What is Irritable Bowel Syndrome (IBS)?

Irritable bowel syndrome (IBS) – facts- It is a group of symptoms that occur together, including repeated pain in the abdomen and changes in the bowel movements, which may be diarrhea, constipation, or both. With IBS, one has these symptoms without any visible signs of damage or disease in the digestive tract.

In the past, doctors called IBS colitis, mucous colitis, spastic colon, nervous colon, and spastic bowel.

What are the different types of IBS?

There are four types of IBS and are based on different patterns of changes in bowel movements or abnormal bowel movements.

Many people with IBS have normal bowel movements on some days and abnormal bowel movements on other days.

1. IBS with constipation (IBS-C): Most of the stool is hard and lumpy.
2. IBS with diarrhea (IBS-D): Most of the stool is loose and watery.
3. IBS with mixed bowel habits (IBS-M): When one has both hard and lumpy bowel movements and loose and watery movements on the same day.
4. IBS Unclassified (IBS-U) The final IBS subtype may come with a mixed bag of symptoms. IBS-U is diagnosed if one has met the criteria for IBS but the symptoms don’t fall into the IBS-C, IBS-D, or IBS-M categories.

How common is IBS?

The prevalence of IBS in the general population of India is 15%. Most of the patients approach the general practitioner and only 30%–50% of the workload at gastroenterology outpatient clinics.

What causes IBS?

Doctors are not sure what causes IBS.

Certain problems are more common in people with IBS. Experts think these problems may play a role in causing IBS. These problems include

• Stressful or difficult early life events, such as physical or sexual abuse

•    Certain mental disorders, such as depression or anxiety.

•    Bacterial infections in the digestive tract

•    Small intestinal bacterial overgrowth, an increase in the number or a change in the type of bacteria in the small intestine.

•    Food intolerances or sensitivities, in which certain foods cause digestive symptoms.

• GI Motor Problems: Abnormal intestinal contractions, such as spasms and intestinal paralysis.

Research suggests that genes may make some people more likely to develop IBS.

Microbiome and irritable bowel syndrome

The microbiome consists of microbes that are both helpful and potentially harmful to humans. Most are symbiotic (where both the human body and microbiota benefit) and some in smaller numbers, are pathogenic (promoting disease).

 In a healthy body, pathogenic and symbiotic microbiota coexist without problems. But if there is a disturbance in that balance—brought on by infectious illnesses, certain diets, or the prolonged use of antibiotics or other bacteria-destroying medications—dysbiosis occurs which stops these normal interactions. As a result, the body may become more susceptible to disease.

** Microbiota is the range of microorganisms.

** A microbiome is the community of microorganisms that can usually be found living together in any given habitat.

Gut microbiota is thought to play important role in the development of IBS. This is evident from the fact that IBS occurs more frequently after intestinal infection or antibiotics treatment when the microbiota is disturbed.

Diet for IBS

1.    Gluten-Free Diet

Gluten is a protein found in certain grains. People who are intolerant or sensitive to gluten can experience IBS symptoms when gluten is present in their diet. Gluten can damage the intestinal lining in such individuals. So, gluten must be completely avoided in such cases. A diet that excludes Gluten is called A Gluten-Free Diet.

Avoid Wheat, Barley, and Rye and Foods containing them.

Include: Rice, Millets, Buck Wheat, Flax Seeds, Quinoa, and Sabudana (Tapioca)

 2. Elimination Diet

This diet is recommended by The International Foundation for Functional Gastrointestinal Disorders (IFFGD). Anyone who is newly diagnosed can start with this diet and see if there is an improvement in their condition. This diet mainly focuses on the elimination of four foods from the diet:-

• Coffee
• Chocolate
• Insoluble Fiber
• Nuts.

Completely avoid one food from the above list for 12 weeks, see the difference in IBS symptoms, and then move to the next food on the list. You have to observe the food which when eliminated gave you relief from IBS symptoms and forgo that from the diet.

3. Low Fat Diet

High fatty foods are very bad for people with mixed IBS symptoms – which are characterized by a combination of Constipation and Diarrhea. High-fat foods are contributors to many health issues including Obesity. It can worsen the symptoms in obese people with IBS patients. Embracing a Low-fat diet is helpful in weight loss, heart health, and improving uncomfortable bowel symptoms.

Avoid Red Meat, Deep Fried Foods, Junk foods like french fries, namkeen, Papad, Pizza, Burgers, Fritters, Full Fat Dairy, etc.

Include Lean Meat, Fruits, Vegetables, Grains, and Low Fat Dairy products.

4. Fiber Diet

Fiber is very essential to bulk up the stool and proper bowel movement. An adult must consume around 20-35 grams of fiber per day. Soluble fiber is very helpful to treat IBS symptoms. Insoluble fiber may cause discomfort during IBS. So, take insoluble fiber mindfully and try to limit it as much as possible. Ensure good water intake while consuming fiber-rich food.

Insoluble Fiber: Whole grains, Nuts, Tomatoes, Raisins, Cabbage, and broccoli

Soluble Fiber: Leafy vegetables, Parboiled Rice, Berries, Apples, and Oats.

1. Avoid Diary products

One of the biggest irritants to the gut might just be lactose- milk sugar. As infants, we have an enzyme called lactase, that helps us break down and digest lactose (milk). But after about the age of two years, humans tend to lose this enzyme. This makes digesting dairy impossible for adults and presents IBS symptoms. Avoid Milk and Milk products.

In addition, have adequate sleep and try to avoid stress.

Consult your primary physician if you have symptoms of IBS.

For awareness purposes only.

Ujjal Dutta

Corporate and Pharmaceutical Trainer (Author).

Published as per views expressed by the author. All responsibilities lie with the author only.