Understanding irritable bowel syndrome and how to manage it

IBS presents as a group of symptoms, including abdominal pain, bloating and changes in bowel movements, which may be diarrhoea, constipation, or both. Photograph used for representational purposes only

Irritable Bowel Syndrome (IBS), known in the past as mucous colitis or spastic bowel, is a common disease affecting about 5-10% of Indian population. It is a disorder of the gut-brain interaction, which causes the gut to become more sensitive and reactive in response to diet, infections, and emotions.

IBS presents as a group of symptoms, including abdominal pain, bloating and changes in bowel movements, which may be diarrhoea, constipation, or both. Though patients have these symptoms, they do not have any visible signs of damage or disease in their digestive tract. IBS is a chronic condition but does not increase one’s risk for colon cancer.

Risk factors for IBS include having a family member with IBS, a history of stressful or difficult life events, and having had a severe digestive tract infection. Women are more likely than men to develop IBS.

The diagnosis of IBS is based on typical symptoms and the absence of alarm symptoms like weight loss, fever, and blood in stools. Lab tests including blood tests, stool tests and imaging studies like colonoscopy and CT scan/MRI may be conducted.

Treatment includes lifestyle changes, diet changes and medications. Treatment takes time to work and improves symptoms, but rarely cures the disease.

Meal changes advised by a dietitian may include increasing fibre in the diet, limiting dairy products and avoiding gassy foods like beans, dal, cabbage and carbonated sodas. Dieticians may also advise a low FODMAP diet (reducing hard-to-digest carbohydrates) and drinking plenty of water. Lifestyle changes advised are regular exercise, getting 7-9 hours of sleep at night and trying relaxation techniques like yoga and meditation.

Medications to relieve persistent symptoms include laxatives for constipation, antidiarrheals for loose stools and antispasmodics for intestinal cramps. Small doses of anxiolytics or antidepressants will help those with anxiety or depression.

Living with IBS is challenging because symptoms come and go throughout life. The strategy to a comfortable life is to figure out trigger factors that cause symptoms and avoid them.

(Dr. Ashok Chacko is a senior consultant at the department of gastroenterology, Naruvi Hospitals, Vellore. [email protected])