(HealthNewsDigest.com) – Abdominal pain, cramping, diarrhea, constipation: Today most doctors recognize these symptoms as possible signs of irritable bowel syndrome (IBS).
But standardized criteria to diagnose this condition didn’t exist until the 1980s. Prior to then, some doctors dismissed IBS as a psychosomatic issue due to the absence of physical evidence related to IBS (e.g., bleeding, growths, obstructions).
With one in six Americans suffering from this disorder, you may find that hard to believe. And that’s not the only thing that might surprise you about IBS, says Michael Brown, MD, a gastroenterologist at Rush University Medical Center.
According to Brown, there are a few other common misconceptions about this disorder, so he offers the following facts:
1. Men get it, too.
While young and middle-aged women tend to attract more media attention when it comes to IBS, it affects men as well.
In fact, one third of those suffering from IBS are men. Doctors also diagnose it in children and older adults.
2. And yes, doctors do diagnose IBS.
Diagnosing IBS involves a process of elimination and can take time. But make no mistake, the condition is real and has a set of clearly defined diagnostic criteria that can reduce the need for invasive and expensive testing.
If you experience symptoms that interfere with your daily living, you should definitely discuss it with your primary care physician or a gastroenterologist. To diagnose the condition, doctors will refer to the Rome criteria, [see below] which specifies the types and duration of symptoms that define IBS and its subtypes.
Bloating is a common but not uniform feature of IBS
3. Stress plays a key role, but it’s not the source.
While stress can trigger and even worsen symptoms — perhaps because of disruption in communication between the gut and the brain — it isn’t what causes IBS.
Actually, no one knows for sure what causes IBS, but the nerves and muscles surrounding bowels appear to be super sensitive in people with IBS, which can cause sensitivity to only mild bowel irritation and gut movement abnormalities that result in constipation, pain and diarrhea.
4. Irritable bowel syndrome differs from inflammatory bowel disease.
While some symptoms may be similar, IBS is not inflammatory bowel disease, or IBD, a term covering Crohn’s disease and ulcerative colitis.
While doctors define these two conditions as diseases, they categorize IBS as a syndrome. Why?
- To be classified a disease, a condition must have a known cause, and IBS has none, yet
- Both Crohn’s and colitis can cause rectal bleeding; IBS does not
- Unlike colitis, IBS does not increase the risk of colon cancer
While stress can trigger and even worsen symptoms — perhaps because of disruption in communication between the gut and the brain — it isn’t what causes IBS.
5. Dietary changes can help you feel better.
Like stress, some foods spark IBS symptoms, and even the simple act of eating can sometimes bring about symptoms. While food affects everyone differently, for those with IBS, certain culinary culprits appear to be especially problematic, from alcohol to fried foods to dairy products.
Brown recommends keeping a food diary so you can see which foods in your current diet are causing flare-ups.
Depending on your specific symptoms and triggers, one or more of these dietary approaches may help:
Eat more fiber.
Fiber plays a key role in preventing constipation, making stools softer and easier to pass, so people with IBS-related constipation may benefit from getting more soluble fiber (the kind of fiber found in oats, fruit and beans).
Aim for the recommended daily allowance of 22 to 34 grams. But make sure to boost your fiber intake gradually, since too much fiber at once can cause gas and bloating.
Go gluten-free.
If you experience IBS symptoms after eating foods that contain gluten (a protein found in wheat, barley and rye), avoiding gluten may provide some symptom relief.
Try a low-FODMAP diet.
A low-FODMAP diet has been shown to help people with IBS both manage symptoms and improve how they feel overall.
FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) are specific types of carbohydrates that are hard to digest and, as a result, can cause a whole host of bothersome symptoms, including gas, bloating, distension and diarrhea.
These are some high-FODMAP foods, many of which are also common triggers for IBS:
- Artificial sweeteners such as sorbitol, maltitol or xylitol
- Carbonated drinks such as soda
- Certain fruits (e.g., apples, apricots, blackberries, cherries, mango, nectarines, pears, plums and watermelon)
- Certain vegetables (e.g., artichokes, asparagus, beans, cabbage, cauliflower, garlic, lentils, mushrooms, onions, sugar snap peas, snow peas)
- Chickpeas
- Dairy products (e.g., milk, soft cheeses, yogurt, cottage cheese, custard, ice cream)
- Foods that contain wheat and rye
- Honey and other foods containing high-fructose corn syrup
If you notice that these foods are among your triggers, consider trying a low-FODMAP diet for 2 to 3 weeks to see if that helps improve your symptoms. If it does, you can then work with your doctor to figure out which specific foods are the culprits; you may actually be able to tolerate some foods that contain FODMAPs and reintroduce them into your diet.
Beyond diet
Of course, dietary changes alone may not be enough to completely curb symptoms. Managing stress and anxiety can also play an important role in alleviating symptoms, as can medications for more severe cases.
Some patients may also benefit from physical therapy which can help tighten (or loosen) the pelvic floor and abdominal muscles, areas that may contribute to IBS symptoms.
To get an individualized treatment plan from a multidisciplinary team of specialists that tackles IBS on multiple fronts, contact the Program for Abdominal and Pelvic Health at Rush or Michael Brown, MD, whose clinics focus on functional bowel disorders.
Rome III Criteria for Irritable Bowel Syndrome
Duration of recurrent abdominal pain or discomfort* of at least three months, with onset occurring at least six months prior. Regarding pain or discomfort, two or more of the following must be true:
- Improvement with defecation
- Onset associated with a change in frequency of stool
- Onset associated with a change in form (appearance) of stool
*Discomfort means an uncomfortable sensation not described as pain.