Dominic Stone
Irritable bowel syndrome (IBS) is a chronic disorder that affects the large intestine or colon. While the exact cause of IBS is unknown, it is believed to be linked to how the muscles of the colon move and contract, causing abdominal pain, cramps, constipation, and diarrhea. IBS is also associated with stress and emotional factors, and it often co-occurs with fibromyalgia. The condition can be managed through dietary changes, medications, and lifestyle modifications, including stress reduction techniques.
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IBS and abnormal gut muscle contractions
Irritable bowel syndrome (IBS) is a chronic disorder that affects the lower gastrointestinal (GI) tract, including the small and large intestines (colon). While the exact cause of IBS is unknown, it is believed to be a neurogastrointestinal disorder, indicating a problem with how the gut and brain coordinate to facilitate digestion. This coordination issue can lead to dysmotility, which is when the GI muscles contract more frequently and abnormally, causing pain and cramps.
The colon muscles contract to move food through the GI tract, and eating can trigger these contractions, typically within 30 to 60 minutes after a meal. However, with IBS, this urge to have a bowel movement may come sooner. The colon's contractions can be influenced by the presence of fat in the diet, and certain foods like dairy products with lactose and poorly digested carbohydrates (FODMAPs) are common triggers for IBS symptoms.
Stress is another factor that can affect colon contractions in people with IBS. While the exact mechanism is not fully understood, it is believed that the involvement of the nervous system in controlling the colon's movements may play a role. Emotional stress and severe stressors in childhood, such as physical, sexual, or emotional abuse, have been linked to IBS.
The abnormal gut muscle contractions associated with IBS can result in various symptoms, including constipation, diarrhea, gas, bloating, and abdominal pain and cramps. These symptoms can vary in intensity and frequency, with most people experiencing a mix of normal and abnormal bowel movements. The abnormal bowel movements define the specific type of IBS an individual has: IBS-C (constipation-predominant), IBS-D (diarrhea-predominant), or IBS-M (mixed bowel habits).
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IBS and diet
Irritable Bowel Syndrome (IBS) is a chronic disorder that affects the lower GI tract, including the small and large intestines (colon). While the exact cause of IBS is unknown, it is believed to be caused in part by a problem with how the muscles of the colon move and contract. Eating makes the colon muscles contract, which normally gives you the urge to have a bowel movement 30 to 60 minutes after a meal. With IBS, this urge may come sooner, and it can also cause cramps or diarrhea.
IBS is a condition that cannot be cured, but it can be managed through diet, lifestyle changes, and medication to minimize its impact on overall health and quality of life. Dietary changes can help improve IBS symptoms, and a doctor or dietitian may recommend specific adjustments based on an individual's needs. Here are some general dietary guidelines that may be suggested for managing IBS:
- Increasing soluble fibre intake: Soluble fibre can help improve constipation by making stools softer and easier to pass. Good sources of soluble fibre include oats, pulses, carrots, peeled potatoes, and linseeds. However, it is important to introduce high-fibre foods gradually, as too much fibre at once can cause gas and trigger IBS symptoms.
- Avoiding gluten: Gluten is a protein found in wheat, barley, and rye. Some people with IBS experience more symptoms after consuming gluten, even if they do not have celiac disease.
- Reducing FODMAPs: FODMAPs are a group of poorly digested carbohydrates that are easily fermented by colonic bacteria, leading to increased fluid and gas in the bowel. This results in bloating and changes in digestion speed, causing gas, pain, and diarrhea. A low FODMAP diet has been shown to improve IBS symptoms, with one study reporting a 76% improvement rate. However, some health professionals believe this diet is too restrictive. It is important to work with a registered dietitian when considering this diet, as it involves eliminating FODMAPs and then gradually reintroducing them one at a time to identify tolerance levels.
- Staying hydrated: Drinking enough fluids, such as water or herbal tea, can help improve IBS symptoms. It is recommended to aim for 8 to 10 drinks (around 1.5 litres) per day.
- Avoiding hard-to-digest foods: Certain foods, such as cabbage, broccoli, cauliflower, Brussels sprouts, beans, and onions, are difficult to digest and may worsen IBS symptoms.
- Limiting high-fibre foods: While fibre can be beneficial for constipation, those with IBS may need to cut down on high-fibre foods like wholegrain products (brown bread, brown rice), nuts, and seeds, as they can contribute to gas and bloating.
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IBS and stress
Irritable Bowel Syndrome (IBS) is a digestive disorder that affects around 20% of people worldwide. It is a chronic condition that needs to be managed long-term. The exact cause of IBS is unknown, but possible causes include over-sensitive nerves in the gut, food passing through the gut too quickly or too slowly, stress, or a family history of IBS.
There is a clear link between IBS and stress, with stress being a well-known trigger for IBS symptoms. A worldwide study has shown a close connection between IBS and mental health conditions such as anxiety and depression. The prevalence of at least one psychiatric disorder in IBS patients typically ranges from 40% to 60%, and has been reported as high as 80%. The most common mental ailment in people with IBS is generalized anxiety disorder, with over 60% of IBS patients suffering from this type of anxiety. Another 20% have depression, and the rest have other disorders.
Stress and anxiety can activate the central nervous system, which releases hormones that negatively impact the gut and can cause diarrhoea, constipation, gas, or discomfort. This is due to the gut-brain axis, which is the strong link between gut health and mental health. The gut has its own nervous system, known as the enteric nervous system, which controls how we digest food and is the reason we get "butterflies in our stomach" when we are nervous.
IBS can also trigger stress and anxiety, creating a vicious cycle. For example, the symptoms of IBS can cause concerns that start to disrupt our work and social lives, which can then lead to anxiety or depression. Additionally, major life traumas, such as a marital separation or the death of a parent, have been frequently reported prior to the onset of IBS symptoms.
There are several ways to manage the stress and anxiety associated with IBS. Identifying key stressors and keeping a diary of gut symptoms can help to understand the connection between mental state and IBS flare-ups. Mind-body exercises such as meditation, relaxation breathing, yoga, and tai chi can trigger the body's relaxation response. Hypnotherapy can also be used to put patients in a relaxed state, making them more open to positive suggestions for managing stress.
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IBS and fibromyalgia
Irritable Bowel Syndrome (IBS) and fibromyalgia (FM) are two disorders that often coexist. FM is a chronic pain syndrome characterised by muscle and joint stiffness, insomnia, fatigue, mood disorders, cognitive dysfunction, anxiety, depression, and intestinal irritability. IBS is a gastrointestinal disorder that causes cramping, abdominal pain, bloating, gas, and diarrhoea.
The exact cause of the onset of both FM and IBS is unknown, but researchers have investigated several possible causes, including alterations in gut microbiota and the role of the gut-brain axis. The gut-brain axis has been proven to be the link between the gut microbiota and the central nervous system, which can then control the gut microbiota composition.
The two disorders share many symptoms, including chronic pain, fatigue, and intestinal irritability. FM and IBS patients may also experience insomnia, anxiety, and depression. Researchers have found that over half of IBS patients also have symptoms of FM, and vice versa. The presence of generalized pain among IBS symptoms caused the most robust increase in the likelihood of FM.
There is no one-size-fits-all treatment for FM and IBS, as the diverse range of symptoms varies from patient to patient. However, the two disorders share common treatments, including prescription medications, psychotherapy, behavioural therapy, and cognitive behavioural therapy (CBT). Exercise, especially cardio, is also recommended to help build muscle strength and improve mental health.
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IBS and extra-intestinal symptoms
Irritable bowel syndrome (IBS) is a chronic disorder that affects the lower gastrointestinal (GI) tract, including the small and large intestines (colon). While the colon appears normal in people with IBS, it does not function as it should.
IBS is characterised by uncomfortable or painful abdominal symptoms, including constipation, diarrhoea, gas, and bloating. These symptoms are caused by issues with the contractions of the colon muscles, which are responsible for moving food through the GI tract. The colon muscle in people with IBS tends to contract more than usual, resulting in cramps and pain.
IBS patients often experience extra-intestinal symptoms in addition to the primary intestinal ones. A study comparing IBS patients with inflammatory bowel disease (IBD) patients and non-patients found that IBS patients scored significantly higher on constipation, dyspepsia, and reflux scales. Furthermore, IBS patients experienced extra-intestinal symptoms to the same extent or even more than IBD patients. Reflux symptoms were the strongest predictors of extra-intestinal symptoms in IBS. Urinary, thoracic, and oral symptoms were also reported to be similar in IBS and IBD patients, with both groups scoring higher than the control group.
The exact cause of IBS is unknown, and it is likely that different factors contribute to the development of IBS in different individuals. However, diet and emotional stress are known to exacerbate IBS symptoms. Treatment options include dietary changes, medications, and behavioural therapy.
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Frequently asked questions
Irritable bowel syndrome (IBS) is a long-term health condition that affects the large intestine or colon. IBS causes uncomfortable or painful abdominal symptoms, including constipation, diarrhea, gas, and bloating. It does not damage the digestive tract or increase the risk of colon cancer.
IBS affects how the brain and gut work together, and the condition may cause the muscles in the gut to contract more than usual, leading to lower abdominal pain and cramping. Eating, especially consuming fat, can cause contractions in the colon. IBS can also cause constipation by slowing down gut muscle contractions.
Many treatment options are available to help manage IBS symptoms, including medications, diet and lifestyle changes, herbal supplements, antidepressants, and brain/gut interventions such as cognitive behavioral therapy (CBT) or hypnotherapy.
