If you have digestive trouble and it is labelled as IBS (Inflammatory Bowel Syndrome), you are not alone. This is among the most common reasons people seek medical help for. According to estimates, IBS affects about 15 per cent of the population and unfortunately, there is no effective treatment or medicine. Inflammatory bowel disease (IBD) such as colitis, crohn’s disease and reflux are also on the rise; however, they are distinct from IBS.
IBS is a common intestinal motility disorder characterised by spasms of the colon or large intestines, with alternating constipation and diarrhoea, heartburn, cramps and gas. Other symptoms could include abdominal pain, bloating, mucus in stools. Severity of symptoms determines whether it is a mild irritant or distressing and disabling. Most people learn to live with it and may have periods alternating between severe and mild. IBS accounts for at least half of all gastro-intestinal problems and it often begins between 20-40 years of age.
Symptoms of IBS are non-specific and common to many other conditions. It can therefore mask more serious conditions like celiac disease, inflammatory bowel disease (IBD) including ulcerative colitis and crohn’s, tuberculosis and others. It is important to screen the individual for these conditions before treatment starts. Recent research suggests the role of immune system and imbalance in gut microflora due to parasitic, bacterial infections, frequent use of antibiotics, medicines or pain killers which cause inflammation and lead to symptoms of IBS. Symptoms usually get worse with stress.
Many people associate symptoms with specific trigger foods, which typically include milk, tea, coffee, alcohol, citrus fruits, beans and certain vegetables. Heavy meals, spicy, oily and fried food at times cause discomfort and aggravate symptoms of IBS. People often report that gluten and certain grains like corn, oats and even soy trigger symptoms.
Dietary guidelines for IBS include avoidance of milk, wheat, corn, tea, coffee and alcohol. The role of gluten-free diet, low sugar, FODMAP (Fermentable-oligo-di-monosaccharides and polyols) diets and probiotics has been found to be favourable. However, individuals vary in their responses. Among probiotics, specific strains have yet to be identified and individualised. Gut health should be supported by anti-inflammatory foods like omega-3 fats, virgin coconut oil, flaxseeds, chia seeds, turmeric and ginger. Dietary treatment needs to be customised and specific trigger foods and stressors must be addressed. Stress management, relaxation, hypnotherapy, neuro-feedback, yoga and meditation can also reduce symptoms of IBS.
At present, there is no general agreement on the cause of IBS. It is no surprise that no single treatment is currently regarded as being universally applicable to the management of all IBS patients. Screening for food intolerance through tests, maintaining a food diary and elimination diet under the guidance of a qualified professional is advisable to understand trigger foods for long term management.