Everything You Need to Know About Irritable Bowel Syndrome (IBS)

What is Irritable Bowel Syndrome (IBS)?

Irritable Bowel Syndrome, commonly referred to as IBS, is a disorder of the digestive tract that affects the stomach and intestines. IBS can cause widespread abdominal pain and cramping, bloating, gas, and constipation and/or diarrhea. Unlike other bowel disorders, irritable bowel syndrome does not cause any damage to the intestinal tract.

IBS may also be referred to as spastic colon, mucous colitis, spastic bowel or irritable colon. 

3 Types of Irritable Bowel Syndrome

There are 3 main types of irritable bowel syndrome:

• IBS-D is the main type of IBS which primarily causes loose watery stools (diarrhea) alongside abdominal discomfort and bloating
• IBS-C causes chronic constipation with abdominal discomfort and bloating
• IBS-M, or mixed type, which causes combination of both diarrhea and constipation as well as abdominal discomfort, gas and/or bloating

Causes of IBS

Irritable bowel syndrome (IBS) is not a very well understood disease and scientists aren’t entirely sure what causes it though it often begins after a bout of severe diarrhea caused by a bacterial or viral infection. Irritable bowel syndrome may also be caused by an overgrowth of bacteria in the digestive tract.

If someone in your immediate family has irritable bowel syndrome, you are 2 to 3 times more likely to develop it yourself.

What causes the symptoms of IBS?

The intestinal tract is lined with muscles that contract to help stool move through the bowel. With IBS-D the muscles of the intestines contract faster and for longer periods of time than usual, causing gas, bloating and watery stools. On the contrary, with IBS-C, the muscles of the intestine move slower and weaker than normal, causing dry stools which result in constipation. 

Who is Affected by Irritable Bowel Syndrome (IBS)?

Irritable bowel syndrome is a very common gastrointestinal disorder that affects approximately 15% of the population. Women are twice more likely to develop IBS than their male counterparts and diagnosis usually occurs before the age of 40 - often in childhood and young adulthood.

It's estimated that somewhere between 24 to 45 million Americans are living with Irritable Bowel Syndrome. The highest prevalence of IBS is found in South America, with approximately 21% of the population experiencing IBS symptoms. It is believed that approximately 5% of children ages 4-18 have IBS with similar symptoms as adults. 

Children may experience IBS:

• Alongside mental health issues like stress, anxiety and depression
• If they have seasonal allergies
• After having a bacterial infection in their digestive tract
• After a history of child abuse
• If a family member also has IBS

Diagnosing Irritable Bowel Syndrome

Unfortunately there is no one specific test to diagnose IBS so your healthcare provider will take a history of your symptoms and perform a physical exam to help make a diagnosis. Having an occasional upset stomach does not qualify as IBS. In order for doctors to make a diagnosis, you must be experiencing symptoms for a minimum of 3 days a month for at least 3 months or more. 

Occasionally your doctor may run additional testing like bloodwork or a colonoscopy to rule out other more serious bowel disorders like celiac disease, crohn’s & colitis, diverticulitis, etc. Symptoms like bloody stools or bleeding from the rectum, weight loss and anemia are all signs of something more serious and should require further testing.

Common Comorbidities with Irritable Bowel Syndrome

What is a comorbidity?

A comorbidity is an overlapping chronic condition that coincides with one or more other long-term chronic conditions. Studies show that at least 50% of patients with IBS have one or more comorbidities. IBS has quite a few comorbidities including but not limited to: 

• Dyspepsia
• Anxiety and Depression
• Migraines
• Fibromyalgia
• Systemic Lupus Erythematosus (SLE)
• Interstitial Cystitis
• Chronic Fatigue Syndrome

Treating Irritable Bowel Syndrome

The majority of people with IBS can manage their symptoms with lifestyle changes, reduction in stress and diet modifications. Rarely, prescription medication may be needed.

It can be helpful to keep a food and symptom journal for several weeks in a row to help determine what foods might cause your IBS to flare. By keeping a journal, it can help you notice patterns of diarrhea or constipation as well as gas, bloating and abdominal discomfort. If you discover certain foods are a trigger for you, it can help to eliminate them from your diet all together. 

While everyone reacts differently to certain foods and food groups, many IBS patients will find some relief with certain diets like gluten free, FODMAP, AIP Protocol, etc. Changing the way you eat may also help manage your symptoms. Eating smaller meals throughout the day and slowing down how fast you eat may help reduce your IBS flares as well as making sure not to eat too close to bedtime.

Making general lifestyle changes like increasing daily exercise such as going for a walk, bike ride or taking yoga, reducing caffeine, tobacco and alcohol consumption and reducing stress may all help to manage the symptoms of IBS. 

IBS and Probiotics

Studies have shown that taking probiotics may help reduce symptoms of IBS (including IBS-C, IBS-D and IBS-M) by reducing bloating and gas and helping to regulate bowel movements. There are over 500 different strains of probiotics and there are several strains that have shown to be most effective towards managing the symptoms of IBS-D (diarrhea dominant IBS).

Some of those strains include:

• Bifidobacterium longum (B. longum)
• Lactobacillus plantarum (L. plantarum)
• Lactobacillus acidophilus (L. acidophilus)
• Saccharomyces boulardii (S. boulardii)

IBS and CBD Oil 

How can CBD oil help with Irritable Bowel Syndrome?

There are several ways in which CBD oil may potentially help with IBS:

• Anti-Inflammatory Effects: CBD has been shown to have anti-inflammatory properties. Inflammation in the gut is believed to contribute to IBS symptoms, and CBD's ability to reduce inflammation may help alleviate symptoms associated with gut inflammation.
• Pain Relief: CBD has analgesic (pain-relieving) effects, which may be beneficial for individuals with IBS who experience abdominal pain or discomfort. By interacting with receptors in the endocannabinoid system, CBD may modulate pain signals.
• Muscle Relaxation: CBD may have muscle relaxant properties, which could be relevant for IBS as spasms and cramping of the intestinal muscles are common symptoms. By promoting muscle relaxation, CBD may help reduce these symptoms.
• Regulation of Bowel Movements: CBD may influence the motility of the digestive tract. For people living with IBS, who may experience either constipation or diarrhea, CBD's potential to regulate bowel movements could contribute to symptom management.
• Anti-Anxiety Effects: Stress and anxiety often exacerbate IBS symptoms. CBD has been reported to have anxiolytic (anxiety-reducing) effects, which may help individuals manage stress and, in turn, alleviate some IBS symptoms.
• Interaction with the Endocannabinoid System: The endocannabinoid system (ECS) plays a role in regulating various physiological processes, including those in the gastrointestinal tract. CBD interacts with the ECS, and this interaction may contribute to the overall balance and homeostasis within the digestive system.

Irritable Bowel Syndrome FAQ's

What type of doctor should you see for the treatment of Irritable Bowel Syndrome?

Gastroenterologists, sometimes referred to as GI doctors, are specially trained in diseases of the digestive tract and they are typically the ones who will treat IBS, though sometimes patients may be sufficiently treated by their primary care physician. 

Is there a cure for IBS?

While IBS is a chronic (long term) disorder and does not ever go away once you have it it can often be managed with diet and lifestyle changes to the point that there is minimal flareups. 

Is IBS an autoimmune disease?

No, IBS is not an autoimmune disease however it's a common comorbidity with a number of systemic autoimmune diseases.

Does IBS increase your risk of colorectal (colon) cancer? 

No, having IBS does not increase your risk of developing colon cancer or other cancers. If you are experiencing symptoms of rectal bleeding or bloody stools, please consult your doctor for further testing as these are not normal in irritable bowel syndrome alone. 

Can probiotics help IBS?

Studies have shown that probiotics are beneficial in the management of IBS and may help slow down the muscles of the intestine, improve stool consistency and reduce the frequency of bowel movements. Some of the more beneficial strains include Bifidobacterium longum, Lactobacillus plantarum and Lactobacillus acidophilus.

Does taking fiber help treat IBS? 

Yes! Dietary fiber can help reduce IBS symptoms, especially soluble fiber like psyllium. It is believed that many cases of IBS are worsened by a lack of fiber in the diet so increasing fiber may decrease IBS symptoms. Some other examples of soluble fiber include beans, seeds, lentils, nuts, oats, flaxseed, apples, peas, brussels sprouts, potatoes, zucchini and more.

When is Irritable Bowel Syndrome awareness month?

April is Irritable Bowel Syndrome Awareness Month to bring awareness to this disorder that effects approximately 1 in 20 people.