What is irritable bowel syndrome?

A group of symptoms known as irritable bowel syndrome (IBS) includes recurrent abdominal pain and irregular bowel movements that can lead to either diarrhea, constipation, or both. These symptoms occur with IBS without any outward signs that your digestive tract is sick or damaged.

What are the causes of irritable bowel syndrome?

Although a number of things can be considered symptoms of IBS, no one knows exactly what causes it. According to some studies, the colon becomes hypersensitive and overreacts to small stimuli. The intestinal muscles tense up instead of moving slowly and rhythmically. This can lead to constipation or diarrhea.

Scientific evidence strongly suggests that serotonin, or 5HT, is one of the key signaling molecules involved in the peristaltic reflex - and that alterations in serotonin signaling may be responsible for IBS symptoms.

Are women more likely to have IBS?

Women are more likely to be affected by IBS than men, especially if it runs in their family. According to a study titled "Sex-Gender Differences in Irritable Bowel Syndrome" published in the Journal of Neurogastroenterology and Motility, sex differences and sex hormones may play an important role in the pathophysiology of IBS

IBS may be more difficult to detect in women because some have more severe symptoms during their periods.

What do IBS flares feel like?

During an IBS episode, often referred to as an "IBS attack," additional intestinal symptoms may include abdominal pain, bloating, diarrhea, and constipation. An IBS flare-up may last a few hours or several months.

IBS flare-ups can vary in duration and may be accompanied by the following symptoms:

• Altered/increased bowel movements
• Loose stools
• Constipation
• Feeling of fullness
• Discomfort/pain in the abdomen

What can be mistaken for IBS?

The symptoms of IBS could be an almost unlimited number of complaints, as constipation, diarrhea, and bloating are signs of so many diseases, both serious and not so serious. IBS is often referred to as a 'diagnosis of exclusion."

Some of the more serious conditions that can fake IBS include the following:

1. Inflammatory Bowel Diseases

Irritable bowel syndrome is often confused with inflammatory bowel disease (IBD) such as Crohn's disease and ulcerative colitis. IBDs share certain symptoms with IBS, including inflammation, bloating, flatulence, malaise, and frequent rectal bleeding. Disturbances in the microbiota, susceptibility to inflammatory episodes, and lower quality of life are associated with these symptoms. The reasons for misinterpretation are obvious: IBS symptoms often resemble those of inflammatory bowel disease, IBS and inflammatory bowel disease can co-exist, and IBS is a much less serious diagnosis.

When a patient has both IBS and inflammatory bowel disease, it can be difficult for medical professionals to distinguish between the symptoms of the two conditions, especially if the symptoms of inflammatory bowel disease are recent. The diagnosis of IBS can be made more quickly if there is no history of serious digestive problems.

2. Celiac Disease

Because there is a great deal of overlap between the symptoms of celiac disease and irritable bowel syndrome, physicians diagnosing a patient with both conditions may overlook the presence of celiac disease and instead focus entirely on the diagnosis of irritable bowel syndrome. This problem is common and can be exacerbated by the coincidence of other conditions that are more suggestive of IBS than celiac disease.

3. Gluten Sensitivity

When eating gluten-containing foods such as bread and most starchy vegetables, people with gluten sensitivity suffer from indigestion, malaise, bloating and flatulence. A new scientific understanding of gluten sensitivity has shown that it can occur independently of other conditions, although it was previously believed that celiac disease was the primary cause of gluten sensitivity.

Misdiagnosed individuals continue to ingest gluten and suffer from disease flare-ups even when receiving ongoing treatment for IBS. This is a clear consequence of misdiagnosing gluten sensitivity as IBS. The digestive intolerance to gluten is not adequately addressed by IBS treatment, and patients will continue to have symptoms.

4. Anxiety and Depression

Medical professionals believe that irritable bowel syndrome has a psychological component. In fact, most reports of IBS cite anxiety, depression, and obsessive-compulsive symptoms as features of the disease. Although the symptoms are not usually perceived as particularly painful, depression and anxiety often co-occur with IBS. In addition to gastrointestinal symptoms suggestive of IBS, patients with anxiety may also have symptoms that are subclinical or not severe enough to meet diagnostic standards for IBS.

5. Stomach and Colon Cancer

Stomach cancer is one of the most dangerous diseases that can hide behind the diagnosis of irritable bowel syndrome. Heartburn, nausea, vomiting, indigestion, malaise, diarrhea, loss of appetite and constipation are symptoms of stomach cancer. However, stomach cancer is treatable and can even be cured by surgery if detected early and treated immediately. However, under these circumstances, misdiagnosis of IBS can easily be fatal.

Above all, the associated emotional disturbances are likely the symptoms that distinguish true IBS from stomach cancer; the pre diagnosis of stomach cancer is not accompanied by emotional disturbances such as anxiety or depression, whereas IBS is. There is a possibility that a diagnosis of IBS made without a quick mental health evaluation, blood test, or biopsy could mask a much more serious illness.

Another dangerous condition that could be masked by an inaccurate IBS diagnosis is colon cancer. Similar to stomach cancer, symptoms of colon cancer include bloody stools, pain, fatigue, indigestion and malaise. In most cases, bloody stools are the sign that medical professionals can use to quickly distinguish IBS from a more serious condition like colon cancer.

5. Pancreatitis

The symptoms of pancreatitis, such as severe pain in the intestines, nausea, and diarrhea, can sometimes mimic irritable bowel syndrome. However, pancreatitis can also cause fever, jaundice, and increased heartbeat, which is not the case with IBS.

What does mild irritable bowel syndrome look like?

Even if you don't have a severe case of IBS, your body may occasionally act strangely and cause abdominal discomfort, diarrhea or constipation, which may indicate mild IBS.

What foods can aggravate irritable bowel syndrome?

Eating a variety of nutrient-dense foods is an important part of a healthy diet. However, people who suffer from irritable bowel syndrome (IBS) may find that some meals cause unfavorable digestive symptoms. For each person, there are a number of specific foods that trigger IBS.

Foods that may aggravate IBS diarrhea:

1. Fried foods
2. Fatty foods
3. Dairy products (especially if you are lactose intolerant)
4. Foods made with wheat (if you are gluten sensitive)
5. Excess fiber, especially from fruit and vegetable peels
6. Carbonated drinks
7. Chocolate
8. Caffeine
9. Alcohol
   
   

Foods that can make IBS constipation worse:

1. Packaged foods (cookies, French fries)
2. Processed grains (white flour)
3. Dairy products (especially cheese)
4. Excess protein
5. Carbonated drinks
6. Caffeine
7. Alcohol

Avoiding foods is a good strategy if you are not sure which foods are causing your symptoms.

What should you eat for irritable bowel syndrome?

Low-FODMAP diet

A low-FODMAP diet is recommended for people with irritable bowel syndrome. Fermentable oligosaccharides, disaccharides, monosaccharides and polyols are called FODMAPs. These are short-chain carbohydrates found in a variety of foods that tend to ferment, resulting in an increase in the amount of fluid and gas in the small and large intestines.

There are five different types of FODMAPs:

• Fructans (found in onions, garlic, barley, cabbage, wheat and broccoli)
• Fructose (found in honey, fruit, and high-fructose corn syrup)
• Galactooligosaccharides (found in beans and legumes)
• Lactose (found in dairy products)
• Polyols (contained in sweet potatoes, apples and celery)
  
  

Gluten-free diet

If a low FODMAP diet doesn't help, you can try a gluten-free diet to see if your symptoms improve. If so, you can increase your gluten intake to see how much protein you can tolerate.

How can irritable bowel syndrome with diarrhea be relieved?

When people are sick, they often turn to foods high in carbohydrates and sugar to feel better. This is because intolerance to certain carbohydrates in the diet is one of the main causes of IBS. If you suffer from diarrhea caused by IBS, you should eat these meals instead:

• Breakfast: oatmeal with cinnamon, without any added sugar or sweeteners.
• Lunch: Baked sweet potatoes without butter and grilled or baked fish or chicken.
• Dinner: spinach salad with grilled chicken or another lean protein (prepared without oil)
• Protein shake or protein bar as a snack: high fructose corn syrup and artificial sweeteners by themselves can significantly increase the risk of diarrhea, so read the label and stay away from products containing these substances.
• Drinks: Hydrate with water or an electrolyte replacement drink such as Hydralyte or Pedialyte.
  
  

What are the red flags in irritable bowel syndrome?

Although IBS doesn't usually lead to more serious illness, there are some signs that may indicate a more serious condition. One symptom that is unusual for IBS is a "red flag."

The following symptoms should be noted:

• Rectal bleeding: This may be a side effect of constipation caused by a tear in the anus. Hemorrhoids may also be the cause of the bleeding.
• Weight loss: if you notice that you're suddenly losing weight, you should have this checked out.
• Call your doctor if you notice any of the following symptoms: Fever, vomiting, or anemia.
  
  

Symptoms of irritable bowel syndrome in women

Many of the symptoms of IBS in women are similar to those in men. However, some women report that their symptoms worsen during certain phases of the menstrual cycle. Below are the symptoms of IBS in women:

1. Constipation: symptoms of IBS often include constipation. Infrequent, dry stools that are difficult to evacuate are the result. Research shows that constipation is a symptom of IBS that is more common in women.
2. Diarrhea: IBS can lead to loose, watery stools
3. Bloating
4. Urinary incontinence: according to a study titled "Lower urinary tract symptoms in women with irritable bowel syndrome" published in the International Journal of Urology, women with IBS suffer from lower urinary tract symptoms more often than women without the condition.
5. Pelvic organ prolapse: pelvic organ prolapse is more common in women with IBS.
6. Chronic pelvic pain
7. Pain during sexual intercourse
8. Worsening of menstrual symptoms: there is evidence that menstrual symptoms worsen in women with IBS.
9. Fatigue
10. Stress
    
    

Does irritable bowel syndrome make your belly fat?

Bloating and a distended abdomen can be persistent in IBS, although anyone may experience these symptoms occasionally.

Is the IBS pain sharp or dull?

When the pain is at its worst, it can be an intense, stabbing sensation in the abdomen that can be very debilitating, especially if it occurs at the same time as other IBS symptoms.

Can IBS come on suddenly?

Yes. Like any illness, IBS must occur at a specific time. For example, you may have normal bowel movements one day and struggle with changes the next.

Can IBS make it harder to lose weight?

Sometimes doctors can associate weight gain with IBS. Some people with IBS also have more difficulty losing weight or maintaining a healthy weight. This may be due to difficulty exercising regularly and maintaining a restricted diet while avoiding symptoms.

How can I lose weight with IBS and PCOS?

Hormonal abnormalities, irregular periods, and/or the growth of tiny cysts on one or both ovaries are symptoms of polycystic ovary syndrome (PCOS). Sometimes IBS and PCOS can occur at the same time in the same person.

Below are useful tips for weight loss in IBS and PCOS:

1. Reduce your carbohydrate intake
2. Increase the amount of fiber in your diet: foods such as fruits, vegetables, whole grains, and nuts can help you increase your fiber intake.
3. Eat enough protein: After a meal, protein promotes a feeling of fullness and helps balance blood sugar. It can also promote weight loss by reducing cravings, increasing calorie consumption and controlling hunger hormones.
4. Practice mindful eating: Binge eating and emotional eating are two problematic eating habits that can be addressed by practicing mindful eating.
5. Reduce added sugars and processed foods.
6. Regular exercise: Exercise is a proven way to accelerate weight loss.
7. Control your stress: managing stress can help you control your weight because stress is a risk factor for weight gain. Your adrenal glands produce the hormone cortisol, which is released in response to stress. Insulin resistance and weight gain are linked to persistently high cortisol levels. Focus your attention on stress management techniques to lower cortisol levels.ol levels.
   
   

Can IBS lead to loss of appetite?

IBS affects your digestive system. Therefore, it's only logical that the symptoms may also affect your appetite.

How is IBS diagnosed?

There are no specific blood tests to detect IBS. IBS cannot be diagnosed by tests, but you may need some tests to rule out other possible causes. The doctor may order a blood test to detect celiac disease, infections, and inflammatory bowel disease from a stool sample, for example. In most cases, no further tests are needed in the hospital unless your doctor isn't sure what the cause is.

Medical treatment of IBS in women

Recommendations for medical treatment are based on your symptoms and may include the following:

1. Fiber supplements: constipation can be treated by taking supplements, such as psyllium (Metamucil), along with fluids.
2. Laxatives: your doctor may recommend over-the-counter laxatives, such as magnesium hydroxide, if fiber doesn't relieve constipation.
3. Medications to treat diarrhea: Loperamide and other over-the-counter medications may help treat diarrhea.
4. Cholinergic antagonists: medications such as dicyclomine can relieve uncomfortable bowel spasms.
5. Tricyclic antidepressants: while this type of medication helps treat depression, it also slows the function of neurons that regulate the bowel. This could potentially relieve pain.
6. SSRIs: If you suffer from depression, pain, and constipation, antidepressants with selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine or paroxetine may help.
7. Pain medications: Severe discomfort or bloating may be relieved by pregabalin or gabapentin.

Apart from the above medications, medications such as alosetron, eluxadoline, rifaximin, lubiprostone, and linaclotide are for specific treatment of IBS. Your doctor will recommend these medications based on a clinical evaluation.

References

1. Kim, Young Sun; Kim, Nayoung (2018). Sex-Gender Differences in Irritable Bowel Syndrome. Journal of Neurogastroenterology and Motility, 24(4), 544–558. doi:10.5056/jnm18082.
2. Ya-Jun Guo; Chen-Hsun Ho; Shyh-Chyan Chen; Shun-Shuang Yang; Han-Mo Chiu; Kuo-How Huang (2010). Lower urinary tract symptoms in women with irritable bowel syndrome. , 17(2), 175–181. doi:10.1111/j.1442-2042.2009.02442.x