What is Irritable Bowel Syndrome (IBS)?
IBS is defined as "Recurrent abdominal pain, on average, at least 1 day per week in the last 3 months, associated with two or more of the following: related to defecation, associated with a change in frequency of stool, and/or associated with a change in form (appearance) of stool."
In simpler terms, IBS is a chronic condition characterized by abdominal pain and changes in bowel habits that are not explained by any other medical condition.
Causes of Irritable Bowel Syndrome
The exact cause of IBS is technically unknown, but it is believed to be a multifactorial condition with several contributing factors. These include:
Abnormal Intestinal Motility: The muscles in the walls of the intestines contract and relax in a coordinated manner to move food through the digestive system.
In people with IBS, the contractions may be stronger and last longer than normal, or they may be weaker and slower. These abnormalities can cause abdominal pain, bloating, and changes in bowel habits.
Abnormalities in Gut-brain Interactions: The gut and the brain communicate bi-directionally through the gut-brain axis. People with IBS may have alterations in the gut-brain axis, leading to abnormal pain perception, altered motility, and changes in secretion and absorption.
Inflammation: Some studies suggest that low-grade inflammation in the gut may play a role in the development of IBS. However, the cause of the inflammation is not clear. We believe that it may very well be diet or autoimmune driven inflammation.
Food Intolerance: Food sensitivities are a major suspected IBS trigger. Certain foods, especially gluten, dairy and those high in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), can trigger symptoms in people with IBS.
FODMAPs are poorly absorbed in the small intestine and are fermented by bacteria in the colon, producing gas and causing bloating and other symptoms.
Stress: Stress and anxiety can trigger or worsen IBS symptoms. This may be due to the effects of stress hormones on the gut or the brain-gut axis.
Women’s Cycle: Hormones, such as estrogen and progesterone, are produced by the ovaries and play a key role in the female reproductive system. These hormones can also affect other parts of the body, including the digestive system.
In some women with IBS, fluctuations in estrogen and progesterone levels during the menstrual cycle can cause changes in bowel habits and abdominal pain.
For example, during the luteal phase of the menstrual cycle (the second half of the cycle), levels of progesterone increase. This can cause relaxation of the muscles in the digestive tract, which can lead to constipation.
In contrast, during menstruation, levels of both estrogen and progesterone decrease, which can lead to increased bowel movements and diarrhea.
In addition to menstrual cycle-related hormone changes, some women with IBS may experience symptoms related to hormonal contraceptives, such as the birth control pill. The hormones in these medications can also impact bowel habits and abdominal pain.
Research on Irritable Bowel Syndrome
Research on IBS has focused on understanding the underlying causes of the condition and developing effective treatments. Some of the notable research findings on IBS include:
Gut Microbiome: The gut microbiome, which refers to the trillions of microorganisms that live in the gut, has been implicated in the development of IBS. Some studies have found that people with IBS have an altered gut microbiome compared to healthy individuals, with lower bacterial diversity and increased levels of certain bacteria.
Cognitive-Behavioral Therapy: Cognitive-behavioral therapy (CBT) is a type of psychotherapy that aims to change negative thought patterns and behaviors. Several studies have found that CBT can be effective in reducing symptoms and improving quality of life in people with IBS.
Probiotics: Probiotics are live microorganisms that can improve gut health by restoring the balance of beneficial bacteria in the gut. Several studies have shown that probiotics can be beneficial, particularly for bloating and occasional abdominal discomfort.
Low FODMAP Diet: The low FODMAP diet is a dietary approach that restricts the intake of fermentable carbohydrates to reduce symptoms of IBS. Several studies have shown that the low FODMAP diet can be effective in reducing symptoms, but it should only be followed under the guidance of a registered dietitian or healthcare provider.
- Gut-Directed Hypnotherapy: Gut-directed hypnotherapy is a type of psychotherapy that uses relaxation and visualization techniques to improve gut function and reduce symptoms. Several studies have shown that gut-directed hypnotherapy can be effective in reducing symptoms of IBS.
Prevention of Irritable Bowel Syndrome
While the exact cause of IBS is unknown, there are several lifestyle modifications that can help reduce the risk of developing IBS or managing symptoms in those who already have the condition. Some strategies for preventing IBS include:
Eating a Healthy Diet: Eating a diet that is high in fiber, low in fat, and rich in fruits and vegetables can help maintain healthy bowel function and reduce the risk of developing IBS.
Managing Stress: Stress can trigger or worsen IBS symptoms. Techniques such as deep breathing, meditation, and yoga can help reduce stress and improve overall well-being.
- Regular Exercise: Regular exercise can help improve gut function and reduce stress, both of which can help reduce the risk of developing IBS or managing symptoms.
- Avoiding Triggers: Certain foods, medications,a nd activitities can trigger symptoms in people with IBS. Keeping a journal & food diary of what your triggers are can help you identify and avoid them in the future.
Dietary Supplements to Support Gut Health
Several dietary supplements have been studied for their benefits in restoring balance to the gut. Some of the most studied supplement solutions include:
Probiotics: Numerous studies have shown that probiotics can be incredibly beneficial in restoring balance to the gut microbiome, even in patients with IBS. Pure Thera’s Power Probiotic Daily™ and Power Probiotic 100B™ contains four well-studied strains that increase gut transit time, support immune function and are backed with real scientific research doen in a clinical setting. These strains include patented HOWARU® Bifidobacterium lactis HN019, Lactobacillus acidophilus and Lactobacillus plantarum.
Peppermint oil: Peppermint oil is a natural remedy that has been shown to have anti-spasmodic and anti-inflammatory effects. Several studies have shown that peppermint oil can be effective in reducing symptoms of IBS, particularly abdominal pain and bloating.
Psyllium Husk: Psyllium is a soluble fiber that is commonly used as a laxative. Some studies have shown that psyllium can be beneficial in reducing constipation and improving overall bowel function in people with IBS.
Digestive enzymes: Digestive enzymes help break down food in the digestive system. Several studies have suggested that digestive enzymes may be beneficial in reducing inflammatory triggers of IBS by breaking down aggravating proteins as well as digesting FODMAPs.
Probiotic Digest Full Spectrum Enzymes™ is an advanced, comprehensive digestive enzyme formula, enhanced with probiotics (Saccharomyces boulardii), designed to be suitable for vegans, vegetarians, and omnivores alike. It is the ultimate solution for those looking to encourage vibrant gut health, optimize nutrient absorption from a wide variety of foods, and support a healthy inflammatory balance and maximum digestive comfort.
In conclusion, IBS is a common gastrointestinal disorder characterized by abdominal pain, bloating, and changes in bowel habits. While the exact cause of IBS is unknown, several factors, including abnormal intestinal motility, gut-brain interactions, inflammation, food intolerance, and stress, have been implicated in its development. There is currently no “cure” for IBS, but several treatments, including lifestyle modifications, medications, and supplements, can help manage symptoms.
While IBS can be a challenging condition to manage, there are several strategies that can help reduce the impact of symptoms on daily life. By making lifestyle modifications, people with IBS can improve their overall well-being and quality of life.
Chey, W. D., Kurlander, J., & Eswaran, S. (2015). Irritable bowel syndrome: a clinical review. Jama, 313(9), 949-958.
Ford, A. C., Moayyedi, P., Chey, W. D., & Harris, L. A. (2021). American College of Gastroenterology monograph on management of irritable bowel syndrome. American Journal of Gastroenterology, 116(Suppl 1), S1-S70.
McKenzie, Y. A., Bowyer, R. K., Leach, H., Gulia, P., & Horobin, J. (2016). Dietary triggers of abdominal symptoms in patients with irritable bowel syndrome: randomized placebo-controlled evidence. Clinical gastroenterology and hepatology, 14(9), 1342-1349.
Moayyedi, P., Andrews, C. N., MacQueen, G., Korownyk, C., Marsiglio, M., Graff, L., ... & Leontiadis, G. I. (2019). Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Irritable Bowel Syndrome (IBS). Journal of the Canadian Association of Gastroenterology, 2(3), 6-29.
National Institute of Diabetes and Digestive and Kidney Diseases. (2020). Irritable Bowel Syndrome (IBS). Retrieved from https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome
O'Keeffe, M., Jansen, C., Martin, L., Williams, M., Seamark, L., & Staudacher, H. M. (2021). Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome. Journal of Gastroenterology and Hepatology Research, 10(3), 3123-3130.
Saha, L. (2014). Irritable bowel syndrome: pathogenesis, diagnosis, treatment, and evidence-based medicine. World Journal of Gastroenterology: WJG, 20(22), 6759.
Talley, N. J., & Holtmann, G. (2017). Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clinical Gastroenterology and Hepatology, 15(5), 782-790.
van Tilburg, M. A., Palsson, O. S., Levy, R. L., Feld, A. D., Turner, M. J., Drossman, D. A., & Whitehead, W. E. (2015). Complementary and alternative medicine use and cost in functional bowel disorders: a six month prospective study in a large HMO. BMC complementary and alternative medicine, 15(1), 1-12.