September 15, 2023
From abdominal pain and bloating to urgent bathroom trips and constipation, irritable bowel syndrome (IBS) can be a disruptive condition to live with. Fortunately, there are treatments available that can help to alleviate its symptoms — but finding the most effective one often takes some time and patience.
Irritable bowel syndrome is a functional gastrointestinal (GI) disorder. The condition is caused by problems with the interactions between your brain and your gut. About 10 to 15 percent of Americans experience symptoms of IBS, and most cases begin in people under 50 years old.
IBS symptoms can include:
• Stomach pain and cramps
• Gas
• Bloating
• The sensation of fullness
• Diarrhea
• Constipation
A person must experience one or more of these symptoms for at least three days a month over a period of at least three months to be diagnosed with IBS.
Exactly why IBS develops hasn’t been determined. However, certain health problems are more common in people with the condition, including stress caused by life events, mental health disorders, bacterial infections, and food intolerances. Genetics may also play a role in who develops IBS.
No single test can definitively diagnose IBS. If you go to your doctor with IBS symptoms, they likely will try to rule out other conditions by reviewing your medical and family history, performing a physical exam, and ordering diagnostic procedures and tests.
There is no cure for IBS, so treatments are primarily focused on managing symptoms. General treatment categories include:
• Lifestyle changes, such as making sure you’re getting enough exercise and sleep
• Dietary changes, to find which foods cause flare-ups and which don’t
• Stress-reduction therapies
• Medication
• Complementary health approaches
One dietary change that may work is eating smaller meals. This involves using four or five meals to eat the same amount of food your normally eat in three meals.
Avoiding food and beverages that stimulate the intestines, like those that include caffeine, also may be helpful.
Eating more fiber may reduce IBS symptoms. If you try this, you should add fiber to your diet slowly to prevent getting gas, which can trigger other IBS symptoms.
Foods with gluten can trigger IBS symptoms, so avoiding it may reduce them. Gluten is a protein found in wheat, barley, and rye. It is in most cereals, grains, and pasta, as well as many processed foods.
Foods that contain a type of carbohydrate called a FODMAP also can trigger IBS symptoms. (FODMAP stands for fermentable oligo-saccharides, disaccharides, mono-saccharides, and polyols.)
FODMAPs include:
• Fructans, which are found in garlic, onions, and wheat
• Fructose, which is found in fruits, honey, and high-fructose corn syrup
• Galactans, which are found in beans and legumes
• Lactose, which is found in dairy products
• Polyols, which are found in pitted fruits and sugar alcohols
To begin a low-FODMAP diet, high-FODMAP foods are completely avoided for about six weeks. They are then added back one at a time to determine which foods are triggering the IBS symptoms.
A low-FODMAP diet is restrictive, so you shouldn’t begin one unless it’s recommended by your doctor. If they believe it’s the best course of action, they can help you develop a diet that will ensure you receive all the nutrients your body needs.
Because IBS can be triggered by stress, psychotherapy may be helpful in lessening its effects. Mental health therapy techniques used for IBS include:
• Gut-focused cognitive behavioral therapy, in which work you with a therapist to determine how you think and behave in relation to your IBS symptoms.
• Gut-directed hypnotherapy, which is meant to help you gain better control over your symptoms by addressing the communication occurring between your brain and your gut.
• Mindfulness-based behavioral therapies, which teach you to notice your symptoms without trying to avoid or change them, as well as ways to cope with them, such as meditation.
Many medications are available to help people deal with IBS symptoms. They include:
• Laxatives and anti-diarrheal medication
• Secretagogues/prosecretory agents, which improve movement in the GI tract
• Retainagogues, which block the absorption of sodium in the GI tract and allow more waste to be retained in the intestines, resulting in softer stools
• Antispasmodics, which suppress muscle contractions in the GI tract
• Anticholinergics, which reduce spasms or contractions in the intestine
• Neuromodulators, such as antidepressants, which affect nerve signaling
You should talk to your doctor about what medications may be best for you.
These forms of treatment are non-mainstream therapies used in conjunction with traditional ones. In the case of IBS, ones that show some evidence of working include probiotics, peppermint oil capsules, and yoga.
IBS can be very frustrating to deal with until you learn how to manage it. The good news is there are many effective ways to reduce the disruptive symptoms caused by the disorder. It just may take some time to figure out which treatment option(s) works best for you.
