Irritable Bowel Syndrome (IBS); Bloating, Diarrhea, Constipation, and Cramping
- Brian Dooreck MD
- Nov 19, 2022
- 3 min read
Updated: Jul 25, 2023
Irritable bowel syndrome (IBS) is a standard "label" used to describe a wide range of clinical symptoms related to diarrhea, constipation, cramps, abdominal pain, gas, and bloating. Strict criteria (Rome IV criteria) are used to define IBS. However, IBS as a diagnosis is used much more loosely by a patient and their doctors, involving a careful history and physical examination.
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Private Healthcare Navigation and Patient Advocacy when YOU need it mostWhat are the types of IBS?
There are three different forms of IBS:
Diarrhea-predominant (D-IBS) involves abdominal discomfort or pain, urgency, and diarrhea.
Constipation-predominant (C-IBS) involves abdominal discomfort or pain, bloating, and constipation.
Alternating constipation and diarrhea (A-IBS) involve both.
"There are 3 different forms of IBS: Diarrhea-predominant (D-IBS), constipation-predominant (C-IBS), and alternating constipation and diarrhea (A-IBS)."
Is IBS common?
IBS is the most prevalent functional gastrointestinal disorder. It affects approximately 14%
of the global population. The healthcare system has a significant economic impact as many work days are missed because IBS dramatically reduces patients’ quality of life.
Symptoms of IBS are some of the most common reasons patients are referred to gastroenterologists.
What causes IBS?
The precise cause of IBS remains unknown. "Unknown" implies that it involves various factors, such as infection, inflammation, medication, and stress, in a genetically predisposed individual.
"The precise cause of IBS remains unknown."
How is IBS treated?
Treating IBS symptoms can be challenging. There is no one medication that "cures" the disorder. Treatment focuses on improving symptoms and quality of life. Diet has a significant role.
Your Diet and IBS
Many patients report that symptoms are triggered by food. Food ingestion may produce heightened symptoms of IBS. Dietary interventions can improve IBS symptoms. This is the most reasonable initial and ongoing treatment approach.
However, diets' role in treating IBS symptoms is complex and poorly defined. Various factors have limited clinical studies.
"Many patients report that symptoms are triggered by food."
"However, the role of diets for the treatment of IBS symptoms is complex and poorly defined."
Testing for Food Intolerance
Cheap and effective testing for food intolerance is lacking. Avoid expensive and unproven commercial food-specific allergy testing.
Dietary Triggers and IBS
Specific dietary IBS triggers are likely prevalent. The best initial management of IBS with dietary adjustment involves either a single-food elimination diet for some common triggers. These are lactose and fructose.
A typical elimination diet (e.g., low-FODMAP) is usually recommended. After starting a low-FODMAP diet, you can aim for targeted reintroduction after four weeks under the guidance of a registered dietitian.
More extensive studies are needed to better define the efficacy of specific dietary options for IBS patients.
What are FODMAPs?
FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) are short-chain carbohydrates with limited (or minimal) negligible intestine absorption. This leads to hydrogen and methane production in the intestines, probable changes in gut flora, and altering colonic epithelial function, and may also cause local inflammation. These changes can significantly heighten gastrointestinal symptoms in patients with IBS, with excessive gas, bloating, and loose stools.
I will blog more on the low-FODMAP diet shortly.
Personally
I eat a high-fiber, mostly plant-based 🌱 diet, no red meat, drink 4 liters of water a day, exercise, and am focused on keeping nutrition simple. I am sharing what works for me and what I routinely recommend to my patients.
"Balance. Portion control. Keep nutrition simple. Eat Smart. Eat Healthy. 🌱 🌾 🌿"
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