Abnormal functioning of the digestive tract

Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders affecting American adults.

According to the American College of Gastroenterology, IBS affects 10% to 15% of the population. The condition can greatly reduce the quality of life for many sufferers, especially if it goes untreated.

IBS is a functional gastrointestinal (GI) disorder, a term used for conditions where the digestive tract functions abnormally. This dysfunction causes a range of GI symptoms, but it does not cause any lasting damage to the digestive system or lead to other conditions. There are no tests to formally diagnose IBS. Rather, it is what we refer to as a “diagnosis of exclusion,” where we rule out other possible conditions by performing a thorough history, physical exam, laboratory testing and, occasionally, upper and lower endoscopy.

There are three types of irritable bowel syndrome: IBS with constipation (IBS-C), IBS with diarrhea (IBS-D) and IBS-Mixed (constipation and diarrhea).

Symptoms are widely variable but usually persistent over at least six months or longer. Those symptoms include: • Abdominal bloating • Abdominal discomfort, pain or cramping • Changes in bowel movements (diarrhea, constipation or both) • Excessive gas • Mucus in stool The exact cause of IBS is unknown.

Although, research points to a number of factors, including GI tract hypersensitivity, motility issues with the muscles of the digestive tract, communication problems between the brain and the gut, changes in gut microbiome or bacterial overgrowth, and psychosocial stressors.

What is known is that IBS affects more women than men, and it occurs more often in people under 50 years of age.

Other factors that increase the risk of developing IBS include a family history of IBS; a personal history of abuse, anxiety, or stress; or having previously suffered an infection of the GI tract.

Treatment for IBS involves addressing the symptoms of the disorder. For patients with mild symptoms, treatment is usually focused on lifestyle changes. Stress, diet and poor gut health often trigger or worsen symptoms.

Lifestyle changes that can help control IBS symptoms include:

• Avoiding trigger foods

• Ensuring proper hydration with at least eight glasses of water per day

• Daily physical activity/exercise

• Getting good-quality sleep

• Lowering or properly managing stress

• Seeking help for anxiety and/or depression

There are common trigger foods for many IBS sufferers, such as gluten, dairy and gas-inducing foods such as FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols found in specific fruits, vegetables, grains and dairy foods). However, it can be tricky to identify exactly which foods or drinks are producing the IBS symptoms. Your doctor may recommend an elimination diet to identify trigger foods, often undertaken under the guidance of a dietitian.

For those with more severe symptoms or those who don’t respond to lifestyle changes, supplements and medications may help. These can include fiber supplements; antidiarrheal, laxative therapy, antispasmodic drugs; and certain medications called “neuromodulators,” affecting the interactions between your gut and brain. One example is certain anti-depressants often used to treat IBS, even without a history of depression or anxiety. If bacterial overgrowth is a suspected factor, antibiotics may also be prescribed.

Some patients also improve significantly from non-drug therapies, such as cognitive behavioral therapy and hypnotherapy.

Don’t suffer unnecessarily from irritable bowel syndrome. If you are experiencing ongoing digestive tract symptoms that are not improving or worsening, talk to your doctor.

Abby Linzay, MD, is a board-certified gastroenterologist at GastroIntestinal Specialists, A.M.C., the largest independent gastroenterology group in Northwest Louisiana. To schedule an appointment, visit www.gis.md or call (318) 631-9121.