All About: Irritable Bowel Syndrome

Tuesday, April 12, 2016

Irritable Bowel Syndrome (IBS) is extremely common. Many studies indicate that up to 20% of American adult individuals may suffer from IBS, although this condition does not discriminate against age or race, it does tend to be more common in women than in men.

What causes IBS? 

Unfortunately, the causes of IBS are not yet well understood. Currently, much research about this disease is ongoing. Several theories exist based on research and understanding of the gastrointestinal tract:
  • One theory relates to food sensitivity (not to be confused with food allergies). It is theorized that IBS may be related to poor digestion or absorption of some carbohydrates (sugars) in affected individuals. Some diets to counteract IBS have been successful.
  • Another theory suggests that individuals suffering with IBS may have a disruption in the nervous signals between the brain and GI tract or intestinal nerves.
  • IBS is often found in association with mental health disorders, such as anxiety, depression, or stress. These disorders heighten the neurochemicals in the body that increase IBS symptoms.
  • Lastly, researchers have shown that IBS may be linked to bacterial overgrowth in the small intestine or disruption in the normal bacterial flora of the GI tract which may occur after a gastrointestinal infection (such as bacterial gastroenteritis, food poisoning, infectious colitis, etc).

How is IBS diagnosed & treated?

IBS is often a diagnosis of exclusion. This means that other important conditions and diseases that may be contributing to IBS-like symptoms must be ruled out to ensure that a correct and accurate diagnosis is given.

Once a diagnosis is established, a route of treatment that will work best for the patient’s comfort level and lifestyle can be established. Tracking and monitoring patient symptoms is an important part of making sure the treatment is successful.

How do I know if I need to see a gastroenterologist?

Symptoms of special concern and alarm include unexpected weight loss, vomiting, severe abdominal pain, dramatic change in bowel habits, and bleeding. Also, if your gastroenterology problems are unmanageable or you cannot function with your symptoms, it is recommended you see a doctor.

How does a nutritionist play a role in IBS management?

As mentioned previously, those with IBS may have a sensitivity to certain short-chain carbohydrates called Fermentable Oligo-Di-Mono-saccharides and Polyols, or FODMAPs for short. These poorly absorbed carbohydrates are favorite foods for the bacteria that normally live in the digestive tract. When bacteria eat the FODMAPs, they produce gas in a process called fermentation. The production of gas by these bacteria is a major contributor to IBS symptoms including abdominal pain, intestinal gas, bloating, and change in bowel habit.
A team of researchers in Australia at The Monash University developed a dietary approach to help minimize IBS symptoms. It is called the low FODMAP diet.
The low FODMAP diet is a “learning diet” and should be undertaken with guidance from a registered dietitian who has been trained in the area.
The diet eliminates high sources of FODMAPs for a period of 2 to 6 weeks. During the elimination phase, you eat foods that are least likely to provoke gastrointestinal symptoms. Because FODMAPs have a cumulative effect, we reduce the total FODMAP load consumed at each meal or across the day.
After this, your dietitian will guide you through re-introduction of FODMAP categories in a systematic manner in order to identify your personal triggers.
The ultimate goal is to be able to gradually increase to levels well-tolerated by the individual and achieve and maintain the most healthy, well-balanced diet tolerated.