea – repeated periods of diarrhoea
- IBS with constipation – repeated periods of constipation
- IBS mixed – repeated periods of both diarrhoea and constipation
You can switch from one to the other, or go long periods with few or no symptoms at all, which can become very difficult when trying to make a diagnosis!
Similar again to PCOS and Endometriosis (still think they’re not all connected? Eh?) there is no cure for IBS. You literally have to manage the syndrome and the subsequent symptoms via your diet and lifestyle.
Medications can occasionally be prescribed. As I’ve mentioned in the past, I was prescribed Movicol — a laxative which I then developed a dependency on for the next ten years. It helped me — at least I think it did — but by the end of it all, I can’t really say. My body became dependent on its assistance to do what it was supposed to do. So I’m relieved I broke that cycle — though I’d be lying if I said I didn’t have a box of the stuff stashed under my bed… just in case, you know? (Gosh, I sound like an addict!)
Living With It
While the symptoms of IBS are a pain in the ass (ha punny!!), the condition itself doesn’t actually pose a serious threat to your health. It doesn’t increase your chance of developing cancer or anything like that, it’s just something you have to live with. You may go many months, or even years, with no symptoms, and then suddenly — BOOM… unexpected flare up. It can then take months for the symptoms to settle down again, meanwhile you sit around feeling sorry for yourself and wondering what you did differently to cause it. It’s just the nature of the condition I’m afraid.
I know IBS can make you feel very negative about the whole situation. It can be painful, embarrassing and stressful, and can really impact on your quality of life (I couldn’t possibly go camping, I need to be within a few meters of a flushing toilet day and night — sound familiar?). However, with appropriate lifestyle and diet changes you should be able to live a reasonably symptom free life.
Focus on Diet
Start with your diet. If you’re on this blog you’ll know how much I believe that what you put in your mouth contributes significantly to your overall health and wellbeing. Changing your diet will be a huge part of controlling your IBS symptoms, however, like in my other posts, I must stress: everyone is different. You must find the diet that works for you. There is no ‘one size fits all’ diet. Sorry!
Your best diet will depend on your symptoms and how you react to different foods. I highly recommend you check out the low-FODMAP diet, SCD diet, or Paleo. I truly believe these diets can be very beneficial in assisting with digestive distress, it’s just a matter of finding the right one for you and tweaking it to your needs. It’s helpful to keep a food diary and record what you notice makes your symptoms better or worse. If a food makes your symptoms worse, avoid it for a while. You don’t need to avoid it for life, but if it’s causing you problems you do need to avoid it until you’ve restored good gut health once again.
One factor that often comes into play with IBS, that doesn’t come into play with Endometriosis, Leaky Gut, or PCOS, is that patients with IBS are often advised to modify the amount of fibre in their diet. There are two main types of fibre: soluble (body can digest) and insoluble (body cannot digest). IBS with diarrhea patients are often recommended to cut down on the insoluble fibre (wholegrain bread, bran, cereals, nuts and seeds) they eat as well as avoiding the skin, pith and pips of fruit and vegetables. Meanwhile those who have IBS with constipation are encouraged to increase the amount of soluble fibre (oats, barley, rye, fruits such as bananas and apples, root vegetables such as carrots and potatoes) and increase their water consumption.
Changing the way you eat can also significantly improve your symptoms. For example have regular meals and eat slowly. Don’t rush through that food! Avoid missing meals or leaving long gaps between eating. Drink plenty of fluid throughout the day but restrict your tea and coffee intake to three cups a day (that’s maximum… not a rough guide, sorry coffee addicts!). Lower the amount of alcohol and fizzy drinks you consume…. It would be even better if you could eliminate these drinks entirely. Reduce your intake of resistant starch – this is a type of starch that resists digestion in the small intestine and reaches the large intestine fully intact. It’s usually found in processed or re-cooked foods… nasty huh! Limit your fresh fruit intake to three portions a day. If you have diarrhoea avoid sorbitol and if you have bloating and wind avoid cereal for at least six weeks and/or increase your intake of linseeds. Have a routine. Eat within an hour of the same time every day. It helps, trust me.
If you’re planning on trying an exclusion diet I would recommend speaking to a registered dietician who is aware of your health battles.
Hey, don’t roll those eyes at me! Exercise is legendary at relieving the symptoms of IBS. I know it doesn’t feel like it at the time but I promise it helps. Do at least 30 minutes of some kind of activity at least three times a week — more if possible. It should be strenuous enough to get your heart rate up and to get a bit of a puff going. You don’t have to join a gym, just find a whole lot of steps to climb or a hill to walk up briskly — it’s a great way to get some fresh air, too!
I’ve mentioned before the benefits of probiotics and when it comes to IBS I really would recommend them. However, that is just my personal opinion and there is no existing scientific evidence to suggest that probiotics work and have beneficial health effects. I just know based on what I’ve felt and experienced. Probiotics contain ‘good bacteria’ which is supposed to jump in there and destroy the ‘bad bacteria’ which theoretically help keep your gut and digestive system smiling their creepy gut smile. It also promotes overall good gut flora which is ideally what you want to keep digestive distress at bay.
Finally, if you can reduce the stress in your life you may see significant improvement in your IBS symptoms. Good ways of reducing stress include relaxation techniques such as meditation, breathing exercises, and mindfulness (I’m very pro-mindfulness!); physical activities such as yoga, pilates, or tai chi; and regular exercise such as running, walking or swimming. Personally for IBS I recommend swimming or aqua jogging. For me it was something about being in the water, not having to bear the weight of the pain and the feeling of weightlessness really seemed to help.
If you’ve tried these more natural approaches and nothing seems to be working, I would approach your GP or your ‘Gut Doctor’ about medicinal options — laxatives, anti-depressants, pain medication, etc — to see if they help. Alternatively, you could seek psychological help and look into hypnotherapy, psychodynamic interpersonal therapy, and cognitive behaviour therapy.
No matter what you choose, you can beat those symptoms. You can beat the negativity that threatens to consume you. And you can reclaim your life. Believe that!
Love to you all ❤