Navigating Life with Irritable Bowel Syndrome (IBS): Understanding, Coping, and Thriving

Introduction

Living with Irritable Bowel Syndrome (IBS) can be challenging, frustrating, and at times, isolating. Yet, it's a condition that affects millions worldwide, and understanding it better can lead to more effective coping strategies and improved quality of life (1). In this blog, we'll delve into what IBS is, its symptoms, potential triggers, and most importantly, strategies for managing and thriving despite its presence.

Understanding IBS IBS is a chronic gastrointestinal disorder characterised by a cluster of symptoms, including abdominal pain, bloating, gas, diarrhoea, and constipation (2). During digestion the gut squeezes its content along the digestive tract (3). This process usually goes un-noticed but for people with IBS due to increased sensitivity, certain foods, stress or excess wind can irritate the colon and cause symptoms (4). What distinguishes IBS from other digestive disorders is its unpredictable nature – symptoms can vary widely in frequency and severity, often without any apparent trigger.

Symptoms and diagnosis

Common symptoms

1. Abdominal pain or discomfort: This is often relieved by passing bowel movements.

2. Bloating: Feeling of fullness or swelling in the abdomen.

3. Changes in bowel habits: Including diarrhea, constipation, or alternating between the two.

4. Excessive gas: Belching or flatulence.

5. Mucus in the stool (5)

The doctor will want to rule out other medical conditions, you may need a blood test to rule out conditions including coeliac disease, anaemia and to test for adequate liver and kidney function. Also a stool test may be required to infections and inflammatory bowel disease (IBD). But the symptoms reported will most likely allow them to make a diagnosis (6).

Triggers

Identifying triggers can be crucial in managing IBS. While triggers vary from person to person, common ones include:

1. Certain foods: Such as dairy, gluten, caffeine, spicy foods, and artificial sweeteners (7).

2. Stress: Emotional or psychological stress can exacerbate symptoms (8).

3. Hormonal changes: Particularly in women, symptoms may worsen during menstruation (9).

4. Medications: Certain medications, especially antibiotics, can disrupt the balance of gut bacteria and trigger symptoms (10).

Coping Strategies

Dietary modifications: Keeping a food diary can help identify trigger foods. Experiment with eliminating or reducing intake of suspected trigger foods. Sticking to the low FODMAP diet can help improve symptoms (11)

What is low FODMAP?

The term "Low FODMAP" refers to a diet that restricts foods high in certain fermentable carbohydrates known as FODMAPs. FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols, which are types of short-chain carbohydrates that are poorly absorbed in the small intestine. When these carbohydrates reach the large intestine, they can be fermented by gut bacteria, leading to symptoms such as bloating, gas, abdominal pain, and altered bowel habits in some individuals (12).

Foods that are high in FODMAPs include:

1. Oligosaccharides: Found in foods like wheat, rye, onions, garlic, legumes (such as chickpeas, lentils, and beans), and certain fruits and vegetables (such as asparagus, cauliflower, and mushrooms).

2. Disaccharides: Include lactose-containing dairy products such as milk, yogurt, and soft cheeses.

3. Monosaccharides: Primarily refers to excess fructose found in fruits like apples, pears, mangoes, and watermelons, as well as honey and high-fructose corn syrup.

4. Polyols: These are sugar alcohols found in some fruits (such as cherries, plums, and peaches), vegetables (such as cauliflower and mushrooms), and artificial sweeteners like sorbitol, mannitol, and xylitol (12).
   

Stress management Techniques like deep breathing, meditation, yoga, or counselling can help reduce stress and alleviate symptoms (13).

Regular exercise: Physical activity can improve digestion and alleviate symptoms. Aim for at least 30 minutes of moderate exercise most days (14).

Medications/drug therapy Over-the-counter medications like antispasmodics, laxatives, or anti-diarrheal agents may provide relief (15). Consult a healthcare professional for appropriate recommendations. Some individuals find relief from symptoms by taking probiotic supplements to promote a healthy balance of gut bacteria (16).

Thriving with IBS

Despite its challenges, it's possible to live a fulfilling life with IBS:

1. Self-care: Prioritize self-care activities that promote relaxation and well-being.

2. Support network: Connect with others who understand what you're going through, whether it's through support groups, online forums, or friends and family. https://www.theibsnetwork.org https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/further-help-and-support/

3. Communication: Educate those around you about IBS to enable understanding and support.

4. Seek professional help: Don't hesitate to consult healthcare professionals, such as gastroenterologists, dieticians, or therapists, for personalised guidance and support.

Living with IBS requires patience, understanding, and proactive management strategies. By identifying triggers, adopting healthy lifestyle habits, and seeking appropriate support, individuals with IBS can effectively manage their symptoms and lead fulfilling lives. Remember, you're not alone in this journey, and with the right tools and support, it's possible to thrive despite the challenges posed by IBS.

References

(1) https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/

(2) https://my.clevelandclinic.org/health/diseases/4342-irritable-bowel-syndrome-ibs

(3) https://gutscharity.org.uk/advice-and-information/conditions/irritable-bowel-syndrome/#section-1

(4) Nutrition for Life, Lisa Hark and Dr Darwin Deen (2005)

(5) https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/symptoms/

(6)  https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/getting-diagnosed/

(7) Cozma-Petruţ, A., Loghin, F., Miere, D., & Dumitraşcu, D. L. (2017). Diet in irritable bowel syndrome: What to recommend, not what to forbid to patients!. World journal of gastroenterology, 23(21), 3771–3783. https://doi.org/10.3748/wjg.v23.i21.3771

(8) Qin, H. Y., Cheng, C. W., Tang, X. D., & Bian, Z. X. (2014). Impact of psychological stress on irritable bowel syndrome. World journal of gastroenterology, 20(39), 14126–14131. https://doi.org/10.3748/wjg.v20.i39.14126

(9) Pati, G. K., Kar, C., Narayan, J., Uthansingh, K., Behera, M., Sahu, M. K., Mishra, D., & Singh, A. (2021). Irritable Bowel Syndrome and the Menstrual Cycle. Cureus, 13(1), e12692. https://doi.org/10.7759/cureus.12692

(10) Mamieva, Z., Poluektova, E., Svistushkin, V., Sobolev, V., Shifrin, O., Guarner, F., & Ivashkin, V. (2022). Antibiotics, gut microbiota, and irritable bowel syndrome: What are the relations?. World journal of gastroenterology, 28(12), 1204–1219. https://doi.org/10.3748/wjg.v28.i12.1204

(11) https://aboutibs.org/treatment/ibs-diet/low-fodmap-diet/

(12) https://www.gastroconsa.com/patient-education/irritable-bowel-syndrome/low-fodmap-diet/

(13) D'Silva, A., Marshall, D. A., Vallance, J. K., Nasser, Y., Rajagopalan, V., Szostakiwskyj, J. H., & Raman, M. (2023). Meditation and Yoga for Irritable Bowel Syndrome: A Randomized Clinical Trial. The American journal of gastroenterology, 118(2), 329–337. https://doi.org/10.14309/ajg.0000000000002052

(14) https://www.gastrolondon.co.uk/irritable-bowel-syndrome-ibs/#:~:text=Engage%20in%20stress%2Dreduction%20techniques,most%20days%20of%20the%20week.

(15) https://www.medicalnewstoday.com/articles/what-is-the-best-over-the-counter-medicine-for-ibs

(16)https://www.bda.uk.com/resource/probiotics.html#:~:text=Irritable%20bowel%20syndrome%20(IBS)&text=Some%20patients%20have%20been%20shown,to%20reduce%20symptoms%2C%20particularly%20bloating.