We all suffer from stomach ache or constipation occasionally. For people with Irritable Bowel Syndrome (IBS), however, abdominal pain, constipation, and discomfort associated with it can have a disabling effect. Irritable bowel syndrome (IBS) is a gastrointestinal disorder that affects 12 percent of adults in the US. The exact causes of IBS are unknown. Some of the triggers include stress, diet, and lack of sleep. In this article, you will learn more about the various signs and symptoms of IBS and ways to deal with them.
What is IBS?
Irritable bowel syndrome is a gastrointestinal disorder that results in various symptoms, including cramping, abdominal pain, bloating, altered bowel habits, and food intolerance. It is a chronic condition that needs long term management.
IBS affects 45 million people in the US, most of them women. Most people develop this condition between their late teens or during the early forties. IBS is not a life-threatening illness, but it can have long-lasting problems that can alter the way you live your life.
Types of IBS
There are three different types of IBS. Sometimes people alternate between different types over time.
1. IBS with constipation
This type of IBS causes infrequent or delayed bowel movement and lumpy, hard stools. Stomach pain and bloating are some of the other symptoms.
2. IBS with diarrhea
The symptoms include abnormally frequent bowel movement, watery stools, stomach pain, and discomfort.
3. IBS with mixed bowel habits
This kind of IBS has symptoms of both IBS with constipation and IBS with diarrhea.
Symptoms of IBS
1. Pain and cramps
Abdominal pain and cramping are the two main symptoms of IBS. IBS affects the gut-brain link, which causes the muscles in the gut to contract much more than needed during a bowel movement (1). People with IBS usually suffer from pain in the lower abdomen. In some cases, there may be pain in both the upper and lower abdomen. This pain is generally relieved by bowel movement (2).
A diet low in fermentable carbohydrates and polyols (FODMAP) can effectively reduce pain in patients of IBS. Antispasmodics like peppermint oil also help in treating abdominal pain. Cognitive-behavioral therapy and hypnotherapy can also help (3). Your doctor may also prescribe specific medications to relieve the pain.
When a person finds it difficult to pass stool, it is known as constipation. A person with constipation has less than three stools a week. He/she may feel pain while passing stool. Hard and lumpy stools and a feeling of incomplete movement may also be there.
More than half of the people with IBS have symptoms of constipation (4). Constipation, in general, is not painful, but constipation in patients of IBS can be painful. This pain usually eases after bowel movements. Eating high-fiber foods, drinking plenty of fluids, exercising regularly, and getting enough sleep can help treat constipation.
Diarrhea is a common symptom of IBS. It affects one –third of the patients. IBS that causes increased diarrhea, is known as IBS-D. According to a study by the University of Bari Medical School, Italy, patients of IBS-D have more than 12 weekly stools, which is more than double the frequency of people without this condition (5).
Our gut contracts and relaxes in a rhythmic way to produce regular bowel movements. In IBS, this rhythm is disrupted, leading to more muscle contractions. People with IBS-D also have an increased urgency to have bowel movements. People with higher BMI are at a higher risk (6). The stool may be loose and watery and may also contain mucus.
Over-the-counter anti-diarrhea medications can help. Probiotics from foods like pickles and sauerkraut can also help treat IBS-D. Try to reduce stress, as stress can make diarrhea symptoms worse.
4. Excessive gas and bloating
People with IBS identify bloating as the most persistent problem that can affect the quality of life. During a study by the University of North Carolina, of the 337 IBS patients involved in the study, 82.5% reported symptoms of bloating as the second most bothersome symptom after abdominal cramping. The signs were more prevalent in female patients than male patients (7).
It is not clear why this happens, but there are several theories. According to one theory, IBS causes problems with gut bacteria. These bacteria then produce certain toxins that produce more gas. According to another theory, people with IBS have trouble getting rid of gas because of the problems in the nerves and muscles in their gut.
The intestines of people with IBS may be more sensitive, so even an average amount of gas can cause discomfort. Look out for the foods that may trigger gas and avoid them. Some common trigger foods include beans, cabbage, broccoli, cauliflower, onions, Brussels sprouts, and raisins. The fiber found in whole wheat can also cause excessive gas.
5. Changes in bowel movements
We are now aware that IBS can lead to constipation in some people and diarrhea in some people. In some cases, people can experience constipation alternating with diarrhea. IBS patients sometimes also pass an increased amount of mucus in their stool. Constipation can also cause a tear in the anus, which may lead to rectal bleeding.
6. Sensitivity to certain foods
People with IBS are sensitive to certain foods. When they eat these foods, their gut reacts to it, triggers spasms, and distends with gas or fluid.
Fermentable oligo, di, monosaccharides, and polyols (FODMAP) foods are types of carbohydrates that can cause inflammation and irritation of the gut. Onion, lentils, garlic, beans, almonds, and cashews are some FODMAP foods. Lactose and gluten can also cause sensitivity in certain people. According to a 2017 review, a low-FODMAP diet can reduce the symptoms of IBS like pain and bloating (9).
7. Joint pain
IBS can also lead to joint pain. The connection between IBS and joint pain is unclear. However, there are some theories about why IBS causes joint pain. According to a 2016 study, people with IBS may have heightened pain sensitivity and perception. This heightened pain effect may be higher in people with constipation dominant IBS (10).
Another theory suggests that constipation dominant IBS may affect the immune system. When the feces remain too long in the colon, the excess water gets reabsorbed into the body. During this process, some toxins may also get reabsorbed. This reabsorption could lead to a reaction of the immune system. Activation of the immune system releases inflammatory mediators called cytokines, which may cause aches and pains.
According to a study published in the World Journal of Gastroenterology, people with IBS have a higher risk of developing a type of joint pain called temporomandibular disorder (11).
Fatigue is the third most common extraintestinal complaint of people with IBS (12). According to a 2017 study that assessed 160 people with IBS, fatigue is a distressing symptom that occurs in a sizeable portion of people with IBS. It interferes with the ability to perform physical activities, work, domestic activities, and the ability to interact with others (13).
Fatigue occurs because our body is not able to absorb all the essential nutrients from the food. The good bacteria in the gut are also necessary for producing specific vitamins and converting food into energy. When this system is disturbed, we may feel tiredness and fatigue.
Insomnia is commonly seen in people with IBS. It can cause difficulty in falling asleep, shorter sleep time, frequent arousal, and awakenings or non-restorative sleep (14). During a study from Washington University School of Medicine, people with IBS slept for more extended hours per day than people without his condition, yet they felt less well-rested (15).
Another study reported that poor sleep in people with IBS could lead to more severe symptoms the next day (16).
10. Stress and depression
IBS is linked to stress and depression. Our nervous system controls the gut and responds to psychological stress. Anxiety and IBS symptoms are locked in a vicious circle. Stress can worsen IBS symptoms, and the physical symptoms of IBS can cause mental stress and depression.
According to a study that included 94,000 men and women, people with IBS have 50% higher chances of developing an anxiety disorder and 70% higher chances of developing depression (17). People with IBS who receive cognitive behavioral therapy show a significant improvement in symptoms (18).
11. Brain fog
IBS is also linked to brain fog. Lack of focus, poor memory, headaches, low motivation, and difficulty concentrating are common in people with IBS. More research is needed to understand this symptom of IBS fully.
The symptoms of IBS can be treated, but no single treatment works for everyone. Your doctor may have to try out various options to see which treatment works best for you. He may recommend changing your dietary habits, making lifestyle changes, medicines, probiotics, and mental health therapies.
Irritable bowel syndrome is a disorder that results in various symptoms, including diarrhea, constipation, cramping, abdominal pain, bloating, altered bowel habits, and food intolerance. It affects 12% of adults in the US. There is no cure for IBS, but your doctor can help you lower your symptoms by recommending a combination of dietary changes, lifestyle changes, medicines, and mental health therapies.