Irritable Bowel Syndrome (IBS) is a common functional gastrointestinal disorder, which affects 1 in 7 (15%) people, with most feeling awkward and negatively impacts their personal, professional and social lives (1). I’ve compiled a list over time from clients about IBS, so let's chat about it and answer your burning IBS questions!

What is happening?

In someone with IBS, changes in bowel movements (constipation, diarrhoea or both) are thought to be due to a dysregulation or dysfunction in the connection between our gut and brain (2), whereas symptoms of abdominal pain or discomfort are thought to be due to additional changes in the gut-brain axis, resulting in enhanced two-way communication and the nerves that line the intestines becoming hypersensitive and overactive (2). Essentially, two people could have the exact same bloating, however someone with IBS will feel this & react more so than someone without IBS.

We still do not know the exact cause of IBS, but researchers suggest it is a post-inflammatory and stress-related condition (2). On a positive note, there’s not physical damage to your gut, which is why nothing detected on a colonoscopy.

How is it diagnosed?

There is currently test for IBS, diagnosis is based on the The Rome IV Criteria:

This criteria includes:

"having recurrent abdominal pain or discomfort at least 3 days per month (on average ~1/d week) over a period of 3 months and have at least two of the following:

- Improvement in symptoms after going to the toilet

- Onset associated with a change in frequency of bowel movements

- Onset associated with a change in appearance of bowel movements.

Signs and symptoms to have occurred within the last 3 months and to have started at least 6 months before diagnosis"

Individuals are then categorised according to their symptoms as IBS-C (constipation), IBS-D (diarrhoea), IBS-M (mixed-both constipation and diarrhoea) or IBS-U (unknown-doesn't fit into any category).

Other gut conditions, disorders (coeliac disease or inflammatory bowel diseases) and infections must be ruled out first before a delivery of IBS diagnosis is given (although in my experience, and with social media, this doesn’t always happen).

Help, I’ve been diagnosed, what’s next?

Management and treatment is symptom-focussed (1). There are a few ways someone can manage their condition; diet, yoga/exercise, psychological therapies (eg. gut hypnotherapy, stress management) or medications.

There is a first line treatment of removing foods which can irritate our gut (eg. coffee, alcohol, spicy foods, fatty foods).

If there is no success there, we can venture down the low FODMAP diet route. This is the dietary intervention to identify foods which can trigger symptoms, not everyone will respond to the low FODMAP diet, it’s effective in ~70% of individuals (3). This is incredibly complex and should be performed in collaboration with a digestive dietitian who is experienced in this area. Many high FODMAP foods are prebiotics, which means they’re food for the bacteria in our gut allowing them to thrive & diversify our microbiome (hello healthy gut!). It’s only a short term diet and definitely not to be followed for a long time as it’s restrictive!

If you go down the medications option, remember medications generally have other implications on your health so make sure you and your dietitian work together to find the best option FOR YOU!

Though it may sound difficult to find the right treatment or management for you to feel symptom free-it is possible! If you are concerned you have IBS, contact your GP or I am here to help with your nutritional needs, book an appointment here.

I hope you found this helpful. If you know someone who could benefit from this information, please feel free to forward or share this with them.

Kindest,

Sarah

References

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175452/

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4734998/

3. https://www.gastrojournal.org/article/S0016-5085(13)01407-8/fulltext