Irritable bowel syndrome (IBS) is the most common functional gastrointestinal (GI) disorder. What’s more, it is somewhat of a mystery because clear signs of it are almost never seen on diagnostic tests, and its symptoms can often be confused with other inflammatory bowel illnesses.
IBS impacts between 10–15% of the global population and 45 million people in the United States; however, it is most prevalent among females who make up roughly two-thirds of all IBS patients. The disease is one of the most common conditions seen by physicians, but many patients cannot recognize the presence of IBS.
“Irritable bowel syndrome is a very common condition that affects many Americans,” says Raaj K. Popli, M.D., a board-certified gastroenterologist at Digestive Disease Consultants. “It refers to irregular bowel movements, either diarrhea or constipation or some combination of the two that can result in a lot of abdominal pain.”
How Is IBS Diagnosed?
IBS is diagnosed entirely on symptoms which may include:
- Abdominal pain
- Distention and bloating
- Constipation or diarrhea
- Altered bowel behaviors (such as a change in stool frequency, appearance, or form)
Symptoms of IBS typically resemble those of inflammatory bowel disease (IBD) making it challenging for doctors to tell the two chronic illnesses apart. Because IBS symptoms cannot be identified by diagnostic testing, it is commonly thought that symptoms result from:
- Sensory and motor dysfunction
- Visceral hypersensitivity
- Psychological factors including stress and anxiety
- Neuroimmune variables
- Autonomic dysfunction
- Neurotransmitter distortion
Although not life-threatening, IBS symptoms can recur often and adversely affect one’s quality of life including having to miss work or school, and not being comfortable taking part in regular activities. IBS does not lead to other digestive diseases such as ulcerative colitis, Crohn’s disease, or colon cancer. However, the syndrome does pose significant costs to society to the tune of $21 billion per year in direct medical expenses and indirect costs related to lost productivity and work absenteeism.
“Many patients are affected with IBS,” says Dr. Popli. “It can be a very troubling and frustrating disease, but here at Digestive Disease Consultants we have many therapies and options that are now available for patients to make sure that there aren’t any other concerns along those lines.”
How to Treat IBS
IBS is treatable, but there is no panacea. Every individual has different triggers for their symptoms including:
- Specific foods
- Lifestyle choices
- Emotional stress
Patients will need to work with their physicians to identify their personal triggers and find the optimal treatment plan.
“Treatments often begin with dietary modification,” says Dr. Popli. “As everyone knows, we are what we eat, and that also includes our digestive system and how it responds to certain foods. We will go over a detailed list of your dietary habits and proceed from there. There are other pharmacological agents that we use as well to modify the symptoms.”
The following dietary and lifestyle changes have been shown to reduce the symptoms of IBS over time:
- Cutting out caffeine
- Adding fiber to your diet with fresh fruits, vegetables, and whole grains
- Drinking about one liter of water each day
- Quitting smoking
- Learning relaxation or meditation techniques to reduce stress
- Limiting the amount of dairy you consume
- Eating smaller portions
The following drugs are used to treat IBS:
- Bulking agents like psyllium, wheat bran, and corn fiber
- Antibiotics like rifaximin (Xifaxan) which alter the number of bacteria in the intestines
To relieve abdominal pain and bloating, antispasmodic medicine may help contain colon muscle spasms, but it may also induce side effects such as drowsiness and constipation. Antidepressant medication may help some patients to alleviate their IBS symptoms. Probiotics, can enhance and fortify the digestive system and thereby help improve IBS-related problems.
For patients with constipation, polyethylene glycol (PEG), an osmotic laxative, can help soften the stool and is a viable option for those who have trouble assimilating dietary fiber supplements. Lubiprostone (Amitiza) can help improve constipation in IBS female patients when other treatments have not been successful, and plecanatide (Trulance) can be an effective choice for treating constipation without cramping and abdominal pain.
To relieve symptoms of diarrhea, Imodium slows down the movement through the intestines decreasing bowel movement frequency and making the stool more firm. Bile acid sequestrants can help decrease stool formation in the intestines, and eluxadoline (Viberzi) may be prescribed to help diminish bowel contractions, abdominal cramps, and diarrhea.
When taking any IBS medication, it’s critical to follow your physician’s instructions and guidance to avoid developing a dependency and to achieve the best results. If you are experiencing any symptoms of IBS or have any questions or concerns, please feel free to contact us.
You Have Options
By working closely with your gastroenterologist, you can discover the source of your symptoms and find the best way to treat and alleviate them. More importantly, it’s critical to visit your physician to evaluate your condition and rule out the possibility of your symptoms being related something bigger.
“We’d love for you to have an evaluation with us and go over some of these things with you,” says Dr. Popli.