Understanding IBS: The What, The Why, and The What Next
Irritable bowel syndrome (IBS) is a common, chronic condition that affects the digestive system, characterised by abdominal discomfort and changes in bowel habits. People with IBS might experience symptoms such as bloating, abdominal pain, excessive wind, mucus in stool, diarrhoea, and/or constipation, with the severity and frequency of symptoms varying from person to person. It’s estimated that around 30% of Australians have IBS, with women being twice as likely to be affected compared to men.
IBS can have a significant impact on quality of life. It can disrupt daily activities, leading to missed school or work and avoidance of social activities which can all contribute to poor mental health outcomes, including anxiety and depression.
Since there is no specific test for diagnosing IBS, It is typically identified based on patient-reported symptoms and by ruling out other conditions, such as coeliac disease and inflammatory bowel disease.
The exact cause of IBS remains unclear, and symptoms are typically triggered by a combination of factors unique to each individual. Common risk factors include intestinal infections, abnormal intestinal motility, increased sensitivity to pain, disruptions in the gut microbiota, emotional or psychological stress and food restriction.
Let’s take a look at some of these risk factors more closely.
Infections – Gastrointestinal infections, caused by viruses, bacteria, or parasites, can lead to long-lasting symptoms like abdominal pain and altered bowel habits, even after the infection itself has been treated.
Abnormal Gastrointestinal Movement – Your intestines have muscles that help push food through your digestive tract. If these muscles contract too strongly or too weakly, it can cause problems. When the muscles contract too much, food moves too quickly through the intestines, leading to diarrhoea and bloating. If the muscles contract too weakly, food moves too slowly, which can cause constipation and bloating.
Visceral Hypersensitivity – Visceral hypersensitivity means that your gut becomes overly sensitive to pain signals from the brain through the vagus nerve. This means you might feel abdominal pain or discomfort from things that wouldn’t normally cause problems, like eating a seemingly harmless meal such as chicken, rice and veg or even just moving around.
Gut Dysbiosis – Your gut is home to a massive number of bacteria—about three times as many as there are cells in your body! These bacteria help with digestion, support our immune system, and even influence our mood. Think of the bacteria in your microbiome as a finely tuned orchestra, where each player (bacteria) contributes harmoniously to the overall performance. When this bacterial harmony is disrupted, it’s called gut dysbiosis, which can negatively affect how well your gut functions. Gut dysbiosis can be triggered by several things, including antibiotic use, gut infections, diets high in processed sugars and fats, and chronic conditions like diabetes and obesity.
Psychological stress – Many people with gut issues find that stress can make their symptoms appear or worsen. Stress affects the gut in various ways, often exacerbating conditions like IBS.
Weight loss and food restriction – Rapid and/or significant amounts of weight loss and chronic restriction of food can cause muscle wasting in the intestines. This causes food to take much longer to travel through your digestive tract. When the body is in starvation less enzymes and hormones that are useful in digestion are produced. This often results in constipation, bloating, abdominal pain and wind.
What we eat plays a significant role in IBS, although specific food triggers can vary from person to person. While there is no cure for IBS, various dietary strategies can help reduce the severity and frequency of symptoms.