Irritable Bowel Disease in detail
People with irritable bowel syndrome (IBS) may have different combinations of symptoms, one being dominant, while the other digestive symptoms are more random and unpredictable. These intestinal experiences and their unpredictability can lead to a high degree of anxiety for the person with IBS. Stool consistency can vary greatly, ranging from liquid to firm and so firm that it looks like small pebbles. External factors, such as stress, can affect stool consistency. IBS has different subgroups associated with stool consistency:
- IBS-D is a digestive system that contracts rapidly, causing the products of digestion to pass through the digestive tract quickly, resulting in frequent, loose stools (diarrhea).
- IBS-C occurs when the digestive system contracts slowly, delaying the transit time of products of digestion and resulting in hard stools, difficult to evacuate and infrequent (constipation).
- IBS-M is the time when the transit time in the digestive tract fluctuates, causing patients a mixture of diarrhea and constipation, often alternating between the two. These extreme consistencies can sometimes even occur in the same stool.
Intestinal pain can occur when the material in one section of the intestine passes slowly while the material in another section passes rapidly. These simultaneous actions can produce stools of alternating constipation and diarrhea, sometimes within the same stool.
In addition, prolonged bowel contractions may prevent the normal passage of air and cause bloating, belching, and flatulence. Bloating can become so important that clothes are tight and abdominal swelling becomes visible to others.
IBS is a multifactorial disorder involving an interaction between the gastrointestinal tract, intestinal bacteria, the nervous system and external factors such as stress (see the article on Benefits of Meditation).
Although not proven, there are theories about the factors that influence IBS symptoms, including:
- Neurological hypersensitivity in the gastrointestinal (enteric) nerves
- Physical and / or emotional stress
- Dietary problems such as allergies or food sensitivities, or poor eating habits
- Use of systemic antibiotics
- Gastrointestinal infection
- Malabsorption of bile acids
- Amount or type of physical exercise
- Chronic alcohol abuse
- Abnormal gastrointestinal secretions and / or contractions of the digestive muscle (peristalsis)
- Acute infection or inflammation of the intestine (enteritis), such as traveler’s diarrhea, which may precede the onset of IBS symptoms
- SIBO or too many bacteria in the small intestine
IBS relief and resolution
A person with IBS can take different measures to reduce air ingestion, the main source of intestinal gas, and avoid large amounts of gas-producing foods. To reduce the air swallowed, eat mindfully more slowly with attention to the flavors and textures of food.
Avoid chewing gum, drinking soft drinks, washing down with liquids and drinking hot drinks. Poorly fitting dentures, chronic postnasal discharge, chronic pain, anxiety or tension can also contribute to increased air swallowing.
A proposed treatment for IBS, called a low FODMAP diet, is gaining popularity in North America. FODMAP is an abbreviation for Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols. These are the names of poorly digested carbohydrates, which travel in the large intestine where they are fermented by resident bacteria. For many people, these foods do not cause problems, but some people with IBS find that these foods make their symptoms worse.
The diet is to avoid specific foods for six to eight weeks to see if the symptoms go away. If symptoms improve, you can slowly reintroduce FODMAPs into the diet to a tolerable limit. FODMAP is present in many foods. Therefore, removing them from your diet can increase the risk of nutritional deficiencies. Although the results of studies conducted on low FODMAP diet seem promising as a possible management approach for IBS, it does not help everyone and further research is needed.
It is important to note that IBS is very variable and that each person can experiment with different triggers. By keeping a food diary and noting possible side effects, you can quickly identify and eliminate problem foods from your diet and determine the best approach for you.