Irritable bowel syndrome, commonly known as IBS, is a group of digestive system disorders associated with constipation, bloating, cramping, diarrhea, and flatulence. It is estimated that up to 5-10% of the world's population suffers from IBS, making it one of the most common gastrointestinal disorders.

However, not all symptoms of IBS are equally pronounced or occur with equal frequency in all sufferers. In this blog, we will focus on identifying the most important symptom of IBS and explore its causes, triggers, and treatment options.

Symptoms of irritable bowel syndrome

These symptoms may manifest as a worsening of the frequency or shape of bowel movements, as well as other changes:
  • Cramps
  • Bloating and flatulence
  • Pain in the abdomen
  • Diarrhea
  • Constipation
Other symptoms include the following:
  • Urgency during bowel movements
  • Feeling of incomplete emptying
  • Mucus in the stool
To be diagnosed with IBS, these symptoms must have been present for at least six months, at least once a week.

Remember that these symptoms can be unpredictable and sporadic. The symptoms and treatment of IBS may be of different natures and may very well be inconsistent. They may also last for days or months.

You may be able to tolerate these symptoms and live a normal life, but they can also become a lifelong problem that is difficult to live with.

According to a study titled "The use of psychotropic drugs in irritable bowel syndrome" published in Taylor & Francis Online, about 40% to 60% of patients also suffer from comorbid mental disorders, such as the following:

  • Migraine headaches
  • Anxiety or depression
  • Sleep disorders
  • Chronic pelvic pain
  • Fibromyalgia (chronic (muscle and bone) pain disorder)

What are IBS symptoms in women?

IBS is more likely to affect women than men, as six out of ten sufferers are women. Symptoms of IBS in women include the following:
  • Urge to pee frequently, with increased urgency
  • Excessive urination at night
  • Painful urination
  • Pelvic organ prolapse (loosening of pelvic muscles)
  • Painful sex
During the menstrual cycle, IBS symptoms may worsen in women, including the following:
  • Fatigue
  • Insomnia
  • Back pain
  • Hypersensitivity to certain foods (such as those that cause bloating)

What are the IBS symptoms in men?

Men experience the same symptoms as described above. It is thought that the difference between IBS symptoms in men and women is due to hormones. Estrogens can increase intestinal sensitivity in women, making them more susceptible to IBS.


What is the most important symptom of IBS?

The most important symptom of IBS is abdominal pain or discomfort. It should be accompanied by two or more of the following symptoms:
  • Pain subsiding after defecation
  • Change in the shape of the stool
  • Change in the frequency of bowel movements

According to one report, four out of five people said that pain often contributed to the severity of IBS.

Abdominal pain also occurs in the various forms of IBS, which are:

  • IBS-D: Characterized by abdominal discomfort and diarrhea, with the latter being the predominant condition
  • IBS-C: characterized by abdominal discomfort and constipation, the latter being the predominant condition
  • IBS-Mixed: characterized by abdominal discomfort, loose stools, and constipation, with the latter predominating.


Where does IBS pain most commonly occur?

One of the characteristic symptoms of irritable bowel syndrome is abdominal pain, along with two or more other symptoms, such as:
  • Relief after a bowel movement
  • Change in the frequency of bowel movements
  • Change in the appearance of the stool


How would you know you have irritable bowel syndrome?

The Rome IV system is used to diagnose IBS. It is used to make sure you have IBS and not another similar condition.

According to the Rome IV system, the following factors are considered for IBS diagnosis:

  • Stomach pain and bowel problems for at least 6 months, with symptoms occurring at least once a week.
  • In addition, the stomach pain should be associated with bowel movements.
  • Also considered is the Bristol Stool Form Scale, an instrument used to classify the patient's bowel habits and symptoms. It can be helpful in determining the type of IBS.


What does your bowel movement look like with irritable bowel syndrome?

Depending on the type of IBS, your bowel movements may have the following characteristics:

Type 

Characteristic 

Meaning

Type 1

Separate hard lumps, like nuts (hard to pass)

Constipated

Type 2

Sausage-shaped but lumpy

Constipated

Type 3

Like a sausage but with cracks on the surface

Constipated

Type 4

Like a sausage or snake, smooth and soft

Ideal

Type 5

Soft blobs with clear-cut edges (passed easily)

Ideal

Type 6

Fluffy pieces with ragged edges, a mushy stool

Diarrhoea

Type 7

Watery, no solid pieces (entirely liquid)

Could be diarrhoea, but it could also mean infection or food poisoning, or other problems


In addition to the Roman IV system, the physician also looks at the patient's past and diet and performs a physical examination.

They may also perform some simple tests such as blood tests, fecal tests, etc. To confirm the diagnosis, they may recommend further investigation, such as colonoscopy and upper gastrointestinal endoscopy.


What is the first choice in the treatment of IBS?

The initial treatment of IBS aims to relieve abdominal pain and bowel irregularity. In addition, the treatment options and best medications for IBS depend on the type of IBS you suffer from. However, it is important to know that there is no known cure for IBS. These options can only provide you with relief.

While there are many possibilities, some common ones are as follows:

  • OTC psyllium and guanylate cyclase C agonists
  • Alosetron (the only FDA-approved drug for women)
The best treatment for IBS is the following:
  • Antispasmodics (such as peppermint oil): Helps relax the muscles in the intestines and relieve pain
  • Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants: Improve mood, reduce anxiety, and improve bowel motility, which in turn relieves pain
  • Opioid agonists: help reduce diarrhea
  • Antibiotics: Used to treat possible bacterial infections
  • Bile salt sequestrants: Help bind bile acids and reduce diarrhea
  • Probiotics: Helps restore the balance of good bacteria in the gut
  • Mixed opioid agonists/antagonists and 5-HT3 antagonists: Helps decrease intestinal motility and reduce diarrhea.
  • Chloride channel activators: increase the water content of stool and facilitate its elimination
  • Polyethylene glycol (PEG): Helps hydrate the stool
Your healthcare provider may adjust therapy depending on your response. However, the best treatment for IBS is dietary changes and a healthy lifestyle, such as abstaining from alcohol and smoking.


What are the causes of IBS?

The cause of irritable bowel syndrome (IBS) is not fully understood, but there are several factors, such as:

  • Abnormal muscle contractions in the intestines (exaggerated response of the body to food)
  • Problems with the nerves of the digestive system
  • History of severe infections
  • Early life stress
  • Changes in the intestinal microbiota


What are the signs of irritable bowel syndrome?

Risk factors for IBS may include the following:
  • Being female
  • Anxiety and depression
  • Taking antibiotics
  • Food poisoning
  • Neuroticism


What foods cure irritable bowel syndrome?

Up to two out of three IBS patients report that their symptoms increase after meals. The effects of diet are different for each person, so there is no universal advice. Therefore, there is no universal advice. If you see a doctor, he or she may take a brief history and tell you what to eat in case of an IBS attack.

Generally, patients report that they find certain foods uncomfortable at a certain time of day but not at other times. In such cases, it is helpful to keep a diary and note how and at what time which food affects you.

Some general dietary recommendations are as follows:
  • Eat slowly
  • Eat until you feel full, no more
  • Drink at least 8 glasses of water
Doctors also recommend a diet low in FODMAPs. FODMAPs are carbohydrates that are resistant to digestion. FODMAPs are found in legumes, sweeteners, and some fruits, among others.

Some of the best foods for IBS are as follows:
  • Best vegetables for IBS: eggplant, green beans, celery, sweet potatoes, spinach and carrots
  • Best fruits for IBS: grapes, kiwi, strawberries, blueberries, bananas, cranberries, limes and oranges
  • Best sugar for IBS: honey substitutes


What foods make your IBS worse?

The following foods should be avoided if you have IBS because they make symptoms worse:

  • Caffeine
  • Alcohol
  • Fatty foods
  • Sugars such as sorbitol (in gum and candy), fructose (in honey and some fruits)
  • Spicy foods (especially those with onions and garlic)
  • Gas-producing foods (such as beans, bagels, and raisins)
  • Dietary fiber (such as bran)


Do I have irritable bowel syndrome - quiz

If you think your digestive problems may be IBS, ask yourself the following questions:
  1. Have my symptoms lasted for six months? For it to be IBS, your symptoms must occur (and go away) for at least six months.
  2. Do symptoms occur at least once a week? If symptoms do not occur for more than a week, it may not be IBS.
  3. Does IBS run in the family? People who have IBS in their family are more likely to be diagnosed. The likelihood increases if you are a woman.
  4. Has the appearance of my stool changed? In IBS, stool changes in shape and size.
  5. Are you experiencing alarming symptoms such as blood in the stool? Blood in the stool and weight loss are not associated with IBS.

Conclusion

During IBS, it is important to pay attention to your symptoms and treat them with a combination of diet, lifestyle and medication, if necessary. While it is important to understand the extent of IBS and its treatment options, you should not attempt to self-diagnose and self-treat. Your doctors will review your medical history, perform some tests, and create an appropriate treatment plan for you.

FAQs

Is irritable bowel syndrome dangerous?

Irritable bowel syndrome is not dangerous. Most people can even live with it without treatment. But flare-ups of symptoms can be difficult to manage. In this case, it is recommended to see a doctor.

Is irritable bowel syndrome curable?

No, there is no known cure for IBS.

How to deal with IBS constipation?

Stay away from coffee, alcohol and fatty foods. Try to take dried prunes, ground flaxseeds and prune juice to loosen your bowels.

Were you born with irritable bowel syndrome?

The risk of IBS is higher if it runs in your family, but generally you are not born with IBS.

Can IBS be cured by oneself?

You can not cure IBS completely, but you can manage IBS symptoms by changing your diet and lifestyle.

References

Weaver KR, Melkus GD, Henderson WA. Irritable Bowel Syndrome. Am J Nurs. 2017 Jun;117(6):48-55. doi: 10.1097/01.NAJ.0000520253.57459.01. PMID: 28541989; PMCID: PMC5453305.

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