IBS Information and Management

What is Irritable Bowel Syndrome?

Irritable Bowel Syndrome, or IBS (also known as "spastic colon"), is a disorder that causes discomfort in the gastrointestinal tract. Symptoms include alternating constipation with diarrhea, stomach pain, cramping, among others.

Statistics & IBS

IBS afflicts many people throughout the United States. Men, women, and even children of all ages can have IBS; however, many are never diagnosed, and people over 50 are rarely afflicted.

It is estimated that 25-45 million American women suffer with IBS—this means roughly 2 out of 3 women have IBS. Men are a little less afflicted by IBS, with only 1 in 3 men affected.

IBS affects about 15 percent of the global population.

What Causes IBS?

Although many people suffer from IBS, the exact cause is not clearly understood. Experts believe that there is a problem in the way the intestines, brain, and nervous system work together that cause the symptoms of stomach pain, cramping, and abnormal bowel movements.

Some people believe IBS is caused by eating foods that encourage bacterial over-growth in the intestine. This creates gas, which causes stomach pain and other symptoms. There is even a particular diet that many with IBS follow, called the low FODMAP diet.

Stress has been linked to IBS, but although stress can aggravate the symptoms, it is not the primary cause of this condition.

What is the Low FODMAP Diet?

The low FODMAP diet is based on avoidance of specific short chain carbohydrates (including alcohol, fructose, and sugar) that are not readily absorbed into the small intestine. According to this diet, these foods should be avoided because they ferment in the intestine and produce uncomfortable IBS symptoms.

In fact, the word FODMAP is an acronym for:

• Fermentable: Bacteria causes fermentation in the large intestine.
• Oligosaccharides: Two words that literally mean "few sugars"; these sugar molecules become a chain, once joined.
• Disaccharides: This word means "two sugars", so this is a 2-sugar molecule.
• Monosaccharides: One-sugar molecules.
• And
• Polyols: Sugar alcohols (not the kind that gets you drunk).

Foods on the FODMAP list are fermented in the large intestine by bacteria, which leads to gas, bloating, stomach distention, pain, and other IBS symptoms. FODMAPs are foods that should be avoided, whereas foods that are low in FODMAPs are recommended. Following a diet of foods that rate low on the FODMAP scale can help reduce or even eliminate symptoms of IBS.

Diet: What Foods Should I Avoid?

IBS symptoms can be greatly reduced by avoiding specific foods that cause gas in the body. Foods that are gassy and cause bloating are:

• Onions
• Broccoli
• Cauliflower
• Cabbages
• Raw fruit
• Carbonated Beverages

Further, some people benefit from eliminating gluten from their usual diet. You need to experiment a little to find out what works best for you, but generally avoid eating any raw vegetables, instead lightly steam them for easier digestion.

Below is a sample chart of 10 items you should eat and 10 items you should avoid to improve/eliminate IBS symptoms.

Symptoms of IBS

Many people with IBS suffer from diarrhea or constipation-- or both, with these two problems alternating back and forth. Sometimes these symptoms are very problematic, and can interfere with normal daily activities and reduce one's quality of life.

Other symptoms that are typical of IBS:

• Stomach/abdominal pain
• Recurring or alternating constipation with diarrhea
• Feeling or being bloated
• Gassiness (flatulence)
• Distended abdomen
• Cramps
• Abdominal pain
• Abnormally formed stools

Diagnosis

It is important that you see your doctor to confirm an IBS diagnosis. Once you have been diagnosed, your doctor may prescribe medication to help with your symptoms.

Blood Tests to Diagnose IBS

As recently as 2015, a doctor named Dr. Mark Pimentel from Cedars-Sinai Hospital in Los Angeles, California, created two simple blood tests that can detect IBS—and even help in early detection. Using these two simple blood tests to determine IBS in a patient saves months of trial and error and expensive tests, such as colonoscopies.

Previously, before these blood tests were created, IBS sufferers had to keep track of what they ate and try to figure out which foods to eliminate; i.e., which foods were causing IBS. This method of managing IBS was slow, sometimes taking months to gain any progress.

Signs to Call the Doctor

After you have been diagnosed with IBS, if your symptoms worsen or interfere with your job or daily activities it is time to make an appointment with your doctor.

Danger Signs

Be sure to see your doctor if:

• Your symptoms interfere with your sleep
• Distended stomach from bloating
• Unexplained loss of weight
• Reduced appetite
• Stomach pain that persists after a bowel movement
• Mucous or blood in the stool
• Nausea
• Symptoms that do not improve with usual medication/treatment

Red Flag Warnings

If you are over 50 years old and you develop symptoms of IBS, you should see a doctor to rule out other illnesses such as diverticulitis or cancer.

Family History

If any of your family members have a history of gastrointestinal issues such as Crohn's disease, celiac disease, colon/ovarian cancer, or ulcerative colitis, you should definitely be seen by your primary doctor or a gastroenterologist as soon as possible.

Exercise & Sleep

There is treatment available to help manage the symptoms of IBS, however not all treatments are effective for each person. Often doctors advise patients to start getting 20 minutes of exercise 3 times per week, and make lifestyle changes to reduce stressful situations.

Additionally, getting enough sleep also plays an important role in treating IBS.

Over-the-Counter Medications

Over-the-counter medications, such as Pepto-Bismol, help very well for diarrheal issues, and Milk of Magnesia, a mild laxative, is usually suitable for clearing up constipation overnight. Remember, you are only treating the symptoms, but if these medications are not strong enough, please consult your doctor for prescription medication.

Mental Health

Some people become depressed because of IBS symptoms, especially if they are very severe; in this case, please seek professional help. Prozac is a popular medication prescribed for mild depression, while Xanax is often prescribed (short-term) for anxiety related issues with IBS. Be sure to consult your doctor for best results.

Spearmint, Chocolate Mint, or Peppermint Tea

My son has IBS, and he drinks spearmint tea with honey every morning when he gets up to counteract or avoid symptoms of IBS. He says it helps calm his stomach and reduces the symptoms. I've also read that peppermint tea may be even more effective.

Choose from:

• Spearmint Tea
• Chocolate Mint Tea
• Peppermint Tea

Antispasmodic Herbal Teas

The following teas are antispasmodic and have also been found helpful in reducing symptoms of IBS:

• Anise Tea: Good for those with constipation, but not for those with diarrhea.
• Fennel Tea: Not good for those with diarrhea
• Chamomile Tea: A soothing, calming tea.

Neutral Teas

Will not worsen symptoms if brewed weak:

• Black Tea
• Chai Tea
• Dandelion Tea
• Green Tea
• White Tea

The following links provide further information about IBS:

1. "Which Foods are HIgh or Low in FODMAPs?" This website contains printable/downloadable FODMAP charts, plus more:
2. "Help for IBS: Peppermint Tea." Information about IBS and how herbs such as Peppermint can help reduce symptoms: http://www.helpforibs.com/supplements/peppermint.asp
3. Web M.D./IBS Medications. Discusses IBS symptoms, over-the-counter remedies, and prescription medicines available for IBS: http://www.webmd.com/ibs/guide/irritable-bowel-syndrome-ibs-medications#1
4. "Medications for Irritable Bowel Syndrome." This website includes a comparison of IBS related drugs, plus Q & A, Health Guide, Disease Reference, and more: https://www.drugs.com/condition/irritable-bowel-syndrome.html